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tidalwave 06-28-2003 08:51 PM

Need help with abnormal EKG results!!
Hi, I just found this board. I am a 39 year-old female with no history of heart problems (though my sister was just found to have a large hole in her heart and is preparing for open heart surgery). There is a family history of high blood pressure. I have been experiencing episodes of dizziness on and off for several months. I had been unhappy with my physician's office for several reason and am now looking for a new one.
I went to the ER one day ago due to severe nausea ect. after a trip to Mexico. They did an EKG and said that the results are abnormal and seem to indicate that I've had a heart attack in the past!!
Here is what the EKG said:
Vent rate: 83bpm
PR interval: 176ms
QRS duration 68ms
QT/QTc: 340/399
P-R-T axes: 78 60 60
Normal sinus rhythm
Left artial enlargement
Septal Infarct, age undetermined
Abnormal ECG

I know you are not physicians, but does anyone have any idea if these numbers seem really odd? Or how reliable this test is for this? I don't know what to think, but feel very nervous and can't sleep. My friend gave me the name of her cardiologist and I will call on Monday to see if he is on my insurance plan. I want to see someone quick to get some answers. Has anyone had similar results and then found out it was "nothing"?? Thanks for ANY feedback that you may be able to provide!

NMc 07-01-2003 02:53 PM

Hi Tidlewave:
I see no one has answered your post yet and I'm sure you're probably still concerned about your ekg results. I've not had a similar ekg result, but have read that septal (or anteroseptal) infarct is detected in the precordial leads (V1 and V2), which shows a "disappearing" R wave. An infarct in this region would indicate blockage of the LAD. This same pattern can also be an artifact due to electrode placement, so your latest test results may in fact be due to recording/placement of electrode error. You don't mention whether the ER attending indicated faith in the results nor what his/her recommendation for follow-up was, and so difficult to speculate at this point. It's a good idea to see a cardiologist and have the results (and a second ekg done) analyzed, as well as being assessed for CAD.
Good luck and let us know how things worked out.

NMc 07-01-2003 02:56 PM


[This message has been edited by NMc (edited 07-01-2003).]

NMc 07-01-2003 02:56 PM

Forgot to mention, the other values you gave (aside from left atrial enlargement) appear to be within normal limits. Do you suffer from hypertensive heart disease or valvular disorder by chance?

tidalwave 07-01-2003 09:44 PM

Hi Nancy,

I really appreciate your response. To answer your question doctor has ever said there was anything wrong with my heart before. So I have no known history of valve disease. Though it must be years since I've had an least 7! I have no real history of high blood pressure..though it runs strongly in my family. I did have pregnancy induced highblood pressure 7 years ago and labor was induced prematurely as a result. Turns out this happened due to my kidney diseas which was diagnosed a year after my son's birth...and they then could not believe how long I had held out in my pregnancy (34 weeks). Much of my life, my blood pressure has been on the low side. Though 2 years was high at one point..but not when resting..and not for a significant period. It has been normal since..and was normal when I was in the ER the other day.
The ER doctor didn't comment upon the EKG too much. He just came in with the EKG results and told me it indicated that I had had a heart attack in the past. He did say "or this could just be normal for you"..which didn't make any sense to me. So I got the impression he wasn't too sure about the results. I asked him if he was a cardiologist and he said no. He said that I should "follow up" on it. I asked him if it showed I had a whole in my heart like my sister and he said no. I asked for a copy of it to take to a cardiologist and he made me a copy of all my test ER test results. The whole thing wasn't really sinking it..and at the moment I was kinda just so relieved that I had stopped vomiting that I wasn't too taken by the results. It wasn't really sinking in so I didn't ask some questions maybe I should have. I just took it and figured I'd look into it. Next night when I was better rested and thinking more clearly it hit me..and I started thinking "What the hell is THIS??".

I am glad to hear the #'s on the results look normal. I am so appreciative of your very informative response!
I am going to the cardiologist on Thurs. two day..I will let you know what he says.

tidalwave 07-01-2003 10:25 PM

Nancy..sorry one question...what is a "disappearing R wave"??

NMc 07-02-2003 01:40 PM

Hi again Tidlewave:
It was probably a pretty big shock to learn you might have had a heart attack in the past, but again, it could still be a recording error. It's unlikely the current ekg reflects something "normal for you", else it would have been noted on previous ekgs - especially when you were monitored during your last delivery. Disappearing R-waves can seen on your ekg if you look at leads V1 and V2. The normal QRS complex for V1 and V2 are little (positively deflected) R waves, followed by big (negatively deflected) S waves. If you had an infarct, these recordings should show little deflections for both RS followed by negatively deflected T waves (upside down U). I'm not sure, but I believe the reciprocal leads for V1 and V2 should also show negative T waves if the heart muscle is indeed damaged. Of course, I'm no cardiologist, so going strictly by the book here. A cardiologist should be able to take a look at the ekg and give you definitive answers.
I know you're pretty spooked by the whole thing, but it sounds like you've been doing pretty well despite what may be some blockage of one or more coronary arteries (emphasis on "may"). Hang in there and wait to see what the cardiologist recommends.

