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Old 08-16-2004, 08:28 AM   #1
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Does a normal ECG rule out most hypertensive heart disease?

I know I've written a few times about my heart and blood pressure, but I think this question is one which many ask themselves.

I'm 26, normal weight, but quite inactive... I have had slightly elevated blood pressure since I was a little kid. The first time I ever took my BP was when I was 14, and it showed 180/80. I think I had exercised a few minutes before though... Anyway, since then I have always been nervous when taking my BP, my resting BP has always been at around 150/90. It has remained that way for 12 years!

Now, I had 2 ECGs recently at the ER. These were just routine ECGs at the ER. I think they put about 7 wires on me (5 on my chest, and 2 on my ankles, I think). But they said they were normal. Although my nervousness caused palpitations and a heart rate of 135. Are ECGs as accurate with such a fast heart beat? I'm guessing so, otherwise stress tests wouldn't exist.

My question is, do these routine ECGs usually rule out any heart muscle damage, such as thickening, enlargement, etc? Or does it depend on the doc's interpretation?

I asked the ER docs about these particular things, and they said there was absolutely no evidence of them after an ECG, checking heart sounds, and blood test.

Last edited by junior26; 08-16-2004 at 08:40 AM.

 
Old 08-16-2004, 08:36 AM   #2
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Re: Does a normal ECG rule out most hypertensive heart disease?

in the right clinical circumstances a normal ECG rules out enlargement/thickening of the heart

 
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Old 08-16-2004, 08:43 AM   #3
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Re: Does a normal ECG rule out most hypertensive heart disease?

Great, that reassures me quite a bit. Especially since they did a physical test and blood tests, which were normal.

I just keep thinking that maybe some docs are better at reading ECGs than other docs. Especially at the ER. They're not exactly cardiologists. But then again, ECGs are standard procedure. They've seen thousands.

Thanks again. I will be getting my BP checked out and treated soon. And my anxiety too.

 
Old 08-17-2004, 10:55 AM   #4
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Re: Does a normal ECG rule out most hypertensive heart disease?

I had 3 ECG's in one night last year. 1st at the Urgent Care center, results normal, 2nd when the paramedics arrived, results normal, 3rd at the ER, results normal..... Blood tests confirmed I was in the middle of a HEART ATTACK!

Im a 45 yr old female, (heart attack happend the week before my 44th bd) Im also inactive and overweight. NO OTHER RISK FACTORS....

My advise to you is to GET MOVING.... inactivity can kill.

Best of luck to you.

 
Old 08-17-2004, 10:57 AM   #5
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Re: Does a normal ECG rule out most hypertensive heart disease?

of course early on during a heart attack the ECG can be normal (or just show hyperacute T waves for example) - that is a different question altogether

 
Old 08-17-2004, 11:23 AM   #6
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Re: Does a normal ECG rule out most hypertensive heart disease?

I'm just really scared that my long-term HBP has caused any muscle danage. I just want to reassure myself before I get REAL tests done.

I know that my BP is probably under 140/90 most of the time, but still. I have a lot of anxiety that makes my pressure shoot up like a rocket. I don't want to start dying of heart failure 20 years prematurely because I was negligent in my 20's.

I just don't want this to have caused a drop in my life expectancy. I'm willing to eat right and exercise.

 
Old 08-17-2004, 12:16 PM   #7
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Cool Re: Does a normal ECG rule out most hypertensive heart disease?

The ER physician reads your ECG at the time of your treatment in the ER. But, they are always read by a cardiologist later on. If anything further is discovered they then contact the patient. Your ECG was read by a cardiologist who obviously found nothing abnormal or you would have been notified. You need to stop worrying excessively about your health. It is a good idea to have your anxiety treated. That alone will help you tremendously. You are scaring yourself to death, thats not good for your BP either! Try to relax, accept what the physicians are telling you and don't buy trouble!

 
Old 08-17-2004, 01:14 PM   #8
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Re: Does a normal ECG rule out most hypertensive heart disease?

Thank you so much Shortie. That makes me feel better. And yes, I really need to stop worrying about my health. I'm going to the Montreal Anxiety Clinic tomorrow evening for my first round of Cognitive Behavioral Therapy. I'm actually looking forward to it. Talking to people makes me feel good because I'm alone most of the time. And that doesn't exactly help anxious thoughts from escaping my head.

 
Old 08-18-2004, 01:05 PM   #9
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Re: Does a normal ECG rule out most hypertensive heart disease?

Also a quick question. I was so nervous during my ECGs that my heart was beating at 130-140 beats per minute. The R waves were so close together that you couldn't see any details.

Do you think the doc would have picked up on those details?

Also, does anybody have alternating Bradycardia & Tachycardia. My pulse is quite slow for an inactive person (54-56 BPM). But as soon as I get up and walk around, it shoots up to 130+.

