What are effective strategies for managing health anxiety?
Patient's Query
Hi doctor,
I am a 27-year-old female. A few years ago, I went to the ER, where I was diagnosed with pleurisy and anxiety. I recently reviewed my records from that visit. The EKG indicated sinus tachycardia, with a heart rate of 110 beats per minute, which I suspect was due to either anxiety or difficulty breathing caused by pleurisy. Additionally, I was diagnosed with a lateral repolarization abnormality. The doctor noted "non-specific ST segment and T wave abnormalities" but described the EKG as otherwise normal.
I am feeling quite scared about this and worry that I might have a serious heart rhythm issue that could cause me to suddenly collapse. I struggle with severe health anxiety. Could you please help me interpret the attached EKG? Is there a reason to be afraid? I do not understand why the doctor would have let me go if there was something concerning.
Please help.
Hi,
Welcome to icliniq.com.
I have reviewed the ECG (electrocardiogram) (attachment removed to protect patient identity). There are certain minor variations that are quite common and considered normal. Therefore, there is nothing in your ECG that is worrisome. Additionally, considering your age, the likelihood of any cardiac illness is low, and you did not present any symptoms suggestive of heart disease. Furthermore, the echocardiogram was normal, which also ruled out any cardiac issues. Overall, there is no need to worry, as the ECG is considered normal.
I hope this helps, and please feel free to reach out if you have any questions.
Patient's Query
Hi doctor,
Thank you for the reply,
Is the QT interval normal as well? My QTc was 438 ms with a heart rate of 110 beats per minute (QT was 323 ms). The Bazett formula indicated that this QTc is approaching abnormally prolonged, while the Framingham and Hodges formulas suggest it is too short. Why is that? When I entered the QT of 323 ms into the Bazett calculator, it noted that the QT interval itself was very low but still gave me the same QTc of 438 ms listed on my EKG, which some sources say is close to the high range. Is it possible that my heart rate of 110 beats per minute is affecting the results? Should I be concerned about an issue with my QT interval, especially in light of the "lateral depolarization abnormality" mentioned?
Hi,
Welcome back to icliniq.com.
QT changes with heart rate; specifically, it decreases as heart rate increases, which is a normal phenomenon. This is why it is corrected. Yes, these are compensatory changes due to tachycardia. Your QTc of 438 ms is absolutely normal, and there is no need to worry about it. In females, the normal QTc range is up to 460 to 470 ms. Overall, there is no need for concern, and there are no significant depolarization abnormalities in the lateral leads as well.
I hope this helps you.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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