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Electrical Issue - ST Changes on Holter
This problem is a heart electrical issue more than a rhythm one, but I'm guessing some of you might know more about this issue, too, and these changes weren't mentioned in the initial report.
I had a 24-hour holter, and the report said normal, but when I requested the actual data, I found the ischemic narrative shows significant ST changes, both elevations and depressions, and for longer durations than 1 minute. The ST elevations occurred while I was exercising.
From my understanding, ST depressions or elevations of 1 to 2 mm that last for at least 1 minute can be clinically significant and warrants further patient assessment. Is this not the case? Should I be concerned that no follow up is being done, and that this information wasn't even included in the report?
For background, this cardiologist was a new patient appointment. He did not listen, spent less than 5 minutes with me, the blood pressures and heart rates taken during my appointment are not in my chart, and the two that are in there don't list the correct heart rates, as the heart rates are the same both lying down and sitting -- I have Postural Orthostatic Tachycardia Syndrome (Dysautonomia), hence the high avg HR, and it's impossible my heart rates were the same, my blood pressures rise with sitting and standing (I have orthostatic hypertension, hyperadrenergic POTS), but who knows what the heart rates were. Over half of the notes from my appointment were completely incorrect, my family medical history is missing, and he actually invented past medical history that I've never had and now refuses to change the notes, despite the fact that he essentially diagnosed me with a past disorder that I've never had.
Clearly, I need a new cardiologist, but in finding a new one, in my experience, if this information about the ST segment changes is not in the actual report, no one will see it, & therefore it doesn't exist. Too many things have been missed due to errors like this for me throughout my entire life.
I have Ehlers-Danlos Syndrome, which I had to find myself, after finding POTS, as all my doctors missed both. I'm still waiting to be seen by a geneticist, but I've been diagnosed with "generalized hypermobility of joints" by a Rheumatologist and "whole body pain" and "chronic migraine" by my neurologist. My symptoms overlap with multiple types of EDS, including hypermobile, classic, and vascular. I have both velvety and translucent skin with visible veins. 9/9 Beighton, though my elbows and knees subtly hyperextend, I didn't even know they did.
Age 29, F, 5'3", 120 lb, white, have had chest pain since age 7, Scoliosis, Acrocyanosis, Raynaud's, Livedo Reticularis, Hypersomnia, & many more. Likely have some form of neuropathy, my feet that sometimes fall asleep after I stand and the tingling I feel pretty much constantly all over thinks so, despite the fact that no doctor has yet to pay attention to these symptoms. Grew up in southern US, do take Adderall & Vyvanse for ADD (which likely came from POTS itself), and Chronic Fatigue Syndrome.
Just hoping to get a better understanding of these results, especially since they weren't mentioned at all in the report I received. Thank you.
I had a 24-hour holter, and the report said normal, but when I requested the actual data, I found the ischemic narrative shows significant ST changes, both elevations and depressions, and for longer durations than 1 minute. The ST elevations occurred while I was exercising.
From my understanding, ST depressions or elevations of 1 to 2 mm that last for at least 1 minute can be clinically significant and warrants further patient assessment. Is this not the case? Should I be concerned that no follow up is being done, and that this information wasn't even included in the report?
For background, this cardiologist was a new patient appointment. He did not listen, spent less than 5 minutes with me, the blood pressures and heart rates taken during my appointment are not in my chart, and the two that are in there don't list the correct heart rates, as the heart rates are the same both lying down and sitting -- I have Postural Orthostatic Tachycardia Syndrome (Dysautonomia), hence the high avg HR, and it's impossible my heart rates were the same, my blood pressures rise with sitting and standing (I have orthostatic hypertension, hyperadrenergic POTS), but who knows what the heart rates were. Over half of the notes from my appointment were completely incorrect, my family medical history is missing, and he actually invented past medical history that I've never had and now refuses to change the notes, despite the fact that he essentially diagnosed me with a past disorder that I've never had.
Clearly, I need a new cardiologist, but in finding a new one, in my experience, if this information about the ST segment changes is not in the actual report, no one will see it, & therefore it doesn't exist. Too many things have been missed due to errors like this for me throughout my entire life.
I have Ehlers-Danlos Syndrome, which I had to find myself, after finding POTS, as all my doctors missed both. I'm still waiting to be seen by a geneticist, but I've been diagnosed with "generalized hypermobility of joints" by a Rheumatologist and "whole body pain" and "chronic migraine" by my neurologist. My symptoms overlap with multiple types of EDS, including hypermobile, classic, and vascular. I have both velvety and translucent skin with visible veins. 9/9 Beighton, though my elbows and knees subtly hyperextend, I didn't even know they did.
Age 29, F, 5'3", 120 lb, white, have had chest pain since age 7, Scoliosis, Acrocyanosis, Raynaud's, Livedo Reticularis, Hypersomnia, & many more. Likely have some form of neuropathy, my feet that sometimes fall asleep after I stand and the tingling I feel pretty much constantly all over thinks so, despite the fact that no doctor has yet to pay attention to these symptoms. Grew up in southern US, do take Adderall & Vyvanse for ADD (which likely came from POTS itself), and Chronic Fatigue Syndrome.
Just hoping to get a better understanding of these results, especially since they weren't mentioned at all in the report I received. Thank you.
I don't know that anyone on the site can give you a diagnosis. All we can suggest is that you take your records to a new doctor and see what they think. You have a right to request a copy of all your records so do so and find a doctor who is a bit more conscientious. This said, if you were having st changes while exercising it could be because of movement itself. But regardless just find a new doctor and see what they say. Best of luck sorting it out.
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