sharp chest pain strange ecg's

[heartangel]

I hope someone can ease the confusion. I am a 32yr women, I don't smoke or drink.I had sudden chestpain 9mths ago a ecg revealed LongQT. A cardiologist said the chestpain is from pericarditis and cannot find a LongQT in any other ecg and said that I don't have longQT. I finally healed after taking Naprosen(with the sideeffect of ulcers).
Now 10mths later I developed consistant sharp pains which lasted approx 8hs. I had a ecg done the following morning, with it saying I have a -sinus rythm,
atrial premature complexes,
left atrial enlargement,
atypical right bundle branch block,
cannot exclude inferior myocardial,
infarction. What does it mean, my next appointment is in end of August. What symtoms make this dangerous. What do your suggest?
help .confused.

[Anstal]

A related discussion, probable old anterior myocardial infarction was started.

[heartangel]

I just wanted to thank you for your help and suggestions, I feel you have helped me alot just to know that I might be closer to finding a reason and a solution.

thankyou all

[PikaPika88]

Luke,
I have RBBB but no "I" in the front.  This is the term that given to me on 1973: PAT & RBBB.  Last year ER Report to local Dr mention that I have LBBB (old).  I wonder who is wrong.  I check out on my next visit to my Cardio.  I'm still here in 2005. No one in my family died with heart problem.  Pika.

[LukeL]

I know that the condition is very rare (espeically in the western hemisphere)  but I suffer from panic attacks and have always had a fear of sleep and since Brugada almost always strikes during sleep it makes me more anxious.

I have jumped from every single heart condition out there since I had a series of bad palpitations. After I had an echo which came back 100% negative  I started to worry about electrical condtions like  WPW, LQTS and Brugada. My EKG showed no extra pathways and my qtc interveral was 394 which is well below the critera.

But on one EKG (I have had 3 in 4 months) it showed IRBBB. Does anyone know if this could have been caused by improper placement of the leads, one of the leads was pinching my skin at the time and I was wondering if that could cause a false reading. Also could a PVC or PAC mimic IRBBB. All this info came from a computer read out and was not interpeted by an iternist or cardiologist.

[CCF-M.D.-MJM]

I just want to clarify one important point.  Brugada syndrome is very rare!  Yes it should be considered, but for the most part isn't something people should lose sleep about.  If you have a personal history of syncope or a family history of premature sudden death, this increases the suspicion, but the syndrome itself is very rare.

I hope this helps.

[LukeL]

I also recently had an ECG done and it showed IRBBB I am very conerned about this because it may be a sign of Brugada syndrome. I was wondering if anyone else has IRBBB and if it means anything significant

[CCF-M.D.-MJM]

Hello,

I can understand why you are confused. A young patient with chest pain is a difficult situation to explain and fortunately it is rarely cardiac in origin.

You can certainly have a long QT duration in the setting of pericarditis.  If you truly had pericarditis several months ago, this could explain that isolated finding.

The important thing for you to do now is see a cardiologist and get their opinion of whether this could represent anything real.

Anytime you see a right bundle in a healthy person, especially with a personal or family history of sudden death or syncope, the question of brugada syndrome should come up.  If you have a history of either of these, you should bring this question up with your cardiologist.

If you chest pain is exertional rather than at rest, this is concerning.  Chest pain from anxiety is almost always worse when at rest rather than active -- the more you think about it, the worse it gets sort of thing.

without seeing you or your EKG, I cannot make a judgement about acute concerns or the danger involved.  By age alone you are a low risk person.  If you EKG shows an old inferior MI, that changes things a bit.  But be aware the inferior leads change with respiration and can lead to a false positive diagnosis of MI in some people.

I unfortuately cannot answer all your questions the way you want to read them because I cannot be sure without meeting you.  If you are still having chest pains, consider asking the cardiologist to move up your appointment, see you general doctor, or if the pain is signficant and persistant, go to the ER.

I hope this helps.