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Forum Name: Cardiology Diagnostics

Question: Abnormal EKG with ST and T waves


 ctaylor08 - Sun Nov 15, 2009 12:11 am

Can someone please make since of this for me. I was in the hospital the other day with chest pain, and indegestion, and they did an EKG which was abnormal. Let me start first by saying this happen to me 2 months ago and I followed up with a cardio dr and he did a stress echo and all was normal. Each time I have gone to the ER and the did an EKG, it was abnormal and they did all the heart enzyme test which all came back normal along with chest xray. I have severe anxiety and panic disorder the following is on my EKG report.

Vent. rate 63 BPM
PR Interval 122 ms
QRS duration 86ms
QT/QTc 400/409 ms
P-R-T axer 42 91 5
normal sinus rhythen with short PR
Rightward axis
ST & T wave abnormalitiy

on the report itself it says,

EKG: normal sinus rhyth, normal P waves, normal PRI, Normal QRS complex, Normal axis. T was inversion in lead II, III, aVF, V4, V5, V6

can you PLEASE make since of this to me and explain. I am a 29 year old female, smoker, and boarderling cholesterol.
 John Kenyon, CNA - Fri Nov 27, 2009 11:33 pm

User avatar HI there -- I think I can supply a few salient facts that should hopefully reassure you and make you feel better about this. First, in anxious people the EKG is a sensitive indicator of anxiety, almost always exhibiting flipped T-waves. These are not deeply inverted as in ischemic heart disease, and are non-specific. Couple this fact with this one: EKG machines are programmed to recognize a large number of abnormalities and to note them, but the machine has no clue as to context, and doctors almost never rely on the machine's auto-interpretation that prints out with the tracing. I personally would love to see this feature disabled, but some nursing staff have to rely on this to notify a doctor of something they also don't understand. The doctor then looks at the actual EKG, especially in context of the situation. Non-specific T-wave inversions alone are seen very commonly in anxious patients, and even without anxiety they occur fairly often. They don't mean much of anything unless coupled with other things you definitely have not had. The cardiac enzymes being normal counts for a lot more.
The rest of your EKG was just fine -- according to the machine, which will comment on just about everything but the way you fix your hair. The ST-T abnormalities, coupled with chest pain, require further rule out owing to common sense protocols which must be followed, but you passed with flying colors. People with anxiety problems and panic disorder show up more often than others in the ER, and this is fine, really, because people with those problems can also get sick. Hopefully over time you'll learn to differentiate between what seem to be alarming physical symptoms and those typical of anxiety and panic, but it's no easy trick and it does take a while. Good news is it can be done. Meanwhile, even though you've had this happen and been told (correctly) that you had nothing serious going on, I would never tell you or anyone with anxiety or PD to simply "ignore" symptoms when you're not certain what's causing them. Chances are they're extranious or even anxiety-caused, but don't assume that.

Short answer is your anxiety problem -- which is very serious in its own right due to its ability to mimic serious disorders and disrupt your enjoyment of life -- was a red herring this time, and is likely to be on future occasions too, but by all means let a medical person determine this for you.

I hope this is helpful. Please follow up with us here as needed and good luck to you!

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