how accurate are EKG's?

[medic8r]

I had a heart cath done four years ago, after several bouts of shortness of breath with exertion and chest pains.  The cardio did a nuclear scan/stress test and called me that night to tell me there was a low ejection fraction from my left ventricle and he thought it must be a blockage and wanted to do a cath, I was 28 at the time.  I did the heart cath (well, actually the Dr. did it) but anyway after he said "oops! it must have been a false negative."  Great, for the false negative!  But I went through all that for nothing!

Fast forward to this year, now I get more chest pain that involve a spot deep in the middle of my shoulderblades and my left shoulder and left upper arm with decreased sensation in my left fingertips, and at times my left neck and jaw.  After a month of this the chest pains were a 6/7 on pain scale and the pain deep in between my shoulderblades a 8/9, and one night where I woke up around 2am with sever chest pain, I went to the cardio (a new one as I moved to another state since the cath) and he said "you are only 32 yrs old, theres nothing cardiac going on here, but to make you feel better well do a quick EKG, if anything happened last night it'll show up, I dont think there will be anything on the EKG, though."  He thought it is just stress, sounds good to me!  So we did a quick EKG--it read "Rightward axis, anteroseptal infarct".  I said "uhm???...."  He said he still believed the machine misread something on the EKG, and that it is set up to interpret things (the machine) but he doesnt see anything there on the EKG paper to interpret that way.  O.k., he still had me feeling better about it was nothing.  THis was a Friday.  Throughout the weekend pains continued, went up my jaw and left arm, I was in tears, I drove back to his office (on Monday) patting myself on the back for not going to the ER and they did another EKG saying that the Dr. wasnt in the office.  When it read "Rightward axis, anterosetal infarct and possible lateral infarct" they faxed it to the Dr. who said to go to the ER.  I drove there, the Dr. there said he wasnt worried about what he saw on the two EKGs (i brought copies) and that they didnt scare him, he thought the machine misinterpreted some wave forms, and he ordered triponin levels and d-dimer levels, both normal, and said for me to go home.  He also said, you are only 32 and therefore this cant be cardiac.  Ok, I felt better, skeptical also, and asked him on his way out of my room, "If I were 52 instead of 32 would you think differently?", his answer was yes, as he left.

My question is, can an EKG machine misinterpret certain waves, etc. when there really is nothing there?  Curious note, 90% of my EKG's in the past four years come out reading "rightward axis, or right axis deviation (probably same thing) and septal infarct or anteroseptal infarct."

[heartfluttersflyawayplz]

Good, being calm is better forou anyways

[Kim1102]

Thanks for sharing that. I have calmed down a bit and decided to wait it out and go to the cardiologist.

[heartfluttersflyawayplz]

those dang machine can say many things my hubby had same thing happen to him, went cardio , did stress test, echo it was all good, ekgs you cannot trust, , if you would feel better than go to ER,

they can give you something to calm your nerves, and maybe do another EKG

[Kim1102]

I went to my PCP yesterday because my blood pressure had spiked for two days in a row even on medication. She had me do an EKG which came back abnormal. This has scared me to death. I am being referred to a cardiologist. She said it showed ischemia!!  She said I could have a heart attack! She increased my blood pressure medicine which I took yesterday and today. But now I am so anxious about something being wrong with my heart. I am 59 and have had high BP for six years controlled well on meds. I have not had any prior heart problems. I typically feel very well.  Now I am off work waiting to find out when I can see the cardiologist. Should I just go to the ER. Can a spike in BP cause an abnormal EKG?

[Siva99]

hello, I am going though the same thing you did(im sitting in the hospital bed now), i have done the stress tess, EKG, and blood test and so on...all is normal, but im trying to tell them its not. you mentioned sending your case if it would help. it seems to me that, that would possibly be a good idea for me if your willing and i can send you mine. please let me know how this works, i need to feel much better soon. thank you

[ed34]

