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Suggest Treatment For Recurrent Chest Pains

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Posted on Fri, 24 Jul 2015
Question: I I am having chest pain on and off. I have had multiple ecgs in past three days. Two of them were normal and one showed lvh. The next one showed intra ventricular conduction delay. One month ago my ecg and echo and tmt was normal. What does the recent ecg mean? My doctor says it is fine. But I am very scared.
doctor
Answered by Dr. Priyank Mody (31 minutes later)
Brief Answer:
All is well with your heart, consider reflux gastritis / cervical compress

Detailed Answer:
Dear XXXX. I do understand your concern about the pain.

For a 27 year old male who has a normal ECG, echo and tmt, it is highly unlikely that you have chest pain of cardiac origin. So please don't worry for the same.
As serial ecg are normal again the pain presently doesn't seem like of cardiac origin.
LVH means left ventricular hypertrophy, it's seen in patient for long standing hypertension, which is confirmed by echo. So when you said your echo was normal it meant that the ECG has been mis-interpreted by the machine due to change in lead placement by the sister who tool the ECG.

If you have cervical problem which your previous questions mention, do get an MRI cervical spine with whole spine screening to sort it out once and for all.
Apart from cervical problem, I think you have a component of reflux gastritis, where stomach acid may spill over in the food pipe causing all symptoms you have been describing.
So consider it to be discussed when you meet your doctor again.

Regards Dr XXXXXXX mody
I again reassure everything is fine with your heart

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Priyank Mody (23 minutes later)
What does non specific intraventricular conduction delay no lbbb/hbbb mean in my recent ecg. Is it something to worry about or normal?
doctor
Answered by Dr. Priyank Mody (11 minutes later)
Brief Answer:
Mostly the diagnosis is machine misinterpretation.

Detailed Answer:
As I said most probably the ecg leads were not placed at the most perfect position , so machine interpretation went wrong. I would say that for normal ecg it's ok, for abnormal one the machine is wrong 40% of time. Because in one day these things don't develop. If your previous ecg is normal, LVH and conduction defect can't occur in a single day so be reassured.
However I will help interpret the ecg for you if you can upload all ecg for me.
Also incomplete conduction defect s are mostly not relevant and a normal phenomenon.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Priyank Mody (15 minutes later)
Here are my most three recent ecgs. I had one more done yesterday which was normal,but I do not have a copy of it now.
doctor
Answered by Dr. Priyank Mody (2 hours later)
Brief Answer:
all three ecg s attached are normal

Detailed Answer:
i have been through all three ECG , they are all normal . the one which says conduction defect is also normal , its just the lead V1 was not properly placed . also you must have read the machine interpreted the ecg considering you more than 50 years , so its diagnosis dont stay valid , so dont worry my friend , your heart is all good .
If at all your symptoms are very severe get a upper GI endoscopy and review with me or your gastro doctor ,i think here the stomach might be he culprit .
Take care .
Regards Dr. Priyank Mody , XXXXXXX
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Priyank Mody (30 minutes later)
Thank you doctor, this was such a relief. I was very worried with ECG results. The doctor I went to gave me acidity medicines along with b12 injections since it was low. I am also taking vitamin D since it was also low. I had gone through and endoscopy last year and had erosive gastritis which was then healed but on and off I have had digestion problems.
I was worried because the pain this time was kind of different then usual gastritis pain and on Monday I had severe left arm pain and again a ECG was repeated which was normal along with normal troponin I,my cervical xray was also normal. Now from past one day the pain is on right side above breast area and is burning in nature. It comes when I stand or walk and subsides when I sit or lie which made me panic.
I guess all this is exacerbated by my negative thinking.
Thank you again for explaining the ECG's.
doctor
Answered by Dr. Priyank Mody (13 minutes later)
Brief Answer:
Happy to know you are relieved

Detailed Answer:
I am happy I could help,
Remember that anxiety with exacerbate all the symptoms you may have, so try staying calm in such situations, you can always clear your future doubts by asking rather than allowing it to grow in your head.

No rpt endoscopy is needed if done previously

And for cervical spine, MRI spine would be the best investigation, because we want to see the nerve and the disc between the vertebrae so these are soft tissue visualised best with mri, do ray and ct scan gives the picture of bone which at your age is mostly normal with no degeneration.
Take care friend.
For all future queries, you can send a direct question to me through HCM. Regards
Dr XXXXXXX mody
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Answered by
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Dr. Priyank Mody

Cardiologist

Practicing since :2009

Answered : 918 Questions

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Suggest Treatment For Recurrent Chest Pains

Brief Answer: All is well with your heart, consider reflux gastritis / cervical compress Detailed Answer: Dear XXXX. I do understand your concern about the pain. For a 27 year old male who has a normal ECG, echo and tmt, it is highly unlikely that you have chest pain of cardiac origin. So please don't worry for the same. As serial ecg are normal again the pain presently doesn't seem like of cardiac origin. LVH means left ventricular hypertrophy, it's seen in patient for long standing hypertension, which is confirmed by echo. So when you said your echo was normal it meant that the ECG has been mis-interpreted by the machine due to change in lead placement by the sister who tool the ECG. If you have cervical problem which your previous questions mention, do get an MRI cervical spine with whole spine screening to sort it out once and for all. Apart from cervical problem, I think you have a component of reflux gastritis, where stomach acid may spill over in the food pipe causing all symptoms you have been describing. So consider it to be discussed when you meet your doctor again. Regards Dr XXXXXXX mody I again reassure everything is fine with your heart