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30 year-old female with abnormal EKG
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30 year-old female with abnormal EKG

Hello -

I have recently had fatigue for a week, then chest pressure accompanied by irregular heartbeat.  I went to an outpatient clinic where an EKG was ordered.  It said "Vent. rate 80, PR interval 136 ms, QRS duration 96 ms, QT/QTc 382/441 ms, and P-R-T axes 56 79 - 28, normal sinus rhythm.  ST & T wave abnormality, consider inferior ischemia, ST & T wave abnormality, consider anterior ischemia.  Abnormal ECG."  I was sent directly to the ER, where a repeat EKG showed the same findings.  After blood gas, cardiac enzymes, and about an hour or so on a pulse-ox/respirations/heart rhythm monitor, a few hours later I was sent home from the ER.  The nurse told me the doctor said that he thought it was  a panic attack.  Should I follow up with my primary care physician and have an echocardiogram/Cardiolite stress test/stress echo/etc. done or just accept the diagnosis of anxiety.  I do not have a high-stress life at all.  No financial trouble, no family trouble, no source of worry whatsoever.  I am especially worried because two grandparents have had stents placed, another has had a quadruple bypass 10 years after a double bypass done before, and I have two parents and four grandparents with high blood pressure and high cholesterol.  I"m only 30 years old but I am still somewhat apprehensive about this.  Should I let it go or follow up on it?  Thanks for your time :)
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61536_tn?1340701763
I would follow up.  Women can present differently with cardiac symptoms and a lot of them are dismissed as anxiety cases.  Now, that said, it is possible to have an abnormal EKG and actually be fine.  EKGs, while useful, are not perfect.  The fact that your cardiac evaluation was normal is very reassuring.

I would definitely have the Cardiolite test.  Ask your GP for a referral to a cardiologist, who can perform these tests.  Cardiologists are more familiar with the subtle signs and risks and will know more about how your family history affects your own risk.

Chances are, at 30, you're probably okay - but be proactive.
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264156_tn?1206990594
I think maybe you should have it followed up just for the piece of mind, but I'm pretty sure everything is okay. EKG's will pick up things sometimes that don't exist, or like they said anxiety could have altered your hearts electrical rhythm.  Best wishes!
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Avatar_m_tn
Thanks for the advice!!  My family history (a few of my mom's relatives have had heart problems that first manifested in their 30's) is the only thing that is worrying me, but I will definitely follow up with my primary.  Thanks :)
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Avatar_m_tn
Update:  I had the same symptoms again Sunday, and went back to the ER.  The EKG in the ER was abnormal like the last two.  The ER doctor said something about abnormality in the lateral leads.  I was admitted and a cardiologist was consulted.  I received an echo ultrasound, Lovenox, metoprolol and nitroglycerin (which caused bad headaches) while in the hospital, and after being released today (Tues. 11/13/07) I had a CTA coronary angiogram performed in his office as an outpatient.  I'm still awaiting the results.  I was given Klor-Con at least twice a day while in the hospital, so I suspect that maybe a potassium deficiency caused this maybe?
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