Dr. Yash Kathuria
Family Physician
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am an anxious 31-year-old male who is not a smoker or diabetic and has no family history of heart problems. I get an intense chest ache that lasts for six seconds, but sometimes only a second, and I have strained chest muscles and tender areas on my chest. Before, I experienced jaw and neck pain, for which I underwent surgical tooth extraction and physiotherapy for neck pain, and both of them vanished after treatment. But when tested for ECG (electrocardiogram), it always comes out a bit odd, and today I had the test again, and my heart rate was higher, and I retook the test after one hour. In 2011, I had an angiography, which was super normal, and in 2015, I had a treadmill test and an electrocardiogram, both of which were normal, but my chest pain is still unresolved. I am concerned about the cause. I also included the ECGs and stress ECHO reports (attachments are hidden to protect the patient's identity) from six months ago. Please assist. Thank you very much.
Hello,
Welcome to icliniq.com.
I understand your concern regarding ECG changes and fast heart rate. I have looked at every report that you have provided. Your ECG shows a benign RBBB (right bundle branch block) pattern, which is of no concern because your echocardiogram (ECHO) and stress ECHO is entirely normal. The slightest doubt is also cleared by normal angiography. Your cardiac rhythm is also regular, with no ectopic arrhythmias. Anxiety is something that may lead to increased heart rate, and I am sure you might have been prescribed medications for palpitations. Thyroid disorders, smoking, alcohol consumption, and excess tea, and coffee intake may also cause an increased heart rate. I suggest you check your thyroid level if you still need to do so. Rest as far as your heart is concerned, and there is no issue in there. I hope this helps. Regards.
Patient's Query
Hello doctor,
Thanks for the response. The angioplasty was done in 13 years ago and the ECGs were done today. Also, the stress ECHO was done six months back. My question is if we look at just the ECGs, the first one versus the second one done today, are there any concern areas?
Hello,
Welcome back to icliniq.com.
Comparing your two ECGs, during and after anxiety, the one during anxiety shows some non-specific ST-T changes, which may be attributed to your anxiety attack. The other one shows the reversibility of those changes after your anxiety settles down. So according to me, the main problem which is causing ECG changes ECG changes is recurrent anxiety problems, not cardiac issues. I suggest you get yourself treated for anxiety by your doctor. And make some lifestyle changes, like including yoga exercises and meditation daily. Eat more amount of fruits and vegetables. Avoid tea, coffee, non-vegetarian foods, alcohol, and fatty foods. I hope this helps. Regards.
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Family Physician
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