What is the problem with ECG Report? Is it fine to take Concor tablets?

Question

Hi doctor,

I want to explain my wife's situation, and I need your help and assistance. When my wife was in the kitchen, suddenly she felt some pain and heat in the upper part of her stomach and felt all her body become hot. I took her to the hospital; in the emergency department, her pressure was 110/70 mmHg, and the doctor requested an ECG.

The doctor showed some kind of worry in respect to the ECG, made some mark in the ECG, and requested a blood test. After four hours he repeated the blood test and the ECG, and then he discharged her from the hospital and gave her some medicine for the stomach and advised me to follow up with a heart doctor.

Then we went to a heart doctor, and he did another ECG and echo for her heart and advised us to get a CT image of her heart so that he can decide and give an opinion. We did not go for a CT image until now and went to another doctor. He made another ECG, and once he saw the ECG, he was surprised and said that the ECG belongs to a woman of age 60 years old and not 32 years old. He requested a blood test, gastroscopy, and exercise ECG and prescribed Concor tablets 2.5 mg. Please advise me on what the problem is with my wife's ECG.

And what shall I do next? Shall I go with a CT image or exercise ECG? Is it fine to take Concor tablets? By the way, my wife is 32 years old, and we have four children of ages 12, 9, 6, and 4 years. This is the first time my wife has complained of pain, and now she is feeling better and doing her household work normally. Also, she does not have diabetes or high blood pressure. Her weight is 139 lbs, which is correct for her height.

Please assist and advise me.

Answer 1

Hi,

Welcome to icliniq.com.

First relax. There is nothing to worry about. I have gone through the detailed history and investigations (attachment removed to protect patient identity) you have attached.

I found cardiac markers are quite normal. Her 2D echo is normal.

Her other blood investigations are normal. Endoscopy showing that there is gastritis and duodenitis. It can be cured easily.

Coming to ECG (electrocardiogram), there are some T wave inversions in leads V2 and V3. They are of little concern.

Coronary artery disease is very rare in a woman of 32 years of age. You can go for CT coronary angiogram, which is a very simple procedure.

With reports of cardiac markers and 2D echo, we can say she does not have any cardiac muscle injury, and she does not have any functional problem in her heart.

Just go for a coronary CT angiogram to feel tension-free. Her stomach pain is most likely due to gastritis.

Revert back with the CT angiogram report to an internal medicine physician online.

Answer 2

Hi,

Welcome back to icliniq.com.

You can go for a stress ECG test. It will show up any ischemia if present, coronary disease, or spasm.

Regarding the tablet Concor (Bisoprolol Fumarate), you have to use it very carefully as it reduces blood pressure, and her BP is around 110/70 mmHg. Buy a home blood pressure monitor. Also, avoid Concor on the day of the test.

For further doubts, consult an internal medicine physician online.