Flat T-Waves in Asymptomatic RN

[AlisN1dlan]

54 year-old white female; 5'11" 180 lbs. Athletic build; active lifestyle 'til '00. Smoker (except 1988 - 1997) NKA. Meds: HRT; Zoloft & Trazadone (PTSD w/ depression) Meclezine (vertigo); PO narcotics Rx'd thru pain clinic (unrelenting back pain - '88 L5-S1 diskectomy & fusion w/graft; '00 L4-L5 rupture; sig. degen. disk disease)

'01: after my husband's death in a car wreck; the subsequant loss of my job and my home; my mother's declining health and surviving an assault and a rape attempt, I was admitted to the hospital to R/O MI. Localized chest pain; No SOB. VS/Labs WNL. Evidentally my EKG showed flat T-waves, but this was not communicated to me. I was given the impression all the cautionary measures were due to my family history - my mother and I saw the same PCP and she had suffered 2 AWMI in rapid succession in '99) My chemical Stress Test showed the same flat T-waves. Angiogram: No blockages or schlerotic changes; but noted 'mild electrical abnormalities'. Discharge Dx: Stress related chest pain. (I was told I did not have a cardiac problem; that the "electrical abnormalities" were 'nothing to worry about'.)
Several pre-op EKG's since then but I was never told of any abnormalities - and surgery always went ahead as planned.
Chol/Lipo and Thyroid panels have always been WNL.
4/'06 PE (Pre-op/cosmetic surgery): 0 Resting Pulse: 68 BP: 120/70 I feel fine, but my EKG shows flat T-waves so now cardiology has to clear me for a facelift! This is a new PCP and 1st EKG w/him. (He has old records) Possible causes? (MD Overreaction?) Should I be worried? Thanks much!

[Cleveland Clinic]

alisN1dlan,

An ECG is a general electrical picture of the heart. While some things can be specifically inferred from an ECG, there are many more suble and dynamic findings that can/can not have any significance. Changes in the amplitude of the T wave can have some significance, especially if the changes are new or associated with specific illnesses. For these types of findings, the most helpful thing to do is to compare an ecg with a prior one.

Preoperative clearance is fairly straightforward and entails a specific series of steps related to your medical history. Some physicians feel more comfortable referring this to a cardiologist ehile others feel comfortable doing it on their own.  I would discuss your concerns with your physician.

good luck

[hikerunner]

I know I wouldn't get the surgery.  Health is the most important period.

[AlisN1dlan]

Thank you for the information - especially the suggestion that I speak with the cardiologist: I will definitely do that.

I am not disputing my PCP's request for a cardiology consult - he freely admits being beyond his depth. Nor do I believe I was negligently diagnosed or treated in the past. (And even if I did, I have suffered no great loss or permanent damage.)

My problem - like that of many others here - is that the consultation appointment isn't for another week: and I'm sitting here worrying about something over which I have no control. So let me try and clarify: If - 5 years ago - my flat T-waves were, indeed, without clinical significance, is it probable - or even logical - that now, in the absence of both chest pain and OBJECTIVE risk factors - these same flat T-waves ARE indicative of some cardiac pathology? If so, what disorders come to mind?

I'm sorry if these questions are in some way inappropriate. Please understand I'm genuinely concerned.

[Schmoomcgoo]

Bearing in mind that I know NOTHING about electrical abnormalities of the heart, AND noting that I am one who is highly likely to worry given the slightest reason to and enough time to feed my worry...I would NOT worry in your case.  I would assume the surgeon is covering his @ss or being super-careful or both.  IF there is anything to worry about, you should begin worrying AFTER the cardiac consult.

Also, you've been through some major life traumas, I really hope you do not worry unnecessarily.  You deserve some peace.  Report back, okay?