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Crazy tale some advice needed
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Crazy tale some advice needed

I'm a 25 year old male who suffers from extreme obesity (weight is 340 at last check). In 2006 I had my first PVC and panic attacks and was checked with an EKG then the machine interpreted it as a RBBB but the doctor said I was fine and for me to go home, I did and was prescribed Prozac and it worked.

Then in 2007 I had another attack and went to my Universities' health center there they did another EKG and said I was fine, I had stopped my Prozac for a couple months so they restarted it and I became better. In 2009 and 2010 I also had panic attacks and went to the ER and there the did the cardiac enzyme tests and EKGs and sent me home with anti-anxiety medicine.

During the summer I had no health insurance so I had to discontinue the Prozac, I started it again last wed. but I'm getting anxiety/panic attacks again. I visited my general care doctor and he attributed it to anxiety but also put me on high blood pressure medicine ( it was spiking to 150/100).

Yesterday, I had another attack and went to an urgent care facility and had an EKG done, the EKG said I was had a possible anterior infraction. The urgent care PA-C sent the info to my MD who compared it to the 2007 EKG and said it was fine and they were similar. But reading up on the automated analysis it seems the only way for it to come to the conclusion of anterior infraction is the presence of q-waves.

How did this happen yet the doctors when they examine it say I'm normal. The doctor at the urgent care said to see a cardiologist in case I want my fear totally gone, but I worry even before I see him I'm just going to drop dead of a heart condition. Right now I know my weight is my biggest problem and I'm trying to fix it, but I'm terrified of exercising because I think I'm going to have a heart attack.

I wanted to know what are the real chances I had a silent heart attack some years ago and the ER and the previous EKGs see it but no doctor really cares about it for some reason, ldl ~ 115 hdl ~ 44
Avatar_dr_m_tn
Hello,

It is tough to give you an accurate diagnosis but generally speaking severe coronary blockages are rather rare in individuals of your age. You do identify obesity as one of the risk factors for coronary artery disease and it would be great to reduce weight in order to mitigate your future risk.
I think it is certainly worthwhile to pursue your appointment with a cardiologist in order to get your doubts cleared and get the question about the EKG answered.
Generally speaking, we rarely trust the reading that the EKG machine prints out. It is not always correct. Diagnosis of myocardial infarction (heart attack) depends on EKG, its comparison with past EKGs as well as clinical presentation of the individual. I am not sure if you should get overtly concerned about the machine read especially if your doctor has reviewed the EKG and said that it is comparable to prior EKGs.
Panic attacks have been identified as a problem and reinstitution of Prozac was probably in your best interest. Keep in mind that these class of drugs sometimes take upto six weeks to start acting and hence you should continue to take them without stopping for that time, before you would see some benefit.
In my opinion, you are doing all the right things and should continue to do them. If you are concerned about the exercising at the moment, you could start it after you have seen a cardiologist on September 13.
Hope that helps
2 Comments
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Avatar_m_tn
An Update: I went to the ER On Wednesday evening and they ran EKG's, Blood tests, and x-rays all came back clear all blood work was zeroed out. I continued to have the attacks and recently went again to my PCP on Friday, she examined my heart and ran another EKG stating it was in line with all my previous ones.

The worry I have though is that these tests would have not detected severe coronary blockage and I could have it at 25, I have an appointment with a cardiologist  scheduled for the 13th of September but I'm worried that I will drop dead before then. Should I go to a hospital again and demand they give me a cardiac stress test or am I starting to border on insanity?
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