Dr. Isaac Gana
Cardiology
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 went to my primary care provider with occasional shortness of breath and chest pain. In the office, I took an EKG and an echo. Both were purportedly normal, but I would like a second opinion on the EKG. I have had echocardiograms and many EKGs in the past without much note. I do not have a family history or a history of heart problems except from sinus tachycardia. My primary provider did not seem worried about the EKG, but it was taken during an episode of pain, so I would like to know if this is certain that the changes are benign looking. Echocardiogram came back normal with good flow, size, and contractability. Thank you, doctor.
Hi,
Welcome to icliniq.com.
I understand your concern. I reviewed the attached EKG result (attachments removed to protect the patient’s identity). A few changes in your result could indicate narrowing in some part of your heart’s vessel, which results in reduced blood and oxygen flow (known as ischemia). This is usually caused by arteriosclerosis (fat buildup in the vessels). Risk factors include poor eating habits, lack of exercise, and family history. Echo and ECG are abnormal only during pain. They are only abnormal if done as of the time of pain. This is rare in your age group. It is good that you have no family history of heart disease. You have to work on slightly increased cholesterol, but you need a cardiac stress test for better clarification. Do you smoke or drink? Do you still experience pain during physical exertion?
Patient's Query
Hi doctor,
Thank you for the reply. I do not smoke or drink and never have. I have a history of a panic attacks and anxiety with GERD and hiatal hernia. I do not feel pain on exertion, but I do feel pain when I am extremely stressed and panicking. I was having an anxiety attack during the EKG.
Hi,
Welcome back to icliniq.com.
Your panic attack must have been what reflected negatively on the ECG. This is my professional advice. Wait for at least a month, then repeat the ECG if you do not get any additional symptoms. If you do get symptoms before a month, quickly repeat ECG before a month. At this moment, you must observe for symptoms like chest pain that radiates, shortness of breath, etc. Regards.
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Cardiology
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