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Dizziness, nausea, cold sweating, pain in chest and arm. ECG normal. Why?

I was in the ER brought by Ambulance for Severe chest/arm/hand pain.left side of face numb, shoulder , Left side and stomach was nausea , pain cramping. They did a ECG ran blood work, lost blood work lost urine, kept me on heart monitor 3 hrs.Came in told me ECG was normal, labs normal. They thought I was backed up I have a mal-rotated intestine, colan on left, small intestine on right and polyslenia,my intestines been sluggish since I hit 50 yr but with fiber , water exercise, and occasional Maralax Im fine,,this was new stomach pain with chest pain. They said go home take extra Maralax follow with my Dr. MyChart electronic file has a Edited abnormal ECG, probable LVH and artifact. I m still dizzy , nausea, sob always cold sweating, chest , arm sudden pain, my Dr is ignoring ECG findings as normal for me Why She said it made sense because I have several thyroid nodules , scoliosis in thoracic lumbor, maltreated intestine and mitral valave regurgitation moderate so ER doc said all is normal. But Cardiologist who read ECK added it edited to my Chart so all Drs can see it, it says Abnormal LVH and pain continues.. mo treatment Thank you
Asked On : Tue, 4 Dec 2012
Answers:  1 Views:  285
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Cardiologist 's  Response
Thanks for writing in.
I am a qualified and certified cardiologist and I read your mail with diligence. Patients are brought to ER with chest pain first and foremost priority for them is to rule in or rule out a heart attack. The criteria cardiologist follow to diagnose a myocardial infarction or acute coronary syndrome are two out three are abnormal (supporting the diagnosis of ischemic heart disease not supporting are called normal whether they support other conditions like hypertension with left ventricular hypertrophy as was in your case will be called "normal" keeping in mind it is ischemic heart disease you are looking for in ER):
1. Typical chest pain retro sternal, central squeezing, associated with shortness of breath, radiating to neck or left arm, associated symptoms like sweating may be present.
2. EKG changes suggestive of ischemia that is ST changes elevation to begin with associated with upright T later on ST settling with T wave inversion and appearance of q wave
3. Cardiac enzymes elevation serum myoglobin, serum creatine phosphokinase myocardial fraction CPK-MB or Troponin T or I quantitative assay.
If two out three criteria are met a diagnosis of acute mayocardial infarction is made. Oher reports are called atypical or normal it is the purpose of 'sorting out' patients who need immediate treatment. Others are assigned to less acute urgency of treatment and perhaps erroneously called "normal". In the emergency errors like yours can occur in the endeavor to identify and help those who need it first. I am only giving explanation for your interpretation which is slightly different from mine, the emergency doctor had labelled a cardiac patient who also needs attention (not on high priority as the first doctor thought : an unintentional error of judgement perhaps which was corrected by a supervising cardiologist). I hope will understand nothing was an intentional and negligence. With Best Wishes.

Dr Anil Grover
Answered: Sat, 22 Dec 2012
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