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Old 08-31-2003, 02:25 AM   #1
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SFangel HB User
Question Minor heart attacks & EKGs

Hi,

I once read the story of a man who had a minor heart attack, the first one in his life. He went to the Emergency Room because he had all the symptoms of a heart attack. The doctors in the ER did an EKG, which came back normal.

A long time later, he had heart surgery for a heart problem (I do not remember which problem). During surgery, the surgeon discovered that he had had a heart attack because there was some type of scarring on his heart.

How come the EKG did not detect this man's heart attack? Was it because his heart attack was minor? How accurate are EKGs in detecting minor heart attacks?

I sometimes have all the symptoms of a heart attack. I had several EKGs, which came back normal. I know it is not anxiety because I was not anxious at the time. I am worried that I might have had a minor heart attack that was not detected by the EKGs. There is a history of heart problems in my family.

Thanks.

 
Old 08-31-2003, 07:30 AM   #2
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The EKG is not always helpful in diagnosing a heart blockage. If you saw a doctor soon after your suspected heart attack they should have saw something in your blood work. The damage from a heart attack should have raised the triponin level. However, if you waited awhile it might not even show up on the bloodwork. If you are continuing to have symptoms you should probably seek out further testing. You did not state whether you are a man or a woman, but in women the EKG is often not helpful. Some suggest that you need the nuclear scan along with it, but neither test indicated a problem in my case. I did not have a heart attack, but had 75% blockage which needed immediate treatment.

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Old 08-31-2003, 12:26 PM   #3
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Hi, cutup

Thanks for the information. I am a 28-year-old female.

What is the difference between heart blockage and heart attack? Does a heart blockage cause a heart attack?

If the EKG does not always help diagnose a heart attack or heart blockage, why do doctors rely so much on it?

Some of the times when I had symptoms of heart attack, I saw a doctor soon after. However, they did not order any blood work. They just blamed my symptoms on anxiety, which they have the bad habit of doing with so many heart attack patients. These doctors are quacks!

I wonder why the EKG is often not helpful for women. Then doctors should try developing a test that accurately detects heart attacks in women. Why is it that there are so many more tests available for men for different health conditions but not for women?

I have never heard of the nuclear scan. Are you talking about the MRI scan? Is the nuclear scan done at the same time as the EKG?

How was your 75% heart blockage detected?

Thanks.

 
Old 08-31-2003, 06:50 PM   #4
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Hi, sfangel. Well I am a 33 year old woman and I had to have an EKG done because I am scheduled to have plastic surgery under general anesthesia

Well as opposed to your EKG test, my EKG test came back abnormal. My EKG test showed some changes and so I was referred to a Cardiologist where I had a second EKG, an ECG and a stress Thalium test done.

Well my Thalium test came back abnormal as well but then my Cardiologist said that the result of this was inconsistent because he says if the result of the Thalium test came back abnormal, so my exercise stress test was supposed to come back abnormal also. But my exercise stress test came back normal. So he ordered me to go get another ECG or ecco-cardiogram done and then that came back normal so he gave me my medical clearance.

I hope my information has helped you somewhat. I don't know why your EKG came back normal when you think that the result is inconsistent but I would now go for a stress Thalium test which I believe is better accurate than an EKG.



[This message has been edited by yahweh (edited 08-31-2003).]

