EKG abnormalities

[sssyzygy1]

I am a 32 year female, overweight due to hypothyroidism.. I do have slightly elevated BP (130/90) but it is controlled and normal on 50 Atenolol daily and is 120/80 with the meds.  i needed an EKG Chest X-ray and blood work panel for a gynocological surgery.  I had it taken earlier this week.  The chest xray and blood panel were fine.  the EKG came back abnormal.   saying "borderline 1st degree av block right atrial enlargement consider left atrial enlargement nonspecific t waves"

I went to my PCP and they said these are "vague" readings and could mean problems or could mean nothing.  The PCP actually said if it weren't for my one past experience with chest pain two years ago (i tend to suffer from anxiety) she would have just cleared me for the surgery. but since there is a possibility i had cardiac "symptoms" she ordered a stress test and postponed the surgery.   She did said she doesn't necessarily agree with the "borderline 1st degree block" that the computer put out....    

Can someone help relieve my anxiety here and tell me if this sounds serious?  should i be worried i'm a walking heart attack?  Please let me know.

[sssyzygy1]

Thanks for your answer. With 4 abnormal EKGs, three taken with 3 days, all showing basically av block, and the fourth taken one week from the original, showing computer generated read out that a prior anterior infarction couldn't be ruled out, I was getting crazy worried (each EKG seemed worse than the last).   The cardiologist said on women, especially younger woman, the EKGs tend to pick up any manner of "abnormal" readings, and that these are not always correct.

I did have a full nuclear stress test and was seen a cardiologist.  My blood work panel looked good.  My chest xray looked good.  My nuclear stress test results came back normal with excellent functionality, with no signs of heart damage, ischemia, etc.  The cardiologist feels based on the nuclear stress, and the lack of symptoms (chest pain, etc) during exercise and stuff like that, that my heart is good.  His only suggestion was to exercise more.  He felt the av block is caused by my atenolol and if I exercise more, and drop a few pounds, I could get off the atenolol and that will revert back to normal....

Would you feel like I should get a further work up?

[sssyzygy1]

i had a panic attack and ended up in the ER.  they ran another set of blood work. they monitored my vitals for three hours.  they did two more EKGs.  They said per the info they got there was no heart damage but just the 1st degree heart block on the EKGs.  What is the likelihood I could have had a heart attack in the past and not know it?  The ER doctor didn't seem to think that was the case. He said this is really nothing to worry about and i may have this until I'm 85 years old.  They are still sending me for a stress test tomorrow to make sure everything is ok.  I'm still freaking out.   Could my atenolol cause this?  The only thing that stood out on my blood work at all was that my potassium was low.. could that cause this?  I'm so nervous I feel like I am having constant chest and left arm pain.  I don't know what to do... Going back to the ER again seems pointless.  

[Arti Sharma, M.D.]

Hello,
The most common causes of first-degree heart block are an AV nodal disease, enhanced vagal tone, myocarditis, electrolyte disturbances and medication. It is diagnosed by a PR interval greater than 200 milliseconds in length on the surface ECG.This condition usually does not progress to higher forms of heart block but may need outpatient follow-up and monitoring of the ECG.There is a risk of atrial fibrillation. It is best to get evaluated completely. A clinical examination and work up is important for correct diagnosis. Do keep me posted.
Best luck and regards!