An EKG looks at the electrical system of the heart and even if a doctor correcly interprets the results, it may not show anything abnormal. When I had a blocked LAD my EKG never showed a problem, neither did a stress test on a treadmill and neither did a nuclear perfusion scan. The only test which seemed to show a difference was the angiogram. I remember meeting with a cardiac surgeon in 2007 to discuss options. He had looked at my nuclear scan, echocardiogram, EKG and stress tests. His opening sentences were that I had a very healthy heart and needed no intervention. His assistant then asked him to go and take a look at my angiogram. When he returned to the office, he admitted that he was very shocked. There is also a total blockage in my RCA just before the acute margin. I am not able to explain why the tests showed no problems, and I'm sure it isn't the case with everyone, but it must show how some people can slip through the net undetected unless they have a heart attack. If it wasn't for MI, then I would never have been correctly diagnosed, even now. I spent the whole of 2006 on stomach medication, an incorrect diagnosis.
If anyone is concerned about their case and wants to use mine as an example, I will be glad to email them my details including cardiologist name, so yours can correspond with them if necessary. It will prove tests don't pick up everyone.

[riski4142]

I just happened to land on this site and noted your concerns.  I had a nephew that died at age 39 because no one would listen to him.  He had a huge family history of the males having heart attacks starting at age 35.  When he went to the ER they told him he had heart burn from something he ate and to go home.  Two hours later he dropped dead on the kitchen floor.  
As an RN who worked in a very busy ER, we NEVER assumed age was a predictor of a heart attack.  We always ASSUMED the worse just in case.  Do not let any doctor tell you it is nothing and not to worry.  If you are not satisfied with your answers, get 2nd, 3rd, even 4th opinions.  
I now have something going on myself, and trust me, I'll get as many opinions as I can.
I wish you the best.

[Tarheelguy1967]

Sorry, I didn't expand on the EKG specifically.  My EKGs have all come out perfectly normal, even when I had a 99% blockage in my LAD.  I've had significant blockages 5 times, and each time the EKG has come out perfectly normal.  That's the reason I don't trust it.  I don't have any experience w/ false positives, although I know they happen all the time because of problems with the leads.  Since you have had multiple EKGs with the same reading however, I'd recommend you take the printouts if you still have them to the cardiologist and have him read them (plus probably have another one done).  The EKG is best used I think to determine if you've had an MI recently/currently, and the best qualified person to read it (since the accuracy is largely determined by the skill of the person, not machine, reading it).  I wouldn't blow it off since you've had several interpretations of the same problem - worth getting a consult.  But guess I don't have an anser for you about false scary results - sorry!

[medic8r]

Thank you for your comments and advice.  Im sorry you have the family history and had to have stents.  I hope all is well with you.  The cardio here did want to do the cardiac CT, the 64CT you suggested.  Only I am allergic to the dye and my heartrate stays at 100+ with a bloodpressure of average 100/60.  So, I would have to take prednisone for the allergy to the dye and enough metoprolol to get the heartrate down to around 55-60, but metoprolol also lowers bloodpressure, and with it starting out at 100/60 how much lower can you go without bottoming out?  Well, I finally said Ill do it anyway, but was unable to take the prednisone becuase after the first pill I began to urinate every two minutes so excessively that I actually dehydrated that night and couldnt go in the next morning for the test (that is listed as a rare side effect of prednisone).  I am waiting for the 124 slice CT to become more readily available.  

My main question is basically "how accurate are EKG's?"  Has anyone had experience with their EKG's reading some scarry stuff but being completely false?  Thanx again, everyone.

[Tarheelguy1967]

Sorry about your rough go - lots of stress I imagine.  Doctors do tend to dismiss younger people (in my experience) unless there is a strong indicator.  I was a ripe old 38 (6 years your elder) when I started having problems, and if it weren't for my strong family history I would have been dismissed too.  They put me off several times before I pushed, and when they agreed to test me I ended up having 3 stents.  So if you are having strong symptoms, age is a factor but isn't necessarily the only factor.  If you have strong family history of heart disease, smoke, have diabetes, etc. you can push them to test you.  The EKG is okay at catching a heart attack, but I don't trust it at all to find a blockage.  I have not had a heart attack by the way, but caught my symptoms before they led to one.  Anyway, If you are having classic symptoms, I would not stop at an EKG - they can have both false positives and false negatives.  But with a recurring reading that you are receiving, I'd think it would at least warrant another test.  You say you are having pain - is is pressure/pinching sensation or a sharp pain?  If it is the pressure/pinching, I'd recommend additional testing i.e. the nuke stress test.  I know you had a false positive, but they are a pretty good test at finding ischemia.  There's also the 64CT slice scan that might be a good option for you.  Best of luck - don't let them pawn you off simply because of age.