 
Old 08-31-2003, 09:03 PM   #5
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Hi SFangel
I am cutup but I am visiting my son and could not use my username so I am under a different name this time.
You can have a heart blockage but not necessarily have a heart attack. The heart attack occurs when a blood clot or plaque tries to pass through the narrowed artery and cuts off blood supply to part of the heart. My blockage was only found when they did a cardiac catherization. I still don't know why the EKG, and stress tests never showed anything. I never ever had pain or shortness of breath while on the treadmill though.
My cardiologist is the one who admitted that EKG's are not that helpful when diagnosing womens heart blockages. That is why he prefers to do the nuclear scan along with the stress test. The nuclear scan allows them to view your heart immediately after exercise and at rest via a machine. A dye is injected into your veins.
I think the reason the tests are not helpful for women is because they were tested on men for years. Women have different symptoms and are more likely to die from their heart attacks. We tend not to do as well after treatments such as angioplasty and bypass. I had a very hard time getting a correct diagnosis of my chest pain. I kept telling them it was my heart and they kept saying they thought it was my stomach. They played around with me for 6 weeks. How I managed to not have a heart attack boggles my mind. Even after they put a stint in and I kept going back telling them I'm still haveing chest pain, it was difficult to get them to listen. When they finally did another cath I was 97% blocked in the stinted area and had to have emergency bypass surgery. Again even with that severe a blockage the EKG was not helpful. Some doctors just do not take our symptoms serious. Being 28 it would be even tougher for you.

 
Old 09-01-2003, 10:00 AM   #6
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Hi, cutup. I know that you are using your sons username Coledaddy. This is Yahweh. Okay well I guess I should be greatful because my EKG's always comes back with some type of change. So it comes back abnormal.

I understand that you had to have emergency bypass. Now in order for you to have emergency bypass, did they check you before they put you under general anesthesia? I mean what can happen if our ekg comes back abnormal and we go under general anesthesia. You went under general anesthesia and you were alright? I look forward to hearing from you soon. Thanks. Oh by the way in answer to your question as to how you did not happen to have a heart attack boggles your mind well it is because of the loving grace of Yahweh our creator that preserved you and kept you from having that heart attack. Bye

[This message has been edited by yahweh (edited 09-01-2003).]

 
Old 09-02-2003, 01:00 AM   #7
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Hi, Yahweh and Cutup

Thanks for the information. It was really helpful.

I have had 4 surgeries under general anesthesia but no EKG was ever scheduled to check my heart.

I will try getting an ECG and stress Thalium test done to find out if there is anything wrong with my heart. I will also try getting the nuclear scan test. However, I bet these tests are not 100% accurate, so doctors might not find out what has been going on with my heart. I hope they will though.

 
Old 09-02-2003, 02:39 PM   #8
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Quote:
Originally posted by SFangel:
[B]Hi, cutup

Thanks for the information. I am a 28-year-old female.

What is the difference between heart blockage and heart attack? Does a heart blockage cause a heart attack?
I know this was already answered, I just wanted to add something. Coledaddy is absolutely right when he says that a "heart blockage" doesn't always cause a "heart attack". A complete blockage, though, is not from the plaque that's present in your heart's blood suppy (the coronary arteries), but a result of blood clotting AROUND the plaque and blocking the blood flow. It is very rare for a plaque to just grow in and occlude the entire vessel (though it can get pretty darned close sometimes!)

Anyway, the key thing is that the blood flow to the heart must be totally blocked for a few minutes before the heart muscle that's not receiving blood starts to die. When the heart muscle dies, this is called a "myocardial infarction".

