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Re: EKG results

Posted By Chris on June 11, 1998 at 06:21:41:

In Reply to: Re: EKG results posted by CCF CARDIO MD - MTR on June 08, 1998 at 22:45:00:

My son is 17 years old and is a recovering crack addict.  It's been 3 weeks
since he had crack and two weeks before that.  I'm a nurse and today I
decided to do his EKG to show him how much his heart improved since he last
had an EKG.. (basically it showed marked sinus arrhythmia, and frequent PAC's).
I thought for sure it would look better today but to my surprise.. it
looked worse.  
I just wanted to know if this is ok for the recovering addict or should he
consult with a cardiologist.  The doctor I work for thought it was ok and
maybe check it again in a couple months.
I did 3 12 leads:
first one:
sinus bradycardia with 2nd degree SA block (mobitz I)
moderate voltage criteria for LVH, may be normal variant
possible inferior infarct, age undertermined
2nd one:
normal sinus rhythm with marked sinus arrhythmia
moderate voltage criteria for LVH, may be normal variant
ST elevation.  Probably due to early repolarization
3rd :
sinus bradycardia with marked sinus arrhythmia with ventricular excape complexes;
inferior infarct, age undetermined
He says he occasionally becomes short of breath and when he did crack 3
weeks ago, he felt his heart jump.. this really scared him and I think he'll
continue to be scared and hopefully continue to do well in rehab.  He felt
faint yesterday upon standing but this dosn't normally happen this badly.  
I'm not sure wether this is ok to wait and watch or should he go to a
cardiologist?  Is it normal for recovering crack addicts to have this type
of EKG?  

Dear Chris, thank you for your question.  The ECG results you mention were
formulated by a computer program, I presume, so they are not accurate unless
a cardiologist reads the ECG and agrees with the interpretation.  Thus, I
can't really comment on your son's ECG's until that has been done.  The
computer program is generally correct but I would never base a diagnosis
on it's interpretation.  As you know, cocaine can adversely affect the hear -
mainly by causing spasm and constriction of the coronary arteries.  Cocaine
is a powerful vasoconstrictor that has caused acute myocardial infarctions
and is known to be associated with accelerated atherosclerosis when used
chronically.  These should be reasons enough for your son to quit using
cocaine.  It sounds promising, though, that he's in a treatment program.
I would suggest that you do take him to see a cardiologist to get a new
ECG and to have him evaluated.  You should bring along the ECG's you did
to show the cardiologist.  I hope you find this information useful.
Information provided in the heart forum is for general purposes only.
Specific diagnoses and therapies can only be provided by your physician.
Thanks for your help.  I will take him to see a cardiologist.  I just wish the
known effects of cocaine use will convince these kids to quit using but they
think they are immortal.  They think they are too young to die, death happens
to other people only.  My son is still drug free but when I tried to convince
him that he already did some heart damage and he'll probably die if he happens
to relapse again he just said "I won't die!"  And he said it in such a that's
too rediculous type of way.  My brother died at age 28.. he did cocaine and his
heart stopped.  His friends did CPR and then he came out of it.  He didn't
have cocaine anymore after that and 1 week later he died again but was alone
this time.  I'm not sure wether my brother died as a result of cocaine use or
from SCD.. most of us do have a pericentric inversion on our 11th chromosome with
the breakpoint at 11q15.5.  The researcher that's studying our chromosomes says that's where the arrhythmia
gene is located but he's not sure if ours is involved yet.

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