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Does Stress Affect ECG Variation?
A member of my family just experienced an abnormal ECG, indicating an MI. ECG changes within 48 hrs. indicate anterier artey blockage. She was admitted to telemetry for an emergency cardiac cath. Results indicated no cardiac narrowing, blockage, or muscle damage. She was discharged within hours. We have received no explanations as to the possible cause of the abnormal ECG. She is a healthy 75 y/o woman, heart healthy diet, HT. 5'4'', wt. 120 lbs, with regular exercise 3-4 times a week including zoomba class. The only current factor is profound stress, including the sudden death of her husband of 40-something years (two years ago) and the recent divorce of a daughter. I am curious what research is indicated relating intense stress and ECG changes? Thank you for whatever information you may have or resources available.
Mon, 24 Aug 2015
Hello. Thank you for your question and welcome to HCM. I understand your concern.
If the EKG changes, which you were told were indicative of myocardial infarction, there was acute ischemia at the moment. I am assuming we have to deal with a case of Prinzmetal angina (it is characterized by a strong spasm to the coronary arteries, which produce an angina equivalent of myocardial infarction, also EKG changes that resemble it). It is most often found in female population, occur during rest and under a lot of stress. Coronary angiography of these patients results normal or with not significant coronary artery narrowings. If I were her doctor, I would suspect this diagnosis, and do a test which is done during the coronary angiogram, by injecting a provoking agent to the coronary arteries, such as ergonovin or acetylcholine, to confirm or exclude this diagnosis. At this moment, I would recommend that an agent from the calcium channel blocker class and clopidogrel should be added to her therapy. Just to be certain, I would suggest a repeated echocardiogram, to assess the heart muscle movement and motility.
I hope I was helpful with my answer. Best regards.
Dr. Meriton
If the EKG changes, which you were told were indicative of myocardial infarction, there was acute ischemia at the moment. I am assuming we have to deal with a case of Prinzmetal angina (it is characterized by a strong spasm to the coronary arteries, which produce an angina equivalent of myocardial infarction, also EKG changes that resemble it). It is most often found in female population, occur during rest and under a lot of stress. Coronary angiography of these patients results normal or with not significant coronary artery narrowings. If I were her doctor, I would suspect this diagnosis, and do a test which is done during the coronary angiogram, by injecting a provoking agent to the coronary arteries, such as ergonovin or acetylcholine, to confirm or exclude this diagnosis. At this moment, I would recommend that an agent from the calcium channel blocker class and clopidogrel should be added to her therapy. Just to be certain, I would suggest a repeated echocardiogram, to assess the heart muscle movement and motility.
I hope I was helpful with my answer. Best regards.
Dr. Meriton
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