Abnormal EKG Q waves, inverted T and ST depression

[Scott77]

I am a 49 year old white male. My father and grandfather died in their sleep of apparent heart attacks in their 40s after stressful days.  In my latest stress tests, the doctor noted pronounced Q waves on multiple leads, an inverted T wave, and an ST depression.  They did a stress echo focusing on the left ventricle and he said it looked normal.  Consequently, they don't seem to concerned.  10 years ago I had a stress test EKG and everything, including my EKG was normal.  I am thin, I eat well, I exercise (although I could do more), but I also have a high stress job and I travel extensively and I get chest pains from time to time.  I am on a statin for abnormally low HDL2 and high VLDL3.  Two questions: 1) Why would I have an abnormal EKG - pronounced Q wavies, inverted T wave, and an ST depression? 2) What kind of preventative measures including further testing might be in order?

[itdood]

Pronounced Qs *WITH* inverted Ts is usually a sign of a previous infarct.  ST depression points to ischemia.  EKGs aren't the final word in diagnosing the issue.  It would be cause to order further esclation of tests to confirm, which you had and which did not confirm MI.

The next escalation from here if those test were inconclusive would be angiogram, cardiac CT, and/or a cardiac MRI with 3D turbo/contrast.  Your level 2 tests did not indicate a need to escalate.

Since you have strong family history and a change in EKG baseline, I would personally look into aggresive lipid therapy.  You shoud achieve HDL levels of  60 mg/Dl or above.  If you can't through diet, a gorilla statin like crestor can help along with Niacin suplementation.  Niacin in particular is proving to be a great HDL booster.  This along with lifestyle deicsions (diet, weight, exercise) are your main weapon right now.

[karenfiftytwo]

If you can reduce your stressful job. Take in a deep breath. I have had chest pains for several years now. Family history of heart problems and death at early ages. I had an event monitor on for one month. It showed a racing and slow heart rate. The sinus rhythm was fine. The doctor said that was nothing to worry about. So I am doing my best not to worry. I was seeing the doctor for something else one day and mentioned to her about a sore spot on my chest I have had for a long time. She said Costochondritis.
I came home and looked it up online. Yes I suppose the pain could be this. If I would have known sooner, I would not have worried so much. Are you getting 8 hours of sleep. That is a big one. You need sleep. Your heart needs  sleep. I feel so much better when I get 8 hours of sleep. I do noticed a big difference. I wish you well. Take Care. If your doctor is not worried about your problem. Then you should not be. You have a strong and healthy heart.  : )