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    Suggest treatment for severe arm pain

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Posted on Mon, 7 Aug 2017 in Accident and Emergency
Question: I was at the doctor the other day for pre surgery clearance and they said that I had a normal ekg so they had me get another one and said that was abnormal too and that I needed cardiac clearance since I may have had a heart attack. I did have an episode of chest and arm pain that was so intense I went to the ER but they did an ekg and a set of enzymes and said it was normal. I uploaded the ekgs. What do u think?Oh and img1097 was from January. The others were from march
doctor
Answered by Dr. Erion Spaho 2 hours later
Brief Answer:
Seems no miocardial infarction there.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

I examined the ECG's you uploaded too.

Even if I'm not a Cardiologist, I don't see any clear sign of myocardial infarction, there seems to be a j-wave syndrome pattern in some of the leads.

However, only ECG result is not conclusive if you should have surgery or not.

Other aspects to consider include your age, degree of physical activity, type and duration of surgery, obesity or not, any allergies, etc.

Besides Cardiologist's opinion, your Surgeon and your Anesthesiologist should speak the last word if you should have surgery or not.

Getting a further evaluation by the Cardiologist about possible j-wave syndrome is necessary, because it may result in complications outside the anesthesiology and surgery.

In some cases j-wave on ECG is related to hypercalcemia (high calcium blood levels).

In my opinion, at your age, the possible complications rates due to surgery and anesthesiology should be minimal.

Hope you found the answer helpful.

Take care.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Erion Spaho 26 minutes later
Which leads do you see j waves? Im not sure why a cardiologist at my hospital looked at the ekg and said septal infarct. He looked at an ekg from march 2 and said that compared to that there is now a septal infarct present. But I don't have that Ekg and I did not see him in person. Do all of the ekgs look similar? And why would j waves just start appearing now? I have gone through so many cardiac tests and they were fine until recently. Now doctors seem concerned.
doctor
Answered by Dr. Erion Spaho 16 hours later
Brief Answer:
At V1-V3

Detailed Answer:
Hello again.

J-waves seems to be identified at V1-V3 leads.

In some cases j-waves are related to the hypercalcemia, so, this possibility should be evaluated further in my opinion.

I think you should get a second opinion by another Cardiologist and it is better to have all ECG-s with you.

Hope I helped you.

Kind regards.
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3850 Questions

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