Help reading my ECG

[northerngirl39]

I am a very healthy and active 40 year odl female. I have some heart disease in my family and smoked for 15 years. I have been smoke free for over 10 now. I have been have extreme chest pains on the left side that goes up into my neck and jaw, down my left arm for the past 4 months. They start of dull and then intensify to crushing. I wore a heart moniter for 3 days and they found I had Sinus Tachycarrdia. They have also completed two other test and my findings are below. I have had several calls into my doctor to go over the testing but they have not calleed me back so I am sure they are all normal but I would still like to know what they mean. CAN ANYONE HELP PLEASE ;-)

TEST 1
NUCLEAR MEDICINE - MYOCARDIAL PERFUSIN MULTIPLE STUDIES SPECT IMAGING

Finding: A 2-day stress/rest study was performed. The patient exercised 7 min, acheiving 90% of maximum predicted herat rate. Gated cine images today suggest an ejection of just about 70%. End diastolic volume about 70cc. There is relative reduction in kinesis at the apex and septum relative to the remainder of the mycoardium.

Perfusion imaging today demonstrates no discrete fixed or reversable pathology

Conclusion: Ejection fraction maintained. No reversing pathology seen

TEST 2
ECG
Notes:
Sinus or ectopic atrial rhythm
Abnormal R-wave progression, early transition
Minimal ST elevation, lateral leads

Rate/ 77
PR / 167
QT / 383
QTc  / 434

--AXIS--
P /  -58
QRS / 76
T / 55

[kenkeith]

An echocardiogram (ultrasound sonography) can/will rule out any significance of ST elevation, and R wave progression.

**Chest pain may not be associated with the heart unless there is spasm of the vessels that did not show with your stess test....if heart related nitro medication can relieve angina (chest pain associated with the heart).  

You should not be subjected to chest pain.  There are many other causes other than the heart as the underlying cause.  Taking a nitro pill that relieves the chest pain can be a could indication the tests you had were false negative

  **Prinzmetal angina, also known as variant angina or angina inversa, is a syndrome typically consisting of angina (cardiac chest pain) at rest that occurs in cycles. It is caused by vasospasm, a narrowing of the coronary arteries caused by contraction of the smooth muscle tissue in the vessel walls rather than directly by atherosclerosis (buildup of fatty plaque and hardening of the arteries). It occurs more in younger women. Wikipedia.

Hope this helps, and if you have any further questions or comments, I will be available to respond.  Thanks for your response,

Ken

[northerngirl39]

Thank you so much for the information. Could this lead to anything serious in the future?

I had a sonagram of the heart two days ago will this be able to clearify any of the concerns above?

Will I continue to have the chest pain as now just a part of life?

Once again thank you so much

[kenkeith]

Q:"....There is relative reduction in kinesis at the apex and septum relative to the remainder of the mycoardium".

.....There is slight septum (wall separating the right and left side of the heart) kinesis (wall movement impairment) that doesn't appear to be any problem based on your normally  high EF (amount of blood pumped out of the left chamber with each heartbeat.  Usually heart wall movement disorder reduces the heart's ability to contract as strong as normally.  

Q: "Perfusion imaging today demonstrates no discrete fixed or reversable pathology

Conclusion: Ejection fraction maintained. No reversing pathology seen"

.....Perfusion imaging relates to blood flow through the vessels and no pathology seen and heart pumps normally.

Q: "Notes:
Sinus or ectopic atrial rhythm
Abnormal R-wave progression, early transition
Minimal ST elevation, lateral leads"

.....Ectopic heartbeat is an irregularity of the heart rate and heart rhythm involving extra or skipped heartbeats.  Not an uncommon finding and usually of no concern

.....Poor R-wave progression can be due to a number of different causes and requires further testing, correlation with symptoms, etc.  There can be a left bundle branch block .  Bundle branch is the pathways for electrical impulses to conduct and contract ventricles.  It can delay contractions of the left ventricle...usually not a serious problem, but it can be partially blocked or completely blocked.  It can represent an enlarged right ventricle,etc. worst case scenarios.

Minimum raised ST segment could represent a prior heart attack..worst case scenario, but an elevated ST segment can have benign causes as well.

It appears you don't have any serious medical problems, and the ST elevation needs further confirmation.

Take care,

Ken