Abnormal ECG

[denise293]

Hi,  I visited my doctor recently as I had been having chest discomfort, chocking feeling in my throat, sweating,  a cough and excessive phlegm. My doctor put this down to GERD (I was also diagnosed with colitis 20+ years ago).  In view of the fact that my father suffered a heart attack at 52 the doctor agreed to send me for an EKG, although this showed a borderline 'T' wave abnormality the doctor seemed unconcered and the cardiologist had written 'normal ECG' on the the chart. How can it be normal when it was borderline, and why is my doctor unconcerned when I have read so much on the internet that borderline changes on the 'T' wave are very significant in predicting future death from CVD?   I'm worried sick.

[denise293]

I  have been worried to death about the ECG. I have never been diagnosed with any heart related condition, though as stated, I do suffer from a gastro intestinal disorder and I suppose my symptoms could be due to this, though I am a bit of a pessimist and whenever I experience any symptoms I immediately assume it is my heart.  I do have a cough and the odd palpitation and also seem to produce copious amounts of clear or white phlegm, though this is not coughed up but rather seems to come from the back of my throat.  It's a mystery to me!!  Thanks for your reply it is much appreciated.  Denise

[kenkeith]

There are many causes for t-wave changes including certain medications and a normal ECG variant seen in young people...there are congenital causes of t-wave changes, but there usually is a clinical history of cardiac disease in this setting.  

Abnormal T waves may be present in all types of heart disease in acute conditions (such as pericarditis) and in chronic conditions (such as congenital, rheumatic, hypertensive, and arteriosclerotic heart disease). They can be produced in a normal heart, too, by a variety of extracardiac conditions (such as biochemical changes). As a result, T-wave abnormalities are not in themselves diagnostic. In the absence of other electrocardiographic abnormalities, their significance can be determined, if at all, only by correlation with the clinical background.

Your doctor may be unconcerned as there is no clinical evidence to support a heart problem with an abnormal T wave.  For predictive propositions, the t wave is concomitant with ST segment depression, etc... just an abnormal t wave comment on a printout of an EKG is not enough and requires supported findings of other signs, symptoms, and tests.  For instance an individual's heart rate may be above 100 at the time of the test, and the EKG will report an abnormal EKG commenting tachycardia, but the faster heart rate may be due some anxiety, etc.