 
Old 08-18-2004, 02:56 PM   #10
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Re: Does a normal ECG rule out most hypertensive heart disease?

Quote:
Originally Posted by junior26
Thank you so much Shortie. That makes me feel better. And yes, I really need to stop worrying about my health. I'm going to the Montreal Anxiety Clinic tomorrow evening for my first round of Cognitive Behavioral Therapy. I'm actually looking forward to it. Talking to people makes me feel good because I'm alone most of the time. And that doesn't exactly help anxious thoughts from escaping my head.
Please do let us know how the CBT goes, I'm sure lots of us are interested in on how it works for you

I spend most of my time alone too, stuck in the engineering library studying or crunching stats in the lab so I know how you feel, makes me get anxious at times too, it stinks

 
Old 07-30-2005, 05:04 PM   #11
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Re: Does a normal ECG rule out most hypertensive heart disease?

I have had many ECG's after going to Doctors explaining my rapid heart beat and the heart seeming to skip a beat often but not one ECG gave any indication of my Heart Arythmia!!!!!!!
I became very sick with a bladder infectioin and my heart really started beating SO fast I had 4 ECG's and more than one Doctor became involved so now I am on heart tablets for life to regulate my heart beat but this was just picked up by chance albet it had been happening for years so in conclusion
"Unless it is actually happening at the time of an ECG" then ECG's are not a good indication of all heart problems. I had an Ecocardiogram when I came out of hospital and wish I had been offered this many years before I got the bladder infectioin but then again "It's an ill wind that blows no good whatsoever" so I am grateful.
Kay

 
Old 07-31-2005, 08:15 AM   #12
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Re: Does a normal ECG rule out most hypertensive heart disease?

Yes ECG's are very accurate in determining heart problems. Don't ever worry that an ER doc can't read them if they think there is a slight problem or if they are unsure they will call Cardiology. I have just spent three days in the hospital and I had 6 docs read my ECGs (the ER on call doc, 3 arrhythmias docs and two cardiologist) all because my pacer was showing funny signs on the ECG.

I would agree try and exercise a little each day doesn't have to be alot but even a short walk would be a good start.

Kathy

 
Old 07-31-2005, 08:45 AM   #13
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Re: Does a normal ECG rule out most hypertensive heart disease?

Quote:
Originally Posted by KShortie
The ER physician reads your ECG at the time of your treatment in the ER. But, they are always read by a cardiologist later on. If anything further is discovered they then contact the patient. Your ECG was read by a cardiologist who obviously found nothing abnormal or you would have been notified. You need to stop worrying excessively about your health. It is a good idea to have your anxiety treated. That alone will help you tremendously. You are scaring yourself to death, thats not good for your BP either! Try to relax, accept what the physicians are telling you and don't buy trouble!
I have to add my 2 cents worth here. 12/2002, went to ER room with some chest discomfort at a pretty good hospital. EKG was normal so I was told. They could not get an IV started for a Chest CT scan looking for a blood clot so I was dismissed. Two months later I went to pick up reports at this hospital and glanced at then before the lady put them in a folder. EKG read, "Septal MI"......These idiots Never notified me that the final reading showed a heart attack. I was livid. They had all these blatant excuses why they were sooo imcompetent. Don't trust an ER doctor to read these things unless you are at a GOOD HEART CENTER with ER doctors that are employed by that hospital.

Last edited by Caroliz; 07-31-2005 at 08:46 AM. Reason: typo

 
Old 08-02-2005, 10:06 AM   #14
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Re: Does a normal ECG rule out most hypertensive heart disease?

QUOTE:My question is, do these routine ECGs usually rule out any heart muscle damage, such as thickening, enlargement, etc? Or does it depend on the doc's interpretation?

In theory the answer is yes. An EKG is a transducer (device that changes electric signals as input and an analog (gragh) output. The conduction or near lack of conduction of electric pulses through damaged, enlarged, and thickened muscle are different from each other and from the normal; the leads on the body will identify the area and EKG software distinquishes the area and differences then displays a graphic representation. It is an objective test and not much to do with subjectivity so competent doctors should be able to come to the same conclusion.

Last edited by started04; 08-03-2005 at 07:36 AM.

 
Old 08-03-2005, 09:43 AM   #15
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Re: Does a normal ECG rule out most hypertensive heart disease?

I don't think so. I had an ecg done in Nov. last year and doc said it looked ok with just a few irregularies, whicj docs. had been saying for years. I asked if she could tell whether I had blockages or not and she said no I would need further tests. I didn't have them done until June and then they found 3 major blocks 100%, 90% and 70%. So anyway, I don't think the ecg is very reliable. The echocardiogram was a better diagnostic test and the nuclear stress test was even better, but the best was the catherization.

Last edited by Cher2005; 08-03-2005 at 09:47 AM.

 
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