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Abnormal EKG
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Abnormal EKG

I just received an abnormal ekg at the doctor yesterday who then sent me to the emergency room by ambulance thinking i was having a heart attack where i then had two more abnormal ekg's. They did a cardiac enzyme test and checked for blood clots and said they were both normal. I've been feeling very fatigued and dizzy upon any physical exertion, even something as small as walking around the grocery store. i went to the doctor originally for extreme nausea and just spaced out for no reason.  The cardioligist reviewed and  confirmed that yes the ekg is abnormal but doesn't see any reason for concern. I, however, am still scared because I have not felt normal for months. What else can I do? Should I trust the cardiologist when he says it's nothing to worry about? If i've been nauseous for no reason, with back and chest pain as well as EXTREME fatigue over the last 3 months AND now I have an abnormal ekg wouldn't that warrant additional testing? I just want to feel healthy like I used to and am scared.  I am a 33 yr old female. I do have a prior history of alchohol use and drug abuse but that was over 6 years ago and I worry that maybe I've done some type of damage to myself.
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Avatar_m_tn
No body has given a diagnose about what is the abnormally in the ekg and why you feel fatigued?

Jesus
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Avatar_n_tn
well, the doctors office said anytime they see an abnormal ekg their policy is to send the patient to the emergency room and treat it like a heart attack. the emergency room didn't do a whole lot of testing but said they didn't think it was anything to worry about and sent me home. they said my electrolytes were fine and no blood clots but that was it.  i remember the ekg said sinus tachychardia because my heart was racing but it also said something about
probable left ventrical something......i wish i had a copy of it. but anyway, no, no diagnosis.  my sister works for a cardiologist and had him look at the new one and one i had done a month ago and he said with no family history of heart disease that he doesn't believe i have anything to worry about. I made an appointment to go see him to discuss anyway. I would like more testing just for peace of mind atleast. the one i had done a month ago was borderline and the one yesterday was abnormal. the doc at the er said even though it went from borderline to abnormal that both ekg's were very similar and not much had changed. i remember having one done several years ago when i was at the er for something entirely different. maybe i should have them pull that one as well to compare.  

anyway, i feel a little more comfortable knowing that the cardiologist doesn't think i have anything to worry about. i'm guessing that means that even though the ekg was abnormal that it wasn't horrible.  he did say after looking at the ekg that it looks like more of a respiratory problem......whatever that means.  sorry this is so long :)
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367994_tn?1304957193
An abnormal EKG is sometimes of no medical significance.  For instance, a heart rate greater than 100 will produce an abnormal report as the EKG software cannot distinquish a pathological fast heart rate from a fast heart rate due to some stress taking the test. Sinus tachycardia indicates the fast rate originates from the sinus node (system's pacemaker) and not another abnormal source that can cause arrhythmia. The doctor evaluates by symptoms, medication, other tests, etc. and makes a dx.
  
Respiratory rhythms can be evaluated and derived from measured EKG signals utilizing leads placed for ananlysis of chest movement on the EKG signs.  Maybe that is what the doctor is relying on for a respiratory problem!

If you had a copy of your EKG report that would be helpful although it is not very reliable for any medical condition other than arrhythmia.  Fatigue and dizzy can be due to a cardiovascular issue. Symptoms of coronary artery disease include:

Shortness of breath
Palpitations (irregular heart beats, skipped beats, etc.
A faster heartbeat
Weakness or dizziness
Nausea
Sweating
It is not clear by your post with your stated symptoms why there is not more testing to rule out CAD.  The EKG output sometimes but not reliably will show an elevated or depressed "st" wave that sometimes indicates occluded vessels (CAD) or a prior heart attack.  Possibly your doctor dismisses your symptoms based on a normal st wave. However, your doctor should further test for a dx of your symptoms.

Thanks for sharing and if you have any further questions or comments you are welcome to respond.  Take care.

