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Increased heart rate, sweating, odd upper abdominal sensation, have high BP. Are my running days over?

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Practicing since : 1988
Answered : 43 Questions
ST Elevation False Alarm :

I am a 32 year old male with high blood pressure. I take 12.5 mg of Carvedilol twice a day and 12.5 mg of HCTZ once a day. It is usually 116/75 now.

I have battled with anxiety and heart palpitations over the last two years. Two years ago I had an echo – normal except that left wall motion was borderline reduced; EF 53. Normal stress, but my cardiologist put me on bp medicine. In March I started having issues again. Had a stress test with depressed ST waves so they had me do a nuclear stress test, which came back completely normal and I was moved from an ACE to a beta blocker. After a long battle with anxiety I managed to start running again in XXXXXXX and have been up to 3 miles a day since. A few days ago, 30 min after running, I had odd upper abdominal sensations, started sweating, and my EKG. It showed ST elevation. Even though I was asymptomatic for a heart attack, they made me take an ambulance to the ER. My blood work came back normal, so my cardiologist had them release me. I have a follow up next week, and I’m not supposed to run until I see my doctor. Are my running days over? Why did the EKG show MI? If I wasn’t having a heart attack, what’s the problem? Is the fact that my cardiologist decided not to do a heart catheterization a good sign?
Posted Sat, 5 May 2012 in Valvular Heart Disease
Answered by Dr. Gopi A 5 hours later

I have noted the details provided in the query.

All the work up done on you very clearly shows that you DO NOT have any evidence of 'Coronary Artery Disease'. Your blood pressure also appears to be well under control.

ST elevation though is a classical sign of a heart attack, it can be seen in other situations too such as 'Eearly Repolarization Pattern' where the EKG shows ST elevation. Early Repolarization Pattern is considered to be a normal variant seen more commonly in young individuals like you.

I think the symptoms you experienced recently is related to anxiety. However referring you to the emergency room was the right thing to do at that time and I agree to it. We can't be certain unless other tests have been done to to rule out a heart attack. You have been advised not to run as a precautionary measure until the doctor physically checks you up and confirms that all is well.

The fact that the cardiologist did not advise a heart catheterization is a very good sign and would imply that he too feels your EKG changes are a normal variant. You should be back to your running days shortly.

Hope my answer has been useful and reassuring.

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