Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

I carefully reviewed your uploaded resting ECG and would explain that your chest pain coupled with your ECG pattern raises strong suspicions of an ischemic cardiac disorder.

Your resting ECGs show ST segment depression in leads DII, DIII, aVF, and especially in V6.

Coming to this point I strongly recommend you to ask medical assistance to the nearest ER service for continuing chest pain and ECG evaluation (every around two hours) as well as checking repeatedly cardiac enzymes (CK-MB, Troponin), and eventually a cardiac ultrasound.

If sufficient suspicions of ischemic heart disease remain strong, then additional cardiac imagine studies like cardiac stress (dobutamine) ECHO; coronary angio CT; nuclear perfusional cardiac stress test for investigating further the presence of cardiac ischemia (especially if coronary risk factors like heredity for CAD, smoking, hypertension, dyslipidemia, possible glucose metabolic disorder [or diabetes] or other triggering factors like illicit drugs use, etc. are present).

So, I strongly recommend to discuss without delay with an ER doctor.

Hope you will find this answer helpful (because acute coronary syndrome and associated arrhythmia may be very dangerous medical conditions)!

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

Kind regards,

Dr. Iliri

---

Brief Answer:
Opinions as follows:

Detailed Answer:
Hello again,

I advise you to just go to the nearest ER service and have a comprehensive cardiac check up and exclude an ongoing cardiac ischemia.

Your chest pain and associated resting ECG are strongly suggestive of a cardiac ischemia clinical scenario.

As you are quite young and coronary heart disease is rare in that age, other alternative causes should be taken into account as well.

I recommend you to not delay the appointment with an ER doctor, as you can’t predict whether the pain will appear again and when.

The main issue of this entire story is to prevent and protect heart muscle from a possible injury (due to insufficient blood supply??!!)

You may chose also to meet your doctor tomorrow but it doesn’t sound safe while you are actually with recurrent chest pain.

So, just make a try and go to the ER as soon as you can.

Kind regards,

Dr. Iliri

---

Brief Answer:
You are welcome!

Detailed Answer:
Hi,

Nice to hear you have stopped smoking.

I reviewed your last ECG. The previous ST segment depressions seem to have resolved; and this is good news.

Heart rate is a bit slow (less than 60 bpm), so sinus bradycardia is present. But, it is not a finding to concern about. Previous ECGs show faster heart rate, but it was in the presence of more intense chest pain; so everything is explained by adrenergic stress.

It is important that an ongoing cardiac ischemia is ruled out by the preliminary medical evaluation. The remaining cardiac tests will show the clear full view of your cardiac status.

I wish everything will result OK tomorrow.

Please let me know how things are going on.

If possible upload a copy of your tests result.

Regards,

Dr. Iliri

---

Brief Answer:
I would be happy to review further tests as soon as you upload them.

Detailed Answer:
Hello again!

I hope all your performed tests will result normal.

I would be happy to review your Holter monitoring reports for a another professional opinion, as soon as you upload them.

Let me know about your situation.

Regards,

Dr. Iliri

---