HomeAnswersCardiologyecgI had panic attacks and want a second opinion on my ECG report. Please help.

Kindly provide a second opinion on my ECG report.

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Nithila. A

Published At July 31, 2019
Reviewed AtJune 16, 2023

Patient's Query

Hello doctor,

I had a DVT with massive pulmonary embolism with infarction before four years. I had a few änxiety or panic attacks since then. Had a heart sonar and ECG done two months ago, which according to the physician was perfectly normal. I stopped taking Bisoprolol on his advice, and started with Alprazolam and Ativan when needed. Two weeks ago, I had an incident where I had my blood pressure shot up to 210/107 mmHg and a heart rate of 110 bpm. I went to the ER and had an ECG done as well as a cardio markers blood test is done. The doctor who did the ECG said that it looked like the right side of my heart did not get enough oxygen. I made another appointment with a physician, who now wants to send me for an angiogram. I want a second opinion on the latest ECG. The ER doctor said that a panic attack could also influence the ECG.

Hello,

Welcome to icliniq.com.

Your ECG is fine (attachment removed to protect patient identity). There is left axis deviation, which is expected in hypertension or with age. Probably this left axis deviation is mistakenly read as Q waves by a physician and thought of right side not getting enough oxygen. So, by viewing your attached ECG, I do not see any immediate need for an angiogram. However, considering your age and hypertension and a history of pulmonary embolism. It is better to obtain echo is not done recently. Also, better to get one stress test like treadmill test or stress echo. BP spike may be age-related combined with panic or anxiety, so you should have BP apparatus at home and monitor it frequently, at least thrice a day for a week. And if most of the BP readings are above 140/90 mmHg then you should have regular medicines for it. You should take low salt diet and do regular exercises as well. I hope this helps you and get back if you have any doubts.

Patient's Query

Thank you doctor,

It sets my mind at ease. My BP is mostly under the above mentioned. I am mostly inactive as well due to the damage to my leg. And I think the BP was affected due to stopping of Bisoprolol. I feel very normal with HR of between 85 and 100. I suspect if I can start exercising again, it would also help a lot. I do not know if you perhaps had a look at my lung function test if that would also be within normal boundaries after the PE with infarction.

Hello,

Welcome back to icliniq.com.

Although pulmonologist is the best person to tell, it looks fine to me. And yes, Bisoprolol will help you both in heart rate control and BP will not shoot this much.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sagar Ramesh Makode
Dr. Sagar Ramesh Makode

Cardiology

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