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What Does My Lab Test Report Indicate?
Question: I am a 52 year old woman in generally good health. Today, during my EKG, my doctor indicated I have a minor inverted t-wave that requires a trip to the cardiologist. This inversion was not there during my last EKG. My vitals were generally good (112/72, 115lbs). The doctor indicated that medications could help this or a stent. She indicated this could be stress related (I just took a new position at work which is stressful right now) or could just be a muscle spasm. How worried should I be?
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would explain that a minor T-wave inversion is not always an indicator of any serious cardiac ischemia, especially in women of your age.
To conclude about a possible coronary artery disease, it is necessary that a significant clinical symptomatology with certain characteristics of chest pain (or other similar equivalents like dyspnea in diabetic patients) be present coupled with specific ischemic ECG changes.
It is not rarely that in early menopausal women several forms of chest pain symptomatology and ECG changes raise concern about the present of cardiac issues, but in fact the result being only false alarms.
It is well known chest pain symtomatology and ECG abnormalities, even with a positive cardiac stress test but with normal coronary arteries (resulting from coronary angiography) in this special population.
This has been traditionally called "syndrome X".
So, nothing to worry about!
If you have not evidence of any coronary risk factors (diabetes, smoking, dyslipidemia, smoking, hypertension, etc.), that ECG finding doesn't signify anything.
So relax and do not worry about it!
Could you please upload your ECG and explain me in more details any possible complaints?
Hope to have been helpful!
Greetings!
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would explain that a minor T-wave inversion is not always an indicator of any serious cardiac ischemia, especially in women of your age.
To conclude about a possible coronary artery disease, it is necessary that a significant clinical symptomatology with certain characteristics of chest pain (or other similar equivalents like dyspnea in diabetic patients) be present coupled with specific ischemic ECG changes.
It is not rarely that in early menopausal women several forms of chest pain symptomatology and ECG changes raise concern about the present of cardiac issues, but in fact the result being only false alarms.
It is well known chest pain symtomatology and ECG abnormalities, even with a positive cardiac stress test but with normal coronary arteries (resulting from coronary angiography) in this special population.
This has been traditionally called "syndrome X".
So, nothing to worry about!
If you have not evidence of any coronary risk factors (diabetes, smoking, dyslipidemia, smoking, hypertension, etc.), that ECG finding doesn't signify anything.
So relax and do not worry about it!
Could you please upload your ECG and explain me in more details any possible complaints?
Hope to have been helpful!
Greetings!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your quick response. I had a second ECG at Sherman Hospital where the T-wave was no longer inverted. Lots of questions on the validity of the first test because they didn't have any leads below the waist. In any event, I uploaded the new ECG and there are new concerns on Incomplete Right Branch Block. With the QRS at +90ms (which still seems in spec from what I read) and an S-wave at +40 ms (if I'm reading V3/V4 correctly, it looks to be just a smidge over 40ms (but I'm not an experienced EKG reader). My BP was 140/110 by the time of this EKG (because I was very nervous after what my GP had said). Can stress cause the out-range readings?
Brief Answer:
Please try to upload again.
Detailed Answer:
Hi again,
I can't find any uploaded ECG reports. There must have been a problem.
Please would you try once more to upload the ECG records?
An incomplete right bundle branch block doesn't signify anything important, out of a certain clinical context.
So relax!
Nothing to worry about!
Waiting for your upload,
Regards,
Dr. Iliri
Please try to upload again.
Detailed Answer:
Hi again,
I can't find any uploaded ECG reports. There must have been a problem.
Please would you try once more to upload the ECG records?
An incomplete right bundle branch block doesn't signify anything important, out of a certain clinical context.
So relax!
Nothing to worry about!
Waiting for your upload,
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Report should be loaded now. Do you think there is anything else to worry about? V2 looks very "noisy", and perhaps that was just the lead. Thanks again.
Brief Answer:
A cardiac ultrasound would be advisable.
Detailed Answer:
Hi,
I reviewed your uploaded ECG.
Besides an incomplete right bundle branch block, there is nothing else to worry about.
You are right about V2. Oscillations of baseline are just artifacts.
I recommend performing a cardiac ultrasound (ECHO) to conclude a normal overall cardiac structure.
Best wishes,
Dr. Iliri
A cardiac ultrasound would be advisable.
Detailed Answer:
Hi,
I reviewed your uploaded ECG.
Besides an incomplete right bundle branch block, there is nothing else to worry about.
You are right about V2. Oscillations of baseline are just artifacts.
I recommend performing a cardiac ultrasound (ECHO) to conclude a normal overall cardiac structure.
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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