Brief Answer:
I would explain as follows:

Detailed Answer:

Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would like to explain that, it is important to review all your already performed medical tests.

As when facing with a chest pain symptomatology, it is necessary to perform a differential diagnosis, I suppose that the ER doctors have already clarified the most important issues such as the three major acute chest syndromes (acute coronary syndrome, acute aortic syndrome, and acute pulmonary embolism). As you are discharged from the hospital they are excluded for sure.

Regarding your cardiac conductance disturbance (Mobitz II AV block), I would explain that facing your young age, several factors leading to such a disorder should be investigated: an inflammatory disorder (Lyme disease, myopericarditis,etc), a congenital cardiac conductance disturbance, a systemic disease such as sarcoidosis, etc.

But first, could you upload for a direct review your ECG recordings?? And what about the other checked medical tests?

If only a transient episode of Mobitz II block has been noted, then an ambulatory 24 to 48 hours ECG monitoring is necessary for a better cardiac conductance study.

If Grade II Mobitz II AV block really exists, then a comprehensive differential diagnosis accounting for the above mentioned possibilities should be performed.

You should discuss with your attending physician about these possibilities.

Hope to have been helpful to you!

I am at your disposal, whenever you have further issues to discuss!

Best regards,

Dr. Iliri

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Brief Answer:
Several medical tests should be reviewed

Detailed Answer:

Hi again!

Your uploaded lab tests seem generally OK!

Only some small changes (such as total protein, etc)

But, what I would consider important is your ECG recordings (confirming that AV block) and especially ambulatory ECG monitoring.

Several imagine tests, like cardiac ultrasound, chest X ray study, chest CT or MRI, etc. are helpful to differentiate the right cause of your chest pain complain, as well as to elucidate any obvious etiologies of your cardiac conductance disturbance.

If you could upload any of the above for a direct review??

Best wishes,

Dr. Iliri

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Brief Answer:
A stepwise differential diagnosis should be done.

Detailed Answer:
Hi!

When dealing with chest pain, imagine studies are necessary for a comprehensive differential diagnosis. You need to discuss with your attending doctor about all the above mentioned medical tests.

If you have performed any, please upload it for review!

So, my opinion is to primarily investigate that Mobitz II AV block. If it is confirmed by any ECG recordings or ambulatory ECG monitoring (Holter), then a differential diagnosis for the underlying cause should be done.

I am at your disposal if you have further uncertainties for this issue or others, as well!

Regards,

Dr. Iliri

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