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Going crazy or something else
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Going crazy or something else

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

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?
Avatar_m_tn
   You are not insane, but you probably aren't sick either. Palpitations and anxiety conditions go hand in hand and both are benign most of the time. If you are going to see a cardiologist the thing I would ask to have done is an echo, which is basically an ultrasound of your heart. Taking this test will help them rule out a ton of structural heart problems if it comes back normal.
   As far as the possible previous MI, EKG's are designed to be sensitive to heart attacks since they are the most common heart problem. Sometimes a machine might see a little this or that in a particular part of a QRS complex and it will fire off "possible myocardial infarction." This usually isn't actually the case, but it's kind of like a tornado siren. They always go off when it storms, but how often is a tornado actually going to hit? Not often. Better safe than sorry kind of approach with EKG interpretations.
      You very likely have nothing wrong with your heart and will make it to the 13th with no problem. Your cardiologist will probably do another EKG, the echo, and probably give you a Holter monitor so they can try to catch some of these arrhythmias you feel so they can classify them. They are probably PAC's or PVC's, and nothing more.
      Your cholesterol is pretty decent so you likely don't have any blockages in your heart. Loosing weight while you are still young might end up being a lifesaver for you. Other things like high blood sugar, the weight you carry, or any hypertension, or even hormonal imbalances can trigger benign PVC's. Or they could just be idiopathic (no known cause, but still benign).
     I'd also advise you to ask your doctor to check your EKG's for non-structural heart problems like LQT Syndrome, Brugada Syndrome, CPVT, and malignant early repolarization. I say this not because I think you have them (they are all very rare), but if you are anything like me you will end up researching and finding things like them after the echo says your heart is structurally normal and you will be wishing you would have known to ask the first time around. Get it all done in one appointment so you can obtain peace of mind and move on with enjoying life.
    And in the rare event that they do find something wrong, almost every heart condition is treatable, especially at your young age, so you will have caught it in time. Overall, I would say that one way or the the other you will walk away with a better outlook on all this, either because you know they are going to fix the something that is wrong (unlikely) or they are going to tell you nothing is wrong (likely).
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