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    Suggest treatment for arm pain, chest discomfort and shortness of breath

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Posted on Fri, 4 Aug 2017 in Hypertension and Heart Disease
Question: In march I went to the hospital for arm pain and chest discomfort. I had been having issues with tachycardia and shortness of breath for a long time and they had been trying to get me a cardiac MRI but when I showed up at the office complaining of chest pain they decided to keep me over night and get the MRI. When I got there they did an ekg and some blood work and kept me over night for 2 days. They did the MRI but never did another ekg or more blood work. Yesterday I went for an ekg for pre surgery and it said I had a septal infarct. So they brought me into the office again today and they said the ekg again showed an infarct but I think they said anterior or something. So now they canceled my surgery and have to see a cardiologist for clearance. My mind is spinning. I felt that when I was at the hospital they just blew me off and now they are telling me I might have had a heart attack?? Why didn't they test me more when I was there? Could they have done something to help me more? What does this mean now? If it was a heart attack when do they clear for surgery? I am. 35 year old female. Healthy weight. Former smoker -quit 13 years ago. Grandfather had several heart attacks. How long does pain last with a heart attack? Like what makes the pain finally stop?
doctor
Answered by Dr. Bhanu Partap 2 hours later
Brief Answer:
Please clarify a few things.

Detailed Answer:
Hello Ma'am

After going through the medical details provided by you I can understand your concern.

Before I proceed any further I would like some more details:
1. What surgery were you supposed to undergo?
2. Are you a diabetic?
3. Do you have hypertension?

Also I would like to see the EKG, blood reports and MRI report which was done in March and also the EKG which was done yesterday.

Kindly label all the reports properly and upload them from your dashboard for me to review them so that I can guide you properly.

Kind regards
Dr Bhanu Partap
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Bhanu Partap 1 hour later
I don't have any copies of anything yet. I am getting them tomorrow. I was getting a knee arthroscopy. I do not have diabetes or hypertension . cardiology said they thought I had POTS so they told me to take salt tablets and that really helped with the tachycardia and dyspnea. So if they think I had a heart attack what will they do now? Does it take long for clearance for surgery? Why wouldn't it show if I was having a heart attack when they did the EKG at the hospital? And is a septal infarct bad? I will upload those tests when I get the copies tomorrow. I just needed to hear something about this from a doctor because I am so overwhelmed by this right now
doctor
Answered by Dr. Bhanu Partap 8 minutes later
Brief Answer:
Hello Again

Detailed Answer:
First of all as you are a young female so it's not unlikely to have a heart attack in this age group not impossible (female gender do have a natural protection against coronary artery disease till menopause).

That has to be confirmed first probably by running some tests like Echocardiography or stress test like TMT.

Clearance for surgery will completely depend upon the results of those tests.

ECG machines give their own interpretations which are not reliable most of the times and needs clinical co relations so don't just go with with comes printed on the report, let your cardiologist evaluate it for you.

Any infarct in heart is not good and need long term medical support.

Don't worry just relax, think positive and I believe results will be in your favour.

Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Bhanu Partap 18 hours later
Ok I uploaded my MRI report and the ekgs I had when I was in the hospital on March 7th and then the EKGs I had Wed and Thurs. Please let me know what you think.

I also wanted to ask how long does it take for a heart attack to show up on a MRI?
doctor
Answered by Dr. Bhanu Partap 3 hours later
Brief Answer:
Hello again

Detailed Answer:
I think the reports which you were trying to upload didn't get uploaded.

Kindly retry uploading the reports from your dashboard. Otherwise, you can also email them to YYYY@YYYY by keeping the Subject as ATTN:Dr Bahnu Partap and I'll receive them.

Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Bhanu Partap 28 minutes later
Ok I sent them. Hopefully that works
doctor
Answered by Dr. Bhanu Partap 5 hours later
Brief Answer:
Thanks for the details

Detailed Answer:
Got all you reports and after reviewing them carefully i would like to tell you that the ECG which was done on 07 march 2017 and the ECG which was done on 12 and 13 july 2017 are nearly similar with no fresh or significant differences.

Now you MRI was done on 08 march 2017 after a day of your first ECG and the report of your MRI was normal with no evidence of any heart attack (MRI is a highly sensitive test which can detect even an impending heart attack due to detection regional wall motion abnormality). Which signifies that you didnt have had any heart attack back then.

As your recent ECG is almost similar with the previous one which excludes the possibility of any recent attack.

However to confirm this its advisable that you should go for a Stress Echocardiography. And probably your will also advise the same to give you clearance for surgery.

Also considering your young age group the possibility of you having a heart attack is low.

As i said earlier the findings that comes out printed on the ECG are never 100% correct and always needs conformation from a cardiologist.

I hope this information will be helpful. Feel free to ask if you have any more doubts or else you can close the discussion and kindly rate the answer.

Kind Regards
DR Bhanu Partap
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Bhanu Partap 9 hours later
Just another question. A cardiologist at my hospital compared it to an ekg from march 2 and signed it as a septal infarct but I don't have access to that one so I uploaded one from XXXXXXX . Its the one labeled img . I don't know if that makes a difference. And another cardiologist mentioned something about concern for brugada syndrome?
doctor
Answered by Dr. Bhanu Partap 3 hours later
Brief Answer:
Hello Again

Detailed Answer:
Ma'am if you would have had a heart attack then your MRI would have reported it and also those were nonspecific ST-T changes which do not correlate with an attack.

No, ma'am, I didn't find any of your ECG fittings into Brugada ECG criteria.

Kind Regards
Dr Bhanu Partap


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Dr. Bhanu Partap

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Practicing since :2010

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