I am a 32 year old male with high blood pressure. I take 12.5 mg of Carvedilol twice a day and 12.5 mg of HCTZ once a day. It is usually 116/75 now.
I have battled with anxiety and heart palpitations over the last two years. Two years ago I had an echo – normal except that left wall motion was borderline reduced; EF 53. Normal stress, but my cardiologist put me on bp medicine. In March I started having issues again. Had a stress test with depressed ST waves so they had me do a nuclear stress test, which came back completely normal and I was moved from an ACE to a beta blocker. After a long battle with anxiety I managed to start running again in June and have been up to 3 miles a day since. A few days ago, 30 min after running, I had odd upper abdominal sensations, started sweating, and my heart rate monitor went up to 130. It lasted less than 30 seconds and I was fine. To be on the safe side I called my cardiologist’s office. My cardiologist was doing rounds so I had to see the PA. She did an EKG. It showed ST elevation. Even though I was asymptomatic for a heart attack, they made me take an ambulance to the ER. My blood work came back normal, so my cardiologist had them release me. I have a follow up next week, and I’m not supposed to run until I see my doctor. Are my running days over? Why did the EKG show MI? If I wasn’t having a heart attack, what’s the problem? Is the fact that my cardiologist decided not to do a heart catheterization a good sign?
All the work up done till now is not consistent with features of 'Coronary Artery Disease'. Your blood pressure also appears to be under control.
ST elevation though is a classical sign of a heart attack; it can be seen in other situations such as 'Early Repolarization Pattern'. This is considered to be a normal variant seen more commonly in young individuals like you.
I think the symptoms you experienced recently are related to anxiety. That said referring you to the emergency room was the right thing to do at that time. We cannot be certain about the benignity of the problem in a person with a risk factor such as high blood pressure. Hence each time the tests would be done to rule out a heart attack.
You have been advised not to run as a precautionary measure until the doctor physically checks you up and confirms that all is well. The fact that the cardiologist did not advise a heart catheterization is a very good sign and would imply that he too feels your EKG changes are a normal variant. You should be back to your running days shortly.
Hope that this information helps and hope that you will get better soon.
Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.