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Having shortness of breath and feeling heaviness in chest. EKG showed equivocal scar. What's wrong?

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Practicing since : 1981
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I have been having shortness of breath, clamminess, heavy chest feelings upon exertion, sinus tach. Pcp says I have equivocal scar on two ekg's performed within days of each other. However, E.R. says ekg is normal. Today had echo. What could be wrong?
Posted Tue, 4 Dec 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 50 minutes later
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail with diligence.
When some one says 'equivocal' scar it surely does not mean un equivocal old myocardial infarction(MI Heart attack). Generally, among normal poplation of your age group do develop silent MI roughly in 2% of population per year. But, in those cases ECG shows unequivocal evidence of scar. If the first reading is right then echocardiography will show area of hypokinesia and possibly dyskinesia, referred as regional wall motion abnormality (RWMA) that would confirm that you have had a silent MI some months to years ago. If ER doctor is right you will have only findings of hypertension that is Left Ventricular Hypertrophy (thickening of walls of the ventricle) with Diastolic Dysfunction. This diastolic dysfunction means heart is stiff and inability to fill efficiently when it should. That leads to back pressure increase in veins bringing oxygenated blood from lungs (Pulmonary Venous Hypertension). This is responsibe for all the symptoms you are having. Treatment is optimal control of blood pressure and your doctor may like to add a diuretic, specially during winter months. If you have any question to follow, I will be most happy to answer. Good Luck.

With Best Wishes:

Dr Anil Grover
MBBS, MD (Medicine) DM(Cardiology)
Cardiologist and Internist
http:/ WWW.WWWW.WW
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