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What Does This EKG Report Indicate?

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Posted on Mon, 15 Dec 2014
Question: Hi, I am 40 yrs old female and been experiencing a plethora of health issues for the past decade. Prior to this, I was in excellent health & shape. Identified issues so far are: underactive thyroid, vitamin d & b12 deficiencies, low iron, factor 5, asthma. Gallbladder removed few yrs ago emergency surgery. Still pending & undiagnosed : swelling in joints, fatigue, low grade fevers, headaches, intermittent skin rashes. However I am writing regarding my heart... I just wanted to give u a brief synopsis in case it was pertinent. This past summer I was told I had an irregular heartbeat. I had noticed once in awhile I could feel my heart beating fast but nothing significant. Starting oct chest pain & heart palpitations definitely worse .. I think stress induced however just a few days ago pain was so bad I went to urgent care thinking I was experiencing anxiety attack or beginning of heart attack. They gave me EKG. Told me they wanted me to go to hospital I didn't after they administered a few meds that relieved symptoms bc I had to come home to be w small children. Here's what EKG said... Can u help me? Should I be worried? Sinus rhythm, possible septal infarct, QS in V1 V2, minor inferior repolarization disturbance, consider inschemia, LV overload or aspecific changes, flat or low level T in aVF with negative T in III, P/PR 108/140 ms, QRS 86 ms, QT/QTC 374/398ms, P/QRS/T axis. 45/70/-8 deg heart rate 68 Bpm Could u tell me what this means? XXXXXX XXXXXXX
doctor
Answered by Dr. Shoaib Khan (3 hours later)
Brief Answer:
Lets work for together for a better tomorrow

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. After reading your EKG report, I should report on the main point mentioned in the report around which all the other observations lie. This observation is 'septal infarct' .

I am very sorry to inform you about the same, but I shall try my best to explain everything in a manner best understood by you ma'am. The septum is a muscular wall that separates the heart chambers; and an infarct is dead or dying tissue which has almost directly resulted from poor oxygen and blood supply to the region. In short, a septal infarct indicates dead or dying tissue in the septal region (i.e. muscular wall of the heart that separates the hearts chambers) which has unfortunately resulted due to a heart attack.

A hear attack can again be caused due to various issues and in your case I suspect any one of the following:

-Poorly controlled blood pressure
-Extreme stress faced over a long period of time
-Poor diet and health due resulting in a poorly controlled lipid profile

I would recommend checking your:
-Blood coagulation profile
-2D echo of your heart to better visualise the interior of your heart
-Lipid profile
-Blood glucose

I would also suggest initiation of the following:

+Blood thinners (eg. aspirin 75 mg)
+Statins (to help control cholesterol levels)
+Anti-hypertensive medication (if blood pressure is found to be poorly controlled)
+Diabetic medication (if required)
+TLC diet
+Reduce levels of stress

Please discuss the same with your doctor ma'am, and please do not hesitate to write back to me for any further clarifications, I would be more than happy to help you.
Please do not take the above report as a setback, but only as a warning to change your lifestyle and live a more healthy and safe life for your family and yourself.

Best wishes XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (2 days later)
Thank you so much for your information and help. After i wrote u, i had an incident where i ended up calling 911. The ambulance came and on the ride there, performed an ekg. It was similar to the one i shared with you, however when i got to the hospital, a nurse performed an ekg on me while she was on her cell phone, she didnt even speak to me, and roughly handled me, this ekg turned out normal and the dr told me that i was fine, nothing was wrong and i never had a heart attack. He said i was having anxiety attacks. Is he right or is it possible that EKG was flawed? I do have anxiety in my life (who doesnt lol) but at the time of the episode, i was completely calm and having fun time with my family. In addition, i called my family dr and he prescibed me nitrostat and alprazolam. The next day i started having chest pains and decide to try the anxiety med to see if it was indeed anxiety caused. The result was i felt a bit out of it but the chest pain remained, when i took the one tablet under the tongue of the other med, i felt much better except i develped a headache which i read happens.
I guess i just want to ask your opinion... Isnt it possible that hospital EKG was flawed since i received two EKG that stated i had the infract. Thank u in advance for your time, d
doctor
Answered by Dr. Shoaib Khan (9 hours later)
Brief Answer:
Two possible scenarios ma'am

Detailed Answer:
Hello once again ma'am.

It has occurred in my practise that a patient with a well diagnosed heart condition has returned a normal EKG, but when I was reported with such an EKG I ordered a repeat EKG to be conducted by an experienced nurse to see if it would be different and in 99% of cases, it has reported a different and more accurate EKG. For this reason, a doctor who knows the patients history should always be involved. With the many patients I have treated through my online consultations, I really feel the medical system in your country is flawed. Patients who cannot afford medical insurance usually face serious symptoms at home and some suffer serious consequences as well, and some who need consultation with a specialist have to wait for weeks on, and in the meantime get from bad to worse.

As is in your case, the doctor did not feel the need to check your previous medical records or history, and ruled your EKG to be normal without a repeat EKG.

There are two possible scenarios here ma'am:

1. The EKG conducted was inaccurate and reported a wrong result when in reality there could have been a cardiac event

2. The EKG could have been accurate as you are on medication to prevent further damage of the heart tissue by improving blood circulation, and this may have caused a recovery of your heart tissue, thus not leaving any abnormalities detectable through an EKG. And the cause for your presentation was actually anxiety.

As you understand ma'am, I cannot really comment on the more probable cause without being there myself and conducting an EKG or 2D echocardiography myself. I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help.

Best wishes.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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What Does This EKG Report Indicate?

Brief Answer: Lets work for together for a better tomorrow Detailed Answer: Hello ma'am and welcome. Thank you for writing to us. I have gone through your query with diligence and would like you to know that I am here to help. After reading your EKG report, I should report on the main point mentioned in the report around which all the other observations lie. This observation is 'septal infarct' . I am very sorry to inform you about the same, but I shall try my best to explain everything in a manner best understood by you ma'am. The septum is a muscular wall that separates the heart chambers; and an infarct is dead or dying tissue which has almost directly resulted from poor oxygen and blood supply to the region. In short, a septal infarct indicates dead or dying tissue in the septal region (i.e. muscular wall of the heart that separates the hearts chambers) which has unfortunately resulted due to a heart attack. A hear attack can again be caused due to various issues and in your case I suspect any one of the following: -Poorly controlled blood pressure -Extreme stress faced over a long period of time -Poor diet and health due resulting in a poorly controlled lipid profile I would recommend checking your: -Blood coagulation profile -2D echo of your heart to better visualise the interior of your heart -Lipid profile -Blood glucose I would also suggest initiation of the following: +Blood thinners (eg. aspirin 75 mg) +Statins (to help control cholesterol levels) +Anti-hypertensive medication (if blood pressure is found to be poorly controlled) +Diabetic medication (if required) +TLC diet +Reduce levels of stress Please discuss the same with your doctor ma'am, and please do not hesitate to write back to me for any further clarifications, I would be more than happy to help you. Please do not take the above report as a setback, but only as a warning to change your lifestyle and live a more healthy and safe life for your family and yourself. Best wishes XXXXXXX