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What Do These ECG Findings Indicate?
Question: Hello, i've been having some sharp pain in my left side under my armpit and a little under the left side of my left breast. This pain carries into the bottom of my left shoulder blade. The pain seems to take turns where the "epicentre" is. For some time it will feel like it's radiating below my left shoulder blade (like right now), other times it will feel like it's radiating from under and below my left breast. Massage and a heating pad helps a bit as well as advil. My ECG 2.5 years ago (sent because of what they diagnosed as a panic attack) came back as 1st degree heart block even though I was only 19 and not an athlete. I'm 21 now and all further ECG's have come back positive for first degree block. My blood pressure today is 106/68 and my pulse has been at 90-110 bpm RESTING for the last 3-4 days. My normal resting heart rate is supposed to be 72. Echocardiogram came back normal 2.5 years ago as did a stress test. I've been driving myself crazy still thinking that my discomfort is heart related. I get random heart palpitations at times and my chest will randomly feel tight from time to time. I do have anxiety issues, but I've noticed that the anxiety comes after the heart area discomfort, not the other way around.
Brief Answer:
I would recommend as follows :
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would explain that the pain you refer doesn't seem to be related to any cardiac disorders.
The pain characteristics are typical of a musculoskeletal pain (possible bursitis, cervical column disorders, etc.) and exclude any cardiac disease ( including cardiac ischaemia).
I your pain modulated by the posture changes or body movements? This would be very indicative for a musculoskeletal pain.
The fact that your symptoms are relieved by painkillers and hot pads is another argument in favour of this diagnosis.
Regarding your ECG findings, after reviewing your ECG records, I would explain that this type of conductance block has no clinical significance (is not indicative of a cardiac disease).
Anyway it should be monitored with periodically scheduled follow up every 6-12months with ECG and cardiologist consult.
From the other hand, the increased heart rate may be related to different disorders like : anemia, infection or inflammation, thyroid dysfunction, anxiety, cardiac arrhythmia, etc.
In this situation I would recommend consulting with your GP for a careful physical examination, a resting ECG, chest X ray study and some blood lab tests :
- complete blood count (for anemia or infection)
- PCR and sedimentation rate (for inflammation)
- fasting glucose levels
- kidney and liver function tests
- blood electrolytes
- thyroid hormone levels.
An ambulatory 24 to 48 hours ECG monitoring is necessary to examine your heart rhythm trends during the day and exclude possible cardiac arrhythmia.
A cervical column X ray study, a shoulder Xray study and ultrasound (for the soft tissues), followed by a nerve conduction study ( to investigate for nerve compression ) and a possible MRI of the shoulder are necessary to investigate for the cause of your pain.
Meanwhile I recommend you to continue taking painkillers and using warm pads.
Physiotherapy seems to be helpful for the pain.
Hope to have been helpful!
Feel free to ask for any other questions whenever you need!
Greetings!
Dr. Iliri
I would recommend as follows :
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would explain that the pain you refer doesn't seem to be related to any cardiac disorders.
The pain characteristics are typical of a musculoskeletal pain (possible bursitis, cervical column disorders, etc.) and exclude any cardiac disease ( including cardiac ischaemia).
I your pain modulated by the posture changes or body movements? This would be very indicative for a musculoskeletal pain.
The fact that your symptoms are relieved by painkillers and hot pads is another argument in favour of this diagnosis.
Regarding your ECG findings, after reviewing your ECG records, I would explain that this type of conductance block has no clinical significance (is not indicative of a cardiac disease).
Anyway it should be monitored with periodically scheduled follow up every 6-12months with ECG and cardiologist consult.
From the other hand, the increased heart rate may be related to different disorders like : anemia, infection or inflammation, thyroid dysfunction, anxiety, cardiac arrhythmia, etc.
In this situation I would recommend consulting with your GP for a careful physical examination, a resting ECG, chest X ray study and some blood lab tests :
- complete blood count (for anemia or infection)
- PCR and sedimentation rate (for inflammation)
- fasting glucose levels
- kidney and liver function tests
- blood electrolytes
- thyroid hormone levels.
An ambulatory 24 to 48 hours ECG monitoring is necessary to examine your heart rhythm trends during the day and exclude possible cardiac arrhythmia.
A cervical column X ray study, a shoulder Xray study and ultrasound (for the soft tissues), followed by a nerve conduction study ( to investigate for nerve compression ) and a possible MRI of the shoulder are necessary to investigate for the cause of your pain.
Meanwhile I recommend you to continue taking painkillers and using warm pads.
Physiotherapy seems to be helpful for the pain.
Hope to have been helpful!
Feel free to ask for any other questions whenever you need!
Greetings!
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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