techblues 07-04-2003 09:24 AM

Hi Tidal,

Nothing much to add except some re-assurance. My son had an EKG done last year and it came back abnormal showing left ventricular hypertrophy. My first thought and the thought of the pediatrician was Mitral valve disorder just like I had. He had the complete battery of tests including another EKG, echo/doppler, bloodwork, etc which all showed no problem at all. Discovered that the EKG tech placed the ankle leads on him incorrectly. I know it's easier said than done, but, take it seriously, but don't obsess. Even high tech equipment isn't infallible!! [img][/img]
Good luck and God bless.

tidalwave 07-04-2003 10:40 AM

Okay..things look good! Went to the cardiologist yesterday and he reviewed the EKG results and checked me out pretty good. He does not think there is anything wrong with my heart! He said (just like what happened with techblue's son) that the results were probably due to the lead placement and that that happens all the time. He did another EKG in his office and said it looked fine. I am scheduled for an echocardiagram and stress test, just to be certain..but he is not really expecting to find anything. I have had some dizziness and he thinks it is more likely due to an inner ear fluid thing..which I will look into..but right now I am feeling pretty relieved. Thank you Nancy and techblue for your very helpful is comforting to know you are out there! I will let you know what happnes with the new tests for sure..I will be going for them in about 1 1/2 weeks. Thanks again! Just makes me wonder how many people get spooked like this.

JeanE716 07-19-2003 04:14 PM

How did you get to see the results of the EKG? I have spent the last 11 months trying to get one of mine (and I have them every month more if I land in the hospital again). All I am able to get is told it is the same as the last - showing the same abnormalities it has for the past couple of months, etc. But never have I been able to actually get a dr. to show one to me or explain it.

NMc 07-19-2003 07:44 PM

Hi Jean:
I think many doctors fail to show ekg results to patients because explaining what all the waves mean in each lead would be overwhelming (for both the patient and the doctor). However, if pressed, most cardiologists will highlight the important points and explain the logic behind your particular diagnosis. For example, if you've had heart muscle damage as a result of an infarct, he/she can show you which leads detected it (thus identifying which part of the heart was damaged), how old the infarct is (if it was recent), and whether the infarct led to additional problems (conduction disturbances).
Next time you have an ekg, ask your cardiologist if you can have a gander. If you post what your diagnosis is, perhaps I can offer some suggestions for questions you might ask him/her. Remember though, I am not a cardiologist - I just like trying to figure out what all those squiggles are.

skolnik 09-18-2003 11:56 PM

Hi, I am a 24 year old male and I recently visited the doctor for a physical. As part of the physical, they performed an EKG test. I am relatively healthy, try to eat balanced, and exercise occasionally, however I had not been to the doctor for about 4 years prior to this visit. The doctor told me that the results of the EKG indicated that my heart was slightly enlarged and asked me if I work out often. I told him that I work out on occasion but not regularly, and he suggested that the exercise was the cause of an enlarged heart. He assured me that I had nothing to worry about and to just be aware of any symptoms such as chest pain. Can anyone tell me anything about an enlarged heart? Should I be worried? Also, I must mention that the nurse who administered the EKG, while training a second nurse, had trouble sticking the nodes to my skin because I have a lot of hair. He did the test anyway, without shaving me. Any advice or feedback would be much appreciated. Peace.

cutup 09-19-2003 05:09 AM

[quote]Originally posted by JeanE716:
[B]How did you get to see the results of the EKG? B][/quote]

All you need to do is go to medical records at the hospital or doctors office that you had this done at and ask for copies of your records.

NMc 09-19-2003 12:23 PM

Don't put too much stock in ekg recordings that show an "enlarged heart". The standards used to assess ekg findings are based on data collected from people over the age of 40. These results may not be "generalizable" to younger people. The definitive test is the echo, so wait till you get those results. At cutup suggests, request a copy of your ekg next time you visit your doctor.

complex592 09-22-2003 07:35 PM

I read your post and remembered back to 1976 when I had an EKG in the ER and it was not interpreted properly. Having spent the last 27 years working as a cardiology technician, I can tell you that all your parameters, Heart rate, PR QT are within normal limits. Certain changes occur in the EKG of old MI's. These changes are demonstrated in specific lead of the EKG. If the EKG was read by computer initially often these readings are incorrect. The correct reading is done by a cardiologist that signs of on it later. By all means go to a reputable cardiologist and be checked out. They might want a stress test and or a echocardiogram. By all means don't let this make you any more stressed than you need be because your probably fine. I had a slight mitral prolapse that caused my EKG changes. Nothing ---Well 27 years later I hardly think about it except when I read a post like yours and remember lying in the ER chest hurting, and being told I had an old MI. I was 29. I have specialized in heart rhythms and EKG's and currently am employed by an electrophysiologist. Ckeck it out. Let us know how you are doing.

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