Abnormal EKG, ie low voltage, inverted t-waves

[Diane__0__0]

  I am 39yr old female  in good health.  I was scheduled to have sinus surgery (cyst in maxillary canal).  The case was cancelled due to a pre-operative EKG that showed low voltage and inverted t-waves.  I was also told (after having a stat echo cardiogram) that there was a small amount of fluid behind my heart.  I had viral pericarditis in 1982 and am aware that a low volume of fluid around the heart is sometimes common.  In Oct of 98 I had sharp pain across my left upper ribs that radiated into my left upper back.  I also became extremely dizzy and nauseous.  I contacted my primary care physician who felt it was a "Vaso-????" episode as a result of a fall I had taken in April of 98 where I had injured my ribs, (no rib x-rays were ever taken at that time).  I felt pretty sore and weak the day after this incident (a Sunday) and by Monday I was feeling a little tired and did see my physcian that Monday.  He again told me it was "probably" my ribs.  Now I'm being told that I might have had an "infarction" and that I need to follow up with a cardiologist and get a echo stress test.  Are you able to give me any insight on what I should be requesting as a patient?  I'm not getting a lot of cooperation from my physician or the medical center he works out of.  I lost my father to a sudden heart attack last year and I do not want to over react to anything, but I do feel I need to check things out further.  Besides, my ENT surgeon and the anesthesiologist refuse to do any surgery on me now.  Any information will be GREATLY appreciated.  Thanks!
  Dianne

[Cleveland Clinic, MD]

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Dear Dianne,
Thank you for your question.  There are some abnormal findings on both your ECG and your echo but I would not jump to any conclusions yet.  It would be unlikely that you had a heart attack and I suspect that these findings will turn out to be nothing.  Given the elective nature of the surgery however it is wise to have it checked out before hand.  Your cardiologist will review the studies that have been performed and may recommend a stress test if indicated.  Once you are clearer by him/her you should be able to proceed with surgery.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
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