Hi, Thanks for writing in. The EKG findings show that there is some abnormal electrical activity in the heart as seen from a T wave abnormality. This means that there is a possibility that the front portion of the heart is not getting sufficient blood supply. This can be due to clogged coronary arteries. This can be a concern for the achalasia surgery and you need to get investigated in detail to know if your heart can withstand the anesthesia during the surgical procedure. It is suggested that you consult a cardiologist and get an echocardiography test done. This is better than EKG and will show any abnormal wall motion in your heart and the pumping action. If there persists a possibility of heart malfunction or risk of heart attack due to probable coronary artery disease then you might require a coronary angiography that will be done in the cath lab. Any significant blockages will be known and treated depending on findings if any. Please do not worry.