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Overweight. Taking treatment for anxiety. ECG showed ST and T wave abnormality. Any thoughts?

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General & Family Physician
Practicing since : 2009
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I went to the ER with what turned out to be a panic attack - I am treated for anxiety -I exercise frequently but still hold extra weight. I had a complete battery of tests done - ECG, Chest XRay, Full blood work up including all heart, liver enzymes etc. The ER Dr. told me that everything was fine and I was in great health except dehydrated from working outside and my obvious panic attack. I have since been to my PCP and told him, he re-checked me, except for ECG and said I was healthy but we had to control anxiety. However, the ECG printout from the ER says "ST and T wave abnormality, consider inferior ischemia" -what does this mean - he signed off on it as I was healthy! This ECG was done when I was calming down from having a panic attack and these are the numbers Vent Rate 95 BPM, PR Interval 138ms , QRS duration 100 ms , Qt/Qtc 346/435 ms, and P-R-T axes 63 79 -8 . ....I am 33 years old and in other wise great health - former football player
Posted Mon, 4 Mar 2013 in Anxiety and Stress
Answered by Dr. Shoaib Khan 2 hours later

Thank you for your query.

Almost 20-25% of patients who present with chest pain to the ER have panic disorder. You should know that a panic disorder has various mechanisms. The one I am going to discuss is the cardiac mechanism. In this, a panic attack causes autonomic activation and hyperventilation (rapid or XXXXXXX breathing) which can lead to a coronary artery spasm (which is temporary). This spasm can lead to ischemia and chest pain.

Ischemia is the restriction of blood supply to tissues. As I have explained above, the ischemia in your case was caused due to the panic attack, and will subside a while after you calm down.

You ECG also suggested ischemia, which can be possible due to the above-explained mechanism, and would have subsided by now.

Do not worry, you are healthy, and should just focus on treating the anxiety. Do write back to me for any further clarifications.

My best wishes.
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