MI or allergic reaction?

[Mery]

I am a 5' 2", 120 pound, 52 year old female with mild hypertension of one year's duration that is well controlled by Norvasc. I had a normal ECG on January 19, 2004 as a part of a routine physical check up. While out of town on April 26, 2004, I went to an emergency room with bronchitis, asthma, and fever. While there I was accidentally given Motrin. I am allergic to aspirin and NSAIDs and previously I had an anaphylactic reaction to an NSAID. The Motrin caused a bright red rash, low blood pressure, tachycardia, chest discomfort, and shortness of breath. The first of several abnormal ECGs was then done, and the results stated: "Sinus tachycardia, Incomplete LBBB, Anterior infarct, possibly acute, Acute MI, Inferior MI age ?, Abnormal ECG." However, I was admitted and several repeat enzyme and troponin tests were all normal. The results of the last ECG done 24 hours after the first one were: "Sinus tachycardia, Anteroseptal infarct age undetermined, Abnormal ECG, Ventricular rate 119 bpm, PR interval 144ms, QRS duration 120 ms, QT/QTc 346/487, and P-R-T axes 72 18 67. I was released two days later with no recommendation to see a cardiologist. Do you think my abnormal ECGs were the result of my allergic reaction with tachycardia, or have I probably suffered a silent heart attack some time between my January check up and April hospitalization? I can email or fax a copy of the ECG tracings if that will help answer the question. Thank you very much.

[Cleveland Clinic]

mery,

thanks for the post. Sorry for your crazy events.

Based on the information you posted, you probably did not have a myocardial infarction.

Most likely you had ecg changes because your heart rate increased.  These changes could be a normal response or indicative of potential problems including coronary atherosclerosis.

Remember that the machines interpretation of an ecg is not always correct and physician can go over the findings on the ecgs with you.  If there are concerning changes on the ecg, in essence, the hypotension and high heart rate caused by the allergic reaction was a stress test and led to these changes.  Since your biomrkers(CK, Troponin) were negative, there was no infarction.

A more formal evaluation of your cardiac risk if there were concerning changes might involve a regular stress test.

good luck