Dr. Muhammad Majid Hanif
Cardiology
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Patient's Query
Hello doctor,
I just went to my general practitioner due to recently having some issues with shortness of breath and an odd sensation in my heart area. I suspected it was nothing but went in anyways just to be sure. The sensation in my heart area is not at all painful, but just a sensation of "fullness" or "tightness". I got an EKG done, and the results said I have a "minor interior repolarization disturbance, consider ischemia, LV overload or aspecific change. flat or low negative T in AVF with negative T in III". I am a 29 year old male in generally good shape. I smoked for about 10 years but quit two years ago. I still smoke marijuana daily. Also, about eight years ago, I had a root canal done, and it has now re-infected twice. I am scheduled for an apicoectomy next month to deal with the asymptomatic infection. I only mention this as I am worried that maybe the untreated infection could have spread from the root of the tooth to my heart? Also, I live at 7,000 feet elevation which I am sure does not help the shortness of breath, but have lived here about six years. I am currently very nervous thinking I have a serious issue. Can anyone tell me what these results mean? My general practitioner referred me to a cardiologist but I do not want to be a nervous wreck until I hear from them.
Hello,
Welcome to icliniq.com.
I have carefully reviewed your detailed query. You definitely need an in-person cardiologist consultation for appropriate evaluation of the issues. Only EKG (electrocardiogram) is not conclusive in such a case. We need to listen to the heart and then go for thorough physical exam. Tests may include but not limited to exercise stress test, echocardiography, thallium scan, chest X-ray, CT (computed tomography) scan, angiography and others if needed. Once ruled out we can say with confidence if there is any issue that needs proper management. Yes, an infection can spread from the teeth and throat infection to heart and can be diagnosed. Blood work also helps in this regards to find out infectious agents in blood and due to infection, any changes in the blood. If there is blockage to any of the blood vessels supplying the heart, there are chances of shortness of breath and patient can be short of breath even talking for some time, little physical activity or climbing the stairs. Do not panic and just follow as directed by your primary care and go for cardiologist evaluation. Meanwhile, go for apicoectomy and keep in touch with your dentist. Hope it helps.
Patient's Query
Thank you doctor,
If it was the case that the infection spread from my tooth to my heart, would not that be sepsis? And if it was sepsis would not I have a variety of symptoms and be feeling much worse? If it is indeed an infection of the heart, how dangerous is this? Do I need to seek help immediately? Will antibiotics clear up a heart infection easily?
Hello,
Welcome back to icliniq.com.
We are not sure what actually is going on in the heart. Once the diagnosis is confirmed, we can proceed from there to treat the cause. It is not sepsis, rather it is bacteremia meaning simply, bacteria in the blood and these bacteria cause infection of the heart if lodged in the lining of the heart valves. Bacteremia can be even due to routine activities like vigorous toothbrushing. Gums that bleed profusely and more frequently, pose a greater risk of bacteremia. Sepsis is a different condition where there is a widespread reaction of the whole body to bacteria in the blood (bacteremia) and leads to a cascade of mechanisms that may fail many organs including the heart. Please do not mix up the two terms and just follow the instructions as aforementioned. Infection of the heart in this way can be called as infective endocarditis and is manageable. I would say better seek medical attention right now as earlier is always better. Your cardiologist would discuss in detail about the treatment options and you may choose accordingly. Antibiotics: yes antibiotics are still the mainstay of treatment for infective endocarditis. Hope this helps. Regards.
Patient's Query
Thank you doctor,
I have an appointment with a cardiologist in five days. Do you think I should go to Urgent Care or the Emergency Room to get blood work done and get on antibiotics now, or should I wait until Wednesday for my appointment?
Hello,
Welcome back to icliniq.com.
If shortness of breath accompanies fainting, chest pain and nausea, better to go for an emergency visit as these can be due to heart's serious issues. Otherwise, you may wait for the Cardiologist appointment. Hope the things remain under control and you don't need to go to the ED. Regards!
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Cardiology
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