Thank
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Avatar_n_tn
Thanks, I have an appointment Friday with a cardiologist. I have pretty much all those symptoms, nausea and lightheadedness being the worst but shortness of breath usually when laying down. I do get sweaty usually along with the dizziness and palpitations all the time. Hopefully I get some answers from the doctor on Friday. I couldn't even sweep my living room floor yesterday because after 5 minutes I got so dizzy and exhausted...which is definitely not normal.
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367994_tn?1304957193
Thanks for the response.  Stay in touch and keep us informed on what your doctor has to say. You certainly have symptoms that require a medical attention. I wish you well going forward.
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Avatar_n_tn
Thanks :) I have a holter monitor on now and I go weds for an echo and a stress test. I'll let you know how it turns out. Can't wait to take off this holter monitor! It's sooo itchy on my skin.
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367994_tn?1304957193
Let us know the results.  Take care
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Avatar_n_tn
So my doctor says my heart looks healthy. I just have a fast heart rate. resting it was between 102 and 115, during the stress test they got me up to 188 within 6 minutes! he says my heart beats fine other than a few extra beats here and there (still doesn't explain my dizziness or fatigue but oh well)  i'm starting to wonder if i've been feeling so horrible with all of these symptoms from just simply being out of shape.

anyway, he gave me a beta blocker metoprolol to take just "as needed" not every day.
per the instructions that came from the pharmacy it says to not take on an as needed basis because of side effects........sooooo,  not sure if it's safe to take them or not. i definitely do not need to take them every day.  
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967168_tn?1343732745
what was abnormal about the EKG? I'm sorry if I missed it, kind of brain fog today so it's hard to read much.  

I see you have slow tachycardia at 115, dizziness, fatigue, nausea and chest pain. I had all of the symptoms those symptoms and the ones listed for CAD but had clear arteries with no clots, kinks or plaque per a cardiac cath.  Most of my symptoms were caused by my ANS (autonomic nervous system) and confirmed via a tilt table test.

It may be something entirely different, but there are those of us in the Dysautonmia forum who have ANS problems like what you're describing.  It could be simple blood pressure issues or could be something like POTS - Postural orthostatic tachycardia syndrome.  

You may want to ask your dr about this after reading up on autonomic dysfunction - http://www.medhelp.org/posts/Dysautonomia-Autonomic-Dysfunction/Welcome-To-The-Dysautonomia-Community/show/558911
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Avatar_n_tn
Hi Lisa,

You know the doctor never actually told me what was abnormal about the ekg. He said to him it looked normal.  That's why he did the stress test and the echo, to rule out heart disease because of my symptoms. My only issue according to him is the fast heart rate, however my blood pressure is always normal.  yesterday it was 102/85 while i had the fast heart rate. I did notice while i was laying down that my heart rate would slow.  He's a good doctor and I trust his results but I always come up with so many more questions after I've left the office :)  The dizziness seems to only happen when i'm exerting energy like trying to clean, shop, or workout.  the nausea seems to only be when i'm laying down. i'm stumped. maybe it's my hormones going crazy causing all of this. who knows.  
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967168_tn?1343732745
you can request a copy for your own records =)

ANS issues can be very difficult for doctors and patients and some dr's do not even know what it is...After 9 "good" dr's one that I went to for 3 years, I had to go to a heart rhythm specialists and he was the only one I had been to who knew or understood about what was going on.

my bp will be "normal" for me at 90/60 and then for no reason either plummet even lower to 70/40 then other days it will be 150/114 as with my last dr's appt; my HR is even more strange...I could be at 40 or 50 then it will spike to 180's for no reason (resting)

good luck; keep a TTT in mind just in case you don't find any other answers for your symptoms
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967168_tn?1343732745
ugh sorry; I can't even see the screen well; luckily I can type with my eyes closed BUT that doesn't mean my sentences make any sense lol hopefully you understood what I'm saying
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Avatar_n_tn
Thanks Lisa :)  yeah, my heart rate and blood pressure do the same thing. I was watching it on the monitor yesterday and my heart rate was jumping between 70 and 121 resting and then up to the 188 with the stress test.  my blood pressure is usually anywhere from 90/60 to 135/85.   it's never the same.  i'm going to start exercising so hopefully getting myself in shape will maybe help a bit.  I'm ok with my rate and bp fluctuating. it doesn't scare me at all but it's making me feel horrible. I constantly have a headache! and it's so much worse whenever i'm doing anything other than sitting still :(  maybe it has nothing to do with my blood pressure or heart rate at all. i'm just so tired of going to the doctor. i've been to a neurologist 3 times, a gp 3 times and the cardiologist twice and they all tell me they can't find anything wrong. ugh.
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