EKG Changes

[nigel2323]

For the last two years, I’ve been experiencing chest pain, left arm pain, tachycardia, shortness of breath, and palpations. My EKG has always showed an old inferior MI pattern and in 2004, I was told I had concentric LVH. I’m very much overweight at 18 years old, but I’ve found it hard to work out with my pains and palpations.

With the suggestion of my family doctor, I went to the Cleveland Clinic and saw a hypertrophic cardiomyopathy specialist. He told me that my septum was at most, in the upper limits of normal (1.2 cm) and that I didn’t have HCM. However, he still noted that it looked like I might have had a heart attack in the past based on the EKG.

A few weeks ago, I had another EKG done and it showed “hyperacute T waves and ST segment changes”. I was hospitalized and monitored. During the Hospitalization I had more chest pains, but was told nothing changes on their monitor. They performed a cardiac catheraztion which I was told looked amazing. I was told all the pressures within my heart were normal and there was not evidence of a past heart attack. They said my EF was 70%, left ventrical pressure 136/-11, 4, 02 consumption 342.20, LVEDP of 4, and normal aortic pressures.

1. Should I trust the cardiac catheraztion results over the EKG?
2. Are EKG changes common?
3. Can LVH cause chest pain?

[CCF-M.D.-MJM]

Hi Nigel,

I am guessing you saw Dr. Lever or Thamlarison at the Cleveland Clinic.  They are both fantastic.

1.  If the cath shows no major blockages I would believe it.  You are 18 years old and are unlikely to have a heart attack, but it is still not impossible.  When you are over weight, there is a known syndrome of (called syndrome X) which causes chest pain and is thought to represent cororany spasm related to poor endothelial function.  Endothelial cells are the cells the line the inner most layer of your coronary arteries.  The help regulate blood flow news.  It is possible for this dysregulation to cause spasm of the coronary arteries and cause chest pain.  The best way to treat this is to lose weight and try to improve your fitness.

2. EKG changes are common in certain conditions and situations.  The are not common in 18 year old, but this could be your early warning sign to take control of your health before it takes control of you.

3. LVH can cause chest pain, but not typically in someone like yourself where the LVH is so minimal.  I doubt LVH is the culprit here.

I hope this helps and good luck.

[LukeL]

I have had a battery of tests done do to palpitations and I can tell you a cath is far more accurate then an EKG because you are actually getting live images of the heart in action.

EKGs can be very inacurate if the tehnician doesn't place the leads in the right area. Even being off a couple of centimeters can show changes on an EKG tracing. Also if your old doctors were using a computer to read the EKG it could be wrong because the computer uses a set formular to read EKGs.

As for LVH I really don't know.

But I would trust any invasive test over an EKG. You may also want to have an Echo done as this can also show EF and the thickness and size of all the hearts chambers along with any problems in the hearts valves.

[LukeL]

I just wanted to state the above is my opinion from personal expierence and shouldn't be taken as real medical advice.

[LacyMary]

I am curious about pressure readings taken during a Cath.  I had a Cath and the Interventional Cardio doctor said he had to stent an area that the pressure readings were off. (no blockage) He mentioned that a number under 75 was not good. Mine showed 64.  What does all this mean and what does a stent do to alleviate the problem?  My regular cardio doc did not know.

I had a Heart Cath 3 months prior to this one and nothing was ever mentioned about these pressures.

Thanks

[Raleigh]

My father had visited the oral surgeon today and was given an EKG before the procedure, because of the sedation that was going to be administered.  The surgeon made the comment that his EKG had showed "inverted"???  Is something to be worried about and further tests shoulb given???