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What Causes Cardiac Blockage?

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Posted on Fri, 17 Jul 2015
Question: Just admitted to hospital...started with chin and weird neck pain about 1pm.

Went to er about 7pm as doc recommended I get check because I had another hemorrhaging episode on Thursday (under control now, no meds so XXXXXXX finally working but 7 hours of heavy bleeding) and they were going to release me and then er doc came back and said he showed ecg to cardiologist who suggested I be admitted and have a heart XXXXXXX done.

They found another ecg from Feb and saw the same thing but was a copy and hard to see apparently. The issue (took pics while they weren't looking) was low qrs (will attach pic) number was 62ms I think.

Cardiologist via er said might be blockage but er doc says no risk factors, am 45 & had 48 hr holter, echo and reg stress test in Feb of this year all normal. So they did 2nd ecg at 10pm, it was normal. Now in room terrified.

My questions: how likely is this to be a blockage? What else could cause it to show that. Can I do a nuclear stress test, instead? I'm terrified of the heart XXXXXXX & if it is a blockage what will happen to me? If a nuclear stress test was to be clear would that mean I dont have a blockage? Would reg stress test be enough? What would you recommend for me?

Also just found out from nurse that blood work was normal for cardio stuff - triponon was negative - but am now slightly anemic hemoglobin 11.5, hemotacrit 36.2, red blood cells 3.96 ...I'm usually on the high end of the scale and all now lower. Didn't know if that could contribute to the issues..
doctor
Answered by Dr. Benard Shehu (1 hour later)
Brief Answer:
Following advice.

Detailed Answer:
Hi and thank you for asking!
I read your query and understood your concerns.

Since your ECG has an abnormal patern that was also present on february, the cadiac troponins are negative show that you have a low probability to have cardiac blockage.

However cardiac examinations should be done to definitely exclude cardiac issues. Because if you have a blockage it will cause chest pain and infarction.

If you were my patient I would recommend to do the following examinations :
- cardiac nuclear stress
- cardiac ct angiography
This examinations will definitely exclude cardiac blockages.

Hope this was of help!
Wish you health!
Dr.Benard
p.s if you have more questions, please don't hesitate to ask me again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (22 minutes later)
would a reg stress test be ok and is the cardiac ct angiography non invasive? is that a CT with contrast dye?

also...nurse seems to think might be from being in chair position for ecg (was in chair for one in Feb too) and found out the doc "thinks" it was there ecg did not note it.

they are planning to do another ecg in morning...what are your thoughts if that one is normal? second cardiac enzyme test was negative as well. on monitor now and they said so far it's been perfect.

thanks for your advice.
doctor
Answered by Dr. Benard Shehu (11 hours later)
Brief Answer:
Following advice...

Detailed Answer:
Hi back,

Yes a regular stress test is ok for further examinations and it's a good start. Ct cardiac angiography is a non invasive examinations (it's only a heart CT with contrast dye) that it's very helpful to exclude coronary blockage.

Yes the finding on ECG may be related to standing position. However i need to have the ecg image before reaching a conclusion.

It's a good thing that the second ecg and troponins were normal this is a strong evidence against any coronary blockage.

Wish you a fast recovery!
Dr. SHehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (2 hours later)
had 3rd ecg which was normal, 3rd triponin was negative and then had nuclear stress test via treadmill. doc said that I passed with flying colors and my heart is "GREAT!"

Believes that first ecg should never have been anything (he's a cardiologist and FACC at heart center downtown) and wasn't read properly by er doc.

he says after the tests this morning...did 100% hr and was on treadmill for 10 mins and recovered well that there is a less than 1% chance of a blockage and less than 1% chance of heart attack in near future.

thank you for your advice. ..was in hospital and alone and very scared.
doctor
Answered by Dr. Benard Shehu (7 hours later)
Brief Answer:
It's a great thing that all test were normal.

Detailed Answer:
Hi back,
It's a great thing that your test ecg and troponine were normal. This definitely exclude any ongoing cardiac issues.

Wish you a fast recovery!
Dr. Shehu
P.s : if you are satisfied with my answer please close it and rate to maximum.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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What Causes Cardiac Blockage?

Brief Answer: Following advice. Detailed Answer: Hi and thank you for asking! I read your query and understood your concerns. Since your ECG has an abnormal patern that was also present on february, the cadiac troponins are negative show that you have a low probability to have cardiac blockage. However cardiac examinations should be done to definitely exclude cardiac issues. Because if you have a blockage it will cause chest pain and infarction. If you were my patient I would recommend to do the following examinations : - cardiac nuclear stress - cardiac ct angiography This examinations will definitely exclude cardiac blockages. Hope this was of help! Wish you health! Dr.Benard p.s if you have more questions, please don't hesitate to ask me again.