Question: I am a 33 yo old female. I am a smoker with active diagnoses of rheumatoid arthritis and bulimia nervosa. I have had serial ekgs over the years for various admissions into eating disorder facilities. My first EKG showed a partial RBBB. My echo in early 2010 following that was normal with what they called a "low normal" EF of 50-55%. My subsequent ekgs have been unchanged until recently. My most recent ekg (last Monday) showed an inverted T wave in lead III. My MD said I needed a cardiology consult but wouldn't say why. The physician at the eating disorder facility also said I needed a cardiology consult before they would prescribe any medications. They did not draw cardiac labs but drew some metabolic labs. My HGB was 13.9, my Na+ was 139, K+ 4.2, Cl 104. BUN/creat/glucose WNL. Mag level 2.2, calcium 9.3. My cholesterol was 193, LDL-C 110, HDL-C 53, trig-NMR 106. LDL-P 1,152, and small LDL-P 3000. My LP-insulin resistance score was 48. My TSH was 0.4, free T4 was .72, and vit D 35. I have had intermittent chest pain that I have chalked up to bulimia. I underwent an EGD and colonoscopy in late April that were both normal. I do have exercise fatigue but I do not exercise and am not fit. My BP was 120/82. HR 98 sitting. What is your interpretation of the labs? (I know the electrolytes are fine and I'm not sure about the LP-IR or lipid panel). I get the feeling this is probably another normal variant to my EKG; is it at all concerning that there was a change? What are the chances this is actually something serious?