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Dr. Andrew Rynne

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What does this ECG report indicate?

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 5759 Questions

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Posted on Mon, 16 Apr 2018 in Hypertension and Heart Disease
Question: I uploaded an ekg I had today. I've been having intermittent burning and aching in my arms. Mostly left but sometimes right. Also intermittent burning in my chest that radiates up my neck. Sometimes I just feel really worn out. The other day I had an episode that lasted about 4 hours. It had been coming and going the past 4 daysSymptoms were up and down in intensity. Does this ekg show any significant abnormalities? My doctors said he don't think it was cardiac related
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Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
Your ECG is not indicative of any heart attack.

Detailed Answer:
Dear XXXXXXX

Welcome back on HCM!

Regarding your last ECG, I would say that if your prolonged chest pain of about 4 hours were caused by cardiac ischemia (a heart attack), it would have been reflected on the ECG recordings. But, it hasn't.

Furthermore, if a heart attack would have happened (even if the ECG would not reflect it, because this test has not a sensitivity of 100%), it would be reflected on the laboratory cardiac enzyme levels (CK-MB and Troponin). These cardiac enzymes would show abnormally elevated plasmatic levels.

So, another mean to exclude what your doctors have concluded is to check your cardiac enzyme levels.

Coming to this point, you have to ask your doctor to check your CK-MB and Troponin I levels.

As I have referred you before the incomplete RBBB is the only major finding in this ECG and it is not a new pattern as it is present also in your previous ECG.

The possible left atrial abnormality and ST junctional depression, are not specific and they could not be related to any certain cardiac disorders.

In addition, I would like to explain you that the ECG may direct towards a certain diagnosis, but further tests are needed to support the diagnosis.

Hope you will find this answer helpful!

I remain at your disposal, whenever you have any other uncertainties!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka 9 minutes later
Well I am not sure if I should even bother going back to the cardiologist because he said he thought my pain was non cardiac and I feel stupid for going. I just had this ekg at my family doctor. Not sure why my heart was beating so fast when I had it done. And I guess it's pointless to get cardiac enzymes now because it was 2 days ago I had that episode. I really don't know what's causing this but I really feel like something is wrong with my heart. I've done all kinds of different things to try to ignore it or think of other possibilities but I just have this feeling
doctor
Answered by Dr. Ilir Sharka 29 minutes later
Brief Answer:
My opinion as follows:

Detailed Answer:
Dear XXXX!

You don't have to worry about your faster heart rate during ECG recording, as it is normal in cases of increased stress and anxiety. We see it often to happen in many patients. It is just a normal sinus tachycardia and it doesn't signify any cardiac abnormality.

Regarding the cardiac enzymes issue, I would explain that CK-MB levels could detect any cardiac muscle damage up to 48 hours from the chest pain occurrence and Troponin level may remain elevated even a week to 10 days after a heart attack. So, they are valuable tools in this regard.

I think that the conclusions of your cardiologist are the most likely possibility.

Nevertheless, if this doesn't relieve your anxiety you may ask your family doctor to order the cardiac enzymes test.

In addition, I encourage you to discuss with your doctor on the possibility of performing at least a cardiac ultrasound test. This could clarify definitely your doubts of any possible cardiac implications (which in fact would be unusual considering your very young age).

Wishing you a pleasant weekend!

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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