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Does hyperventilating and anxiety cause dip and skipping in heart beat on the stress EKG ?

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
i had t wave abnormalities on resting ekg and took and stress ekg which showed twaves still abnormal and the cardiologist said "now we have a dip also". she has recommended a nuclear stress test and said if that came back abnormal she would send me to the XXXXXXX lab. would a 64 slice scan be suitable intead of XXXXXXX if the nuclear is abnormal? I had an abnomral t wave ekg years ago and the end result was a false positive. I take thyroid meds and blood pressure is controlled with meds. 58 yr old female. I have no chest pain but can feel my hear beat if i indulge in dark chocolate - i am anxiety prone and at times hyperventilate which i could feel happening when i had the stress ekg. should i resort straight to the XXXXXXX lab or try a scan of the nuclear test shows same as the stress test. also can hyperventilating and anxiety cause the changes ( dips and heart skipping) on the stress ekg
Posted Fri, 13 Apr 2012 in Valvular Heart Disease
Follow-up: Does hyperventilating and anxiety cause dip and skipping in heart beat on the stress EKG ? 2 minutes later
my echo showed no abnormality
Answered by Dr. Jasvinder Singh 27 minutes later

Thanks for posting your query. Both the nuclear scan as well as the angiography helps in knowing the status of the coronary arteries.

However, in case the nuclear scan is positive, then an angiography (either the conventional one or the CT angiography) is suggested.

Hence, it makes sense to straight away go for the 64 slice CT scan which should help in knowing the presence and the degree of the obstruction in the coronary arteries and whether any further intervention like the coronary angioplasty is required or not.

The chances of false positive stress EKG’s is more common in females. However, hyperventilating or anxiety doesn’t produce the EKG changes which you’ve mentioned. Good to know that ECHO cardiography is normal.

In my opinion your cardiologist is doing the right thing. I know non interventional procedures like Nuclear stress test are comfortable for anxious people but the doctor and you should be able to take a decision along the cost effective approach. Final call is yours and without your consent your doctor cannot put you under stress.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Does hyperventilating and anxiety cause dip and skipping in heart beat on the stress EKG ? 1 hour later
Thank you for your reassurance in the scan. I have just one additional question.

What are some of the reasons both medical and non medial for t wave abnormalities as well as a "dip". I am also curious to understand if the docs term " a dip" and the ekg techs remark that I have a skip in my hear are the same issue.

thank you again.
Answered by Dr. Jasvinder Singh 11 hours later

T wave abnormalities are very common findings in the EKG. In fact, they can occur even after drinking a glass of cold water.

They are also abnormal in electrolyte abnormalities like hypokalemia.

They are as common. However, they are important and signify the presence of a coronary heart disease if both the limbs of the T wave are symmetrical and they are XXXXXXX and pointed.

The dip means a depression of the ST segment on the EKG during the stress or exercise. This does signify the presence of the coronary heart disease.

However, again there are specific criteria laid down for the ST segment depression to be considered significant. It should be at least 2 mm and flat or down sloping ST segment depression.

The skip in the heart and the dip or the ST segment depression does not mean one and the same thing. I will suggest consulting a cardiologist. I sincerely hope that helps.

Thanks and Regards.
Above answer was peer-reviewed by
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