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What do chest discomfort and breathlessness indicate as per the attached image?

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Posted on Fri, 27 Jul 2018
Question: Dear Dr

Yesterday my wife was having chest disconfort and difficulty in breathing which went away aftet sometime. This happened soon after she returned from a court case regarding disputed land among the family.
Later i took her to a internal medicind Doctor who were available at the local hospital. I requested for ECG snd cardio profile. But he suggested do ECG and if tequired will do Cardiac profile.
After viewing the ECG he concluded it was normal.
I am sending the photo if the ECG to you as you are a heart specialist just to verify the ECG.
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello!

Welcome on HCM!

I passed carefully through your concern and would like to explain that all three uploaded ECG strips have normal repolarization patterns.

No presence of cardiac ischemia signs could be found.

Only a right deviation of the QRS axis in the horizontal plane could be seen (possibly explained by a chronic pulmonary disorder, or chest structure variant).

Nevertheless, resting ECG is not a 100% sensitive test and sometimes it doesn't reveal ischemic changes in certain individuals.

Coming to this point if the chest pain is highly suspicious of cardiac ischemia (considering its characteristics: compressing, squeezing, burning pain in the middle chest potentially irradiating to the neck, lower jaw or the arms, which is not modulated by palpation, respiration of body movements, increasing with physical exertion, etc), especially when coronary risk factors are present (like hypertension, diabetes, dyslipidemia, close smoking contact, and heredity for premature coronary disease), then a full cardiology review should be done, including:

- cardiac enzymes (CK - MB, Troponin),
- cardiac ultrasound,
- chest X ray study,
- complete blood count,
- thyroid hormones level,
- liver and renal function tests,
- fasting blood glucose,
- HbA1C,
- blood lipid profile,
- uric acid


Only after excluding all the above mentioned alternatives anxiety disorders (a panic attack) could be blamed for her recent clinical symptomatology.

You have to discuss with her attending physician on the above mentioned issues.

Hope to have been helpful to you!

In case of any further questions, feel free to ask me again.

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8188 Questions

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What do chest discomfort and breathlessness indicate as per the attached image?

Brief Answer: My opinion as follows: Detailed Answer: Hello! Welcome on HCM! I passed carefully through your concern and would like to explain that all three uploaded ECG strips have normal repolarization patterns. No presence of cardiac ischemia signs could be found. Only a right deviation of the QRS axis in the horizontal plane could be seen (possibly explained by a chronic pulmonary disorder, or chest structure variant). Nevertheless, resting ECG is not a 100% sensitive test and sometimes it doesn't reveal ischemic changes in certain individuals. Coming to this point if the chest pain is highly suspicious of cardiac ischemia (considering its characteristics: compressing, squeezing, burning pain in the middle chest potentially irradiating to the neck, lower jaw or the arms, which is not modulated by palpation, respiration of body movements, increasing with physical exertion, etc), especially when coronary risk factors are present (like hypertension, diabetes, dyslipidemia, close smoking contact, and heredity for premature coronary disease), then a full cardiology review should be done, including: - cardiac enzymes (CK - MB, Troponin), - cardiac ultrasound, - chest X ray study, - complete blood count, - thyroid hormones level, - liver and renal function tests, - fasting blood glucose, - HbA1C, - blood lipid profile, - uric acid Only after excluding all the above mentioned alternatives anxiety disorders (a panic attack) could be blamed for her recent clinical symptomatology. You have to discuss with her attending physician on the above mentioned issues. Hope to have been helpful to you! In case of any further questions, feel free to ask me again. Kind regards, Dr. Iliri