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Hi There I Have A History Of Gad, Gerd ,

Posted on Thu, 14 Feb 2019

Question: hi there

i have a history of gad, gerd, gastritis. have had cardio chkup 6 months ago n tmt. was all fine. i m obese and have history of high lipids. for that i m taking rousavas f10. which helped. i have had episodes of chest pain occassionally and go to hospital l, do ecg which comes bk fine. yesterday i had same episode. i did ecg n it was all fine. but wasn’t satisfied with doc. i just wanted to know on comparing it with previous ecgs their seems smaller in height lines in precordial lead 1. is that ok? attaching ecg too. however in past ecgs they were of good height. i was quite snxious while ecg was taken.

Answered by Dr. Dr Sameer Maheshwari (41 minutes later)

Brief Answer:
Normal ECG

Detailed Answer:
Hi Mr Aqib,
Welcome.
This is Dr Sameer, cardiologist.
You have send just 1 ECG and that is normal except sinus Tachycardia (means high heart rate). Please send the 2nd ECG to compare.
When the heart rate is high the heart gets less time to contract and thus the ECG comes of less height, so that is the cause you must be anxious about.
I also wanted to know about your age and any other risk factors like Diabetes, smoking?
Also when do you get these chest pain? On exertion or exercise or does it come any time?
TMT has a sensitivity of around 70-75%.
We have better tests to detect underlying blockage in heart vessels like CT coronary angiography.
So if you have chest pain on exertion or have any other risk factors I have mentioned, you should go for CT coronary angiography.
Thanks and take care

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr Sameer Maheshwari (1 hour later)

Yes i m a smoker. I get chest pain once in 4 5 months and post normal ecg they send me bk with either anxiety or gerd meds. I m on gad meds. I m attaching prvs ecg too as new attachment

Answered by Dr. Dr Sameer Maheshwari (2 hours later)

Brief Answer:
Get a CT coronary angiography done

Detailed Answer:
Hi,
Welcome back.
The ECG is normal and is not giving adequate information.
As you are a smoker which is a additional risk factor in addition to obesity and abnormal lipids, I will advise you to get a CT coronary angiography down which is a very good and specific test to diagnose whether you have any heart disease or not.
If that comes out negative, than their is nothing to worry from the cardiac side anymore.
Hope this is helpful.
Thanks and regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr Sameer Maheshwari (16 minutes later)

Actually the ecg u saw first is latest one.are both ecgs fine?

Answered by Dr. Dr Sameer Maheshwari (5 minutes later)

Brief Answer:
Yes the ECG is fine

Detailed Answer:
Hi,
Welcome back.
The ECG is fine but as I told you ECG is not definitive of anything and you could possibly be having blockage despite having a normal ECG.
So better do a test in which you can be surely ruled out of this.
I will still suggest you for CT Coronary angiography.
Kindly get a KFT(kidney function test) test done before going for it as it can only be done if the KFT is normal.
Thanks

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr Sameer Maheshwari (4 hours later)

I would like to add up one last thing i get pain on movement and not by breathing. Besides i am allergice to barious meds and i m currently on escitalopram and amitryptiline.

Answered by Dr. Dr Sameer Maheshwari (12 hours later)

Brief Answer:
Detailed answers ahead

Detailed Answer:
Hi,
Welcome back.
CT coronary angiography uses iodinated XXXXXXX
As you have the chest pain on movement, you should absolutely go for CT Coronary angiography.
Chest pain which occurs on breathing is non cardiac.
You can continue Escitalopram & Amitriptyline as advised.
I hope you get a diagnosis soon and get well.
Thanks and take care

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

Above answer was peer-reviewed by : Dr. Vaishalee Punj