HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Causes Elevated T-wave Along With Numb Left Arm And Nausea?

default
Posted on Sat, 18 Jun 2016
Question: Hello, I've thought I had a back issue of some sort, however, it's been pretty extreme over the last two nights. Last night, it woke me up and I felt weird, so I checked my vitals and got my EKG and I noticed my T-wave was elevated. It looked "peaky", which according to reputable sources, indicated hyperlekemia (Didn't believe it, I believe my kidney is fine). Anyway, it seemed like rotating my back clockwise helped the issue and my EKG went back to normal and I fell asleep. Didn't understand it, but anyway, it happened again tonight but this was far more severe. In addition to this slight numbness in my left arm and face and left midback, I was feeling notably nauseous and feeling weird energy over me and NOT falling asleep. I thought perhaps my spine was touching the spinal cord, causing these nausea feelings, but this time I did the exercise and didn't notice improvement took my EKG and the waveform definitely looked like an elevated T wave, just like yesterday night, but this time it looked "wide" instead of peaky, and the T was much higher than the R which was very small. BPM was 50. I remember from my reading that this differentiated it from hyperkalemia and suggested hyperacute ischemia (STEMI), and so I chewed up 350 mg of aspirin, and the nausea feeling largely subsided within a minute and the EKG went back to normal and my heart was now beating at 90 BPM (Very well could be anxiety). So, I'm a 29 male and I think I had/have a mid-back issue (Nerve pains happen on the left side as obviously caused by my back, suspect at the midpoint because it's usually sore to touch), but this seems rather peculiar. Should I see a doctor? I don't want to pay for the ER (Too poor) and it's too late for urgent care (12:39 a.m.) and I'm 29, so I'm thinking I could just be freaking out about nothing(Anxiety), but the evidence seems compelling in my mind. What are your thoughts?
I forgot to mention, when I woke up yesterday, there was pretty noticeable pain in the midback and chest which prompted the rotational back exercise. There was no super obvious 'back pain/chest pain' tonight like last night (The midback is almost always sore to touch), but the feeling of nausea and weird energy and not going to sleep despite feeling sleepy earlier made me want to check my EKG again which didn't look normal at all (ST elevated, R depressed, just like in the picture). It's always been 'normal' every time I've checked in the past.
doctor
Answered by Dr. Ilir Sharka (58 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that your symptoms are not typical of any cardiac disorder, including myocardial ischemia.

Your symptoms seem to be related to anxiety or musculo-skeletal pain.

I reviewed your reports and would explain that these are non specific ECG changes.

I would like to review a full ECG report in order to be able to give a more professional opinion.

I would not recommend going to the ER, as your symptoms are not indicative of any serious disorder.

Just relax and take a deep breath!

I would recommend consulting with your GP for a careful physical exam and a routine check up:

- a resting ECG (if you have not performed a standard one)
- a chest X ray study
- a cervico-thoracic column X ray study
- some other blood lab tests (complete blood count, PCR, sedimentation rate for inflammation), to investigate for other possible causes of chest pain.

Meanwhile, I would recommend trying ibuprofen for the pain. If your symptoms are partially relieved by this drug, it would be indicative of musculo-skeletal pain.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ilir Sharka (15 hours later)
Thank for your response. I called the doctor and I got an appointment a week from now. I was looking at the EKG webpage at http://lifeinthefastlane.com/ecg-library/st-segment/ , and looking through it, it seems that the LBBB graph most closely resembled the trace I got on my machine. I looked up the causes behind it at https://en.wikipedia.org/wiki/Left_bundle_branch_block, and it seemed peculiar that "Primary disease of the cardiac electrical conduction system" was listed among them. Interesting because I notice that the sore pain(When touched) in the particular mid-back vetebra right behind my heart (It's attached to the third rib from the bottom) is on the left side; I can elicit sore pain here when touched, or when rotating my spine in the counter clockwise direction. Is it possible that a spinal issue here could disrupt the cardiac electrical system and induce an LBBB on the EKG? Would this be something I should be concerned about? The fact the sore pain is on the left side of this one midback vertebra and the EKG graph most closely resembles the Left Bundle Branch Block, I'm thinking that it's affecting left side conduction when I'm laying down.
doctor
Answered by Dr. Ilir Sharka (4 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

I understand your concern and would explain that your symptoms are not related to any cardiac disorder, including any possible conduction disorders.

All your symptoms are suggestive for musculo-skeletal pain or a radicular problem.

The fact that touching the muscles of this region triggers the pain, indicates that this is just muscular inflammation. The heart and heart receptors are too deep and can not be triggered by touching.

From the other side, it is impossible for a spinal issue to cause cardiac conduction block.

You should understand that the information on the Internet is very wide and non specific based on individual features. There are several changes in the ECG, which could be related to different causes (including the wrong position of electrodes, or movement of the electrodes during respiration, etc.).

But the findings on ECG should be persistent on different ECG and in the same leading in order to gain significance. From the other hand they should be correlated to the clinical symptomatology in order to come into conclusions.

I would recommend taking ibuprofen and acetaminophen for the pain. It will help.

Hope you will find this answer helpful!

Regards,

Dr. Iliri
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
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Causes Elevated T-wave Along With Numb Left Arm And Nausea?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I carefully passed through your question and would explain that your symptoms are not typical of any cardiac disorder, including myocardial ischemia. Your symptoms seem to be related to anxiety or musculo-skeletal pain. I reviewed your reports and would explain that these are non specific ECG changes. I would like to review a full ECG report in order to be able to give a more professional opinion. I would not recommend going to the ER, as your symptoms are not indicative of any serious disorder. Just relax and take a deep breath! I would recommend consulting with your GP for a careful physical exam and a routine check up: - a resting ECG (if you have not performed a standard one) - a chest X ray study - a cervico-thoracic column X ray study - some other blood lab tests (complete blood count, PCR, sedimentation rate for inflammation), to investigate for other possible causes of chest pain. Meanwhile, I would recommend trying ibuprofen for the pain. If your symptoms are partially relieved by this drug, it would be indicative of musculo-skeletal pain. Hope you will find this answer helpful! Kind regards, Dr. Iliri