I hope someone might be able to tell me if these EKG results are something for which I should press my PCP to refer me to a cardiologist.
I was hospitalized for a mild stroke a couple of weeks ago. I went to the ER suspecting a heart attack. But due to numbness, tingling and speech impairment (along with angina) stroke diagnosis was made. During my hospitalization I was referred to both a cardiologist and a neurologist. Unfortunately due to the blizzard of the century they could not make it to the hospital for the consult. I have today received a copy of my hospital records and they are two abnormal EKGs. One says "probable posterior infarct" and the other "backside prior infarct". There is also a physician's report stating an EKG showing sinus tachycardia and prior posterior infarct. The ER physician ordered cardiac enzymes blood work be done three times every 6 hours. Unfortunately only one test was done and showed both CKMB and Troponin within normal limits.
My PCP has agreed to do a referral to a neurologist but declined the cardiologist referral because my discharge papers only made mention of the stroke.
Should I push for a referral to a cardiologist or are those EKGs inconsequential?
I can't understand why your Dr. won't refer you to a cardio person. Your EKG isn't normal, plus a stroke basically has to do with the heart. My husband had a mild heart attack a week before Thanksgiving and his VA Drs. admitted him for 3 days to have artery surgery. They also told him he may have had a mild stroke as well, even though there were no visible signs. He even had very mild signs of a heart attack, a little chest pressure, indigestion and slight shortness of breath, but I took him to the ER even though he chalked it up to a bad cold.
At first my husband's CKMB and Troponin levels were ok but went up during the first night, so hence the surgery for a blocked artery.
Too bad they didn't make it to the consult and could give their input. I hear you about the blizzard of the century, sick to death of it here too. I think your Dr. needs to talk with the hospital Drs. to see what follow ups you need and with whom. Like you, my husband had to see both Drs. and his PCP for follow ups. Any abnormal EKG should be evaluated by a Cardio person IMO.
I'd get in touch with the Drs. that treated you and find out more info. as to what needs to be done and who you should see. Sounds like your PCP is shrugging this off as not that important...NOT good!
Best of luck...JJ....
When you come to the end of your rope..tie a knot and hang on!
Last edited by JJ; 02-18-2011 at 07:24 PM.
The Following User Says Thank You to JJ For This Useful Post: btedder (02-18-2011)
An EKG is not very reliable source to diagnose the heart's structual physiology...but sinus tachycardia has some merit based on an EKG. But sinus tachycardia can be the result of a heart rate above 100 that can be a normal response due to a non-medical cause.
The EKG indicates prior heart issues that has caused heart damage. The blood test you are referring to has validity for a heart attack that is recent and it appears that is negative.
You should be consulting with a cardiologist. An echocardiogram can determine the medical significance of the alleged infarcts. If there is a problem, the echo will indicate a heart wall movement disorder, and the degree of impairment based on the heart's pumping contractility. Serious wall impairment reduces cardiac output...The underlying cause for the infarct should be determined and treated to reduce further heart cell damage, if any.
The Following User Says Thank You to started04 For This Useful Post: btedder (02-18-2011)
An update. This morning I spoke with my PCP's nurse and she had me fax the documents to her and said she would speak to the doctor and get back to me. I am still awaiting her call and will do my best to put it out of my mind until next week.
The following user gives a hug of support to btedder: JJ (02-19-2011)
The saga continues...I still haven't heard from the neurologist's office for an appointment. My PCP still won't refer me to a cardiologist. He said I need a stress test first. The stress test w/sedation was scheduled for tomorrow morning. Sedation is a necessity for me (long story-past bad experience). Friday I was informed that the cardiologist had written the order and the nurse was versed on the protocol (the normal cardiology nurse is out of town this week). The I got a phone call today saying that the hospital will not allow the sedation. They said it is "against company policy" (fiscal issue I believe). Now my PCP's nurse tells me that he is "requiring" me to have the test as a condition of continued care. They are trying to find another facility that will do the test with sedation.
HUH???? If you need a stress test it is usually done at a Cardio Drs. office. or a hospital facility. Man they sound like they are giving you the run around. If you need a stress test and need to be sedated what is the big deal?
Girl I hope they square this away soon or they are going to make you nuts. Thanks so much for at least updating us, so please let us know how it does finally turn out. Hopefully things get under way soon so you know what is going on.
All my best....JJ.....
When you come to the end of your rope..tie a knot and hang on!
The Following User Says Thank You to JJ For This Useful Post: btedder (03-08-2011)
JJ, I appreciate you following along with my adventure. My PCP's office just called telling me he will go ahead and do the referral without the stress test. My guess is he doesn't like how the hospital is handling this.
In the meantime the hospital "powers to be" picked on the wrong person. I have sent a letter off to the COO at the hospital and cc'd the VP of Operations at the parent company.
The following user gives a hug of support to btedder: JJ (03-08-2011)
Hi I would bring the copies of the hospital records of the EKG's and any other desirable paper and tell him what I want. If there is a refusal I would see another professional. Also one could check the internet to see how many other patients thought this doctor was wonderful.
The Following 2 Users Say Thank You to sjb For This Useful Post: btedder (03-08-2011), JJ (03-08-2011)
krazy2day, thanks for the suggestion. My insurance does allow self-referral. Problem is I have never found a specialist in the area that will accept self-referrals. I believe it is because 90+ percent of the physician's practices around here are owned by corporations that own the hospitals and they refer to and from their own. I did try again with a few cardiologists and no luck.
Update. Just got a call from a cardiologist's office to schedule an appointment. Soonest they can get me in is 3 weeks from today. It's not the cardiologist I requested, but I researched her online and she looks to be pretty good. I'll consider the appointment her interview and make a final decision after that.