Now....usually this shows up on the EKG as something called "ST elevation", "T wave inversion" and later on "significant q waves"....there are instances where neither of these things appear on the EKG...why? Well, they might be small infarcts, or an infarct that's in an area of the heart that is not being picked up by the leads of the EKG. More specifically, though, if you have some type of heart disease, ST elevation/depression will always be present...it's the "significant q waves" which don't always show up. These are actually called "non q-wave myocardial infarctions" and the actual heart attack is picked up with a blood test for cardiac enzymes as someone already explained.
Quote:
If the EKG does not always help diagnose a heart attack or heart blockage, why do doctors rely so much on it?
Well, first of all, not every test is perfect. EKG is a VERY effective test, but by itself can't always detect problems. That's why they do other tests (like the blood tests) to help out patients. The thing with EKGs is that they can give you a TON of information. Rate, rhythm, size of the ventricles, heart strain, heart damage, low blood flow, heart inflammation, lung disease etc. etc. etc. So while 90% of the time it can pick up myocardial infarctions, it's not perfect. Plus, another great thing about the EKG is that it is non-invasive. I'm pretty sure that patients appreciate having an EKG routinely rather than putting a catheter in their veins routinely!
Quote:
Some of the times when I had symptoms of heart attack, I saw a doctor soon after. However, they did not order any blood work. They just blamed my symptoms on anxiety, which they have the bad habit of doing with so many heart attack patients. These doctors are quacks!
Whoa! I certainly hope that doesn't happen to you too often! If you have a history of heart attacks, I REALLY hope that the good ones take you seriously!
Quote:
I wonder why the EKG is often not helpful for women. Then doctors should try developing a test that accurately detects heart attacks in women.
It's not that the EKGs aren't good for women--they are...it's the stress tests which aren't often good for women. Yes, the stress test uses an EKG to find the results, but EKGs are good for other things in women. And the other thing is, it's not that easy to come up with a test just for women. There are things called sensitivity and specificity that are applied when evaluating the efficacy of a test. It is very hard to make a test which has a good score in both these departments...but I assure you, research is being done!
Quote:
Why is it that there are so many more tests available for men for different health conditions but not for women?
I'm not sure what you mean here...can you give an example other than the heart stuff?

 
Old 09-02-2003, 04:47 PM   #9
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Quote:
Originally posted by yahweh:
Hi, cutup. I know that you are using your sons username Coledaddy. This is Yahweh. Okay well I guess I should be greatful because my EKG's always comes back with some type of change. So it comes back abnormal.

I understand that you had to have emergency bypass. Now in order for you to have emergency bypass, did they check you before they put you under general anesthesia? I mean what can happen if our ekg comes back abnormal and we go under general anesthesia. You went under general anesthesia and you were alright? I look forward to hearing from you soon. Thanks. Oh by the way in answer to your question as to how you did not happen to have a heart attack boggles your mind well it is because of the loving grace of Yahweh our creator that preserved you and kept you from having that heart attack. Bye

[This message has been edited by yahweh (edited 09-01-2003).]

 
Old 09-02-2003, 05:08 PM   #10
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. Now in order for you to have emergency bypass, did they check you before they put you under general anesthesia?

The reason I had the emergency bypass is because my stint had failed and I was in immediate danger of dying from a MI. The EKG'S that I had did not show a problem in fact I walked to the cath lab instead of riding in a wheelchair. Something I will never allow to happen again.

I mean what can happen if our ekg comes back abnormal and we go under general anesthesia?

Maybe nothing. It all depends on what the doctors decide about the results of your EKG. I probably have scared you which was not at all my intention. I was just saying that in my case EKG has never been a good tool in diagnosing my heart problem. It is helpful with some people though.

You went under general anesthesia and you were alright?

Yes, but I had absolutely no choice if I wanted to be around much longer. My situation was critical that I get it fixed immediately. Just a small bloodclot or breaking away of plaque would have killed me. My situation is much different than yours. I had a known blockage in a very critical area.

Because of my history I am not secure with the tests that are available at this time. This is a problem I have to learn to deal with. I agree with the person who posted that it is better to not have the invasive test with all of the possible side effects that can occur. I guess I'm just saying make sure they've done everything possible to find out whether the abnormal EKG is a problem or not. They may have already done all that they can at this point to give you that assurance.

You are correct that it was by the grace of God that I'm still here. Before I went under I said a prayer that if I die I'm okay with it because I know I will be with the Lord, but Lord if you can see your way to giving me some more time with my family that would be my choice.
[This message has been edited by yahweh (edited 09-01-2003).][/B][/QUOTE]


 
Old 09-03-2003, 09:12 PM   #11
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SFangel HB User
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Hi, everybody

Thanks for the information.

Projapoti, is it not important for someone to know if they had a small infarct so as to maybe prevent a major one from coming?

I am not saying they should come up with a test just for women but that they should come up with a test that is as accurate for women as it is for men.

“I'm not sure what you mean here...can you give an example other than the heart stuff?” Some examples of these tests are tests for male cancers such as prostate cancer...

 
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