I am 36 and have mitral valve prolapse AND a bicuspid aortic valve. The bicuspid valve was confirmed about 7 years ago with a test done in the hospital where the doc went down my throat with something to see my heart. I have 2 kids, a 3 year-old and a 10 month-old. No problems to speak of during pregnancy. Heart disease, high blood pressure, and diabetes run in my family. Aunt had triple bypass at age of 44. Mom had a couple stents 2 years ago at the age of 59. They are sisters.
Yesterday I went in for my routine EKG and Echo. Normally my cardiologist's office does this but my pcp told me they do it there so I had it done at my pcp's office this time. The nurse doing the EKG wasn't real sure of herself and pulled a couple of the sticky things off my chest a couple times and re-stuck them and taped them down. Then she clipped the leads onto the little tabs and ran the test (they didn't have the sticky things with snap-like things on them for the leads to snap onto). The doc (my PCP) came in and asked if I had a heart attack recently because there are Q waves showing on my EKG. They sent the disc with my Echo and also a copy of my EKG to my cardiologist to review. However, in the meantime I am very worried about it. Every little pain I have stresses me out. I have a "Type A" personality as it is, so I surely don't need this worry. I should also mention I have had an achiness on the left side of my neck for about a month and some occasional mild pain in my left shoulder blade (shoulder blade pain actually feels muscular to me).
MY QUESTION: Could the EKG have been affected because of the nurse removing the sticky things and re-sticking them and also maybe not being hooked up exactly right?????
I really hate to say this, as I have a great deal of respect for most nurses, but I would not trust any result from an office where they were not even sure of placement of leads. One of the doctors I see always wants to do an EKG there at HIS office. I tell him that as I have an EKG done every six months elsewhere that I respectfully decline his office doing it and remind him that the results were mailed to him from the main clinic. I truly think it is more a profit center the doctor is looking for (in my case). Make sure that your PCP sends a copy of the EKG to your cardiologist and see what they say.
The results can be greatly affected if the leads are not in the right place. It sounds like the nurse was a bit confused and I wouldn't get upset about the results from this office. Let your cardiologist review this and maybe even do another EKG in his own office. He is the expert in this area. Don't worry needlessly and don't start second guessing every ache and pain you get. The cardiologist's office will call you right away if they think it is an emergency.
If it were me, I would get these tests done at the cardiologist's office in the future. Cardiologists specialize in heart related things and the PCP is only a general physician who screens and manages your health but needs to refer you out for a problem especially with the heart. Would you really want a PCP to make decisions about heart related problems or heart related medicines? I wouldn't but maybe that is just me. I would want the expert in the field of study though. ??
The same thing happened to me in my cardiologist's office in August. I had my normal cardiac work up that started with an EKG. I then visited with the cardiologist and she was very happy with my progress, blood test results, echo. exercise routine and weight loss. Everything was going great until she read the EKG strip and she stopped dead in her tracks and said "I did not exoect to see this" She then told me she needed some honest answers. She wanted to know if I REALLy was working out every day which I am. She also asked if at any time did I have any pain or sypmtoms of heart disease and I told her absolutely not. Beacause I am a 49 year old male and about 50 pounds overweight, even though I have lost 60 this year and my ECHO was perfect, she said again she needed honsest asnwers because the EKG showed I had a heart attack since my previous visit. After another 10 minutes of questioning she stopped and said "I.m going to send a more expereinced tech in to re-take this EKG". As I ws laying there all hooked up by the new tech I heard her speaking in the hall with the cardiologist who instructed her to bring her the strip immediately beacuase it it was still bad we were heading right to the cath lab. That was NOT reassurring to hear, even though I was not supposed to be part of that conversation. Long story short, the tech ran into the next exam room with the EKG and a minute later my cardiologist came in and said everything was fine, it was just a lead placement issue and once the afffected lead was placed correctly my EKG was normal and looked just like every othe EKG in my file. I asked the doctors on this forum about this in August, you can most likely see my post and is response which was that this happens more often than people realize.
Bottom line is don't panic until you see the cardiologist. Your PCP may have sent you to the cardiologist for a more accurate test. If he thought you had a real prpblem you would not have gotten out of his office, he would have sent you to the ER.
Even my 80 year-old mother's EKG at the GP's office was wrong. The cardiologist gave her a thallium test and it showed she was fine.
Don't get EKGs at th GP's office unless you are calm, confident and have a second opinion waiting in the wings :-)
When you get it done at the cardiologist's office I'm sure you will be found fit and healthy.
My wife and I suffer from PVCs and the such. I, a lifelong sufferer, have quite a track record of tests over the years. She, a more recent sufferer, has worked in Medical Offices for the last 12 years or so, Pulmonary, Family, and now for a Cardiologist.
Story 1. I have an abnormality on my EKG that, when interpreted by the EKG Machine itself, says that I have had a heart attack. All of the Cardiologists that I have seen over the years say I haven't, it's just a phenomenon of the way that the machine interprets my particular waveforms. At one point, after suffering a series of bizarre and seemingly random beats, I ended up at the ER in a small town hospital. They were serious about my results, as it showed that I had a heart attack at one point in the past. They phoned the Internist that I was seeing at the time, he looked at their EKG results, said that there was no change, and told them to increase the dose of the Beta-blocker that I was already taking and to send me on my way. They looked disappointed. My Wife says that a few of their patients carry copies of their own EKGs that show these otherwise benign irregularities so that they may quickly show to any ER or Paramedics that their EKG has been this was before and was not considered a concern.
Story 2. While my wife was working at the Family Doctor's office, at one point she complained of a squeezing pain on one side of her throat, someting that she had complained about to a coworker before. The coworker grabbed my wife in a playful way and said "lets do an EKG, I'll show you that nothing is wrong with your heart". After getting the results of the EKG from my wife's test, the coworker ran out of the room with the paper. The Doctor soon returned, trying to get my wife to take some Nitroglycerin, which my wife refused (at least at that moment). The Doctor then proceeded to contact my wife's Cardiologist, informed him of the reading, and Faxed him the results. He compared them with the records that he had and said that there was no change in the EKG since he last saw my wife. He said that he could see no problem despite the machine's readings.
Story 3. My Coworker, undergoing a physical required by our employer (our work involves Chemical Exposures, OSHA Mandates the testing). The in-plant EKG showed an irregularity in the reading, and the in-plant Doctor was quite concerned, to the point that he was going to put my Coworker on sick leave until the situation was fully comprehended. My Coworker already has a Cardiologist, and the results were forwarded to him. He grew incensed that the in-plant Doctor saw a problem in the EKG, since the comparison to the previous EKGs the Cardiologist possessed showed no change. They were forced to put my Coworker through Stress and Echo Testing to verify that he was fit for work, which he passed with flying colors. The Cardiologist was very mad that my Coworker was forced into these tests due to the EKG reading at work.
Lastly, my wife says that the Cardiologist where she works has this feature turned off on their office EKG machine. He makes the readings, whether in the office at the time, or whether it must be faxed to him, so that this type of confusion is not seen in their office.
Admittedly, there are reasons for concerns on many EKGs done at Family Doctor's offices, and you must heed their concerns when they find specific problems. But, there are times when false alarms are issued for the sake of being too careful, which is preferable to missing something serious. These false alarms will be eliminated by additional testing and by the observations of Doctors with more specialized skills viewing the data.
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