MegaSack DRAW - This year's winner is user - rgwb
We will be in touch
My Doctor scared the living jeebus out of me today after my recent ECG results came back.
To cut a long story short, about a month and a half ago I started getting chest pains. They were not worrying to begin with but began to get worse until about a month ago when I had a horrible bout of chest pain and an ambulance was called. It didn't last long but the pain was horrendous.
The paramedics strapped me up to an ECG for the ride to the hospital and told me I was not having a heart attack or anything heart related but that I might have an irregular heart beat that would need checking out. At the hospital a male nurse did a very quick ECG (less than 30 seconds or so?) And declared there was nothing wrong. Perfectly normal. The Doctor dealing with me came over and told me my white blood cell count and the chest x ray I had done indicated I may have a viral infection causing pain in the fine lining around my lungs. Fine I thought - ill be better in a few weeks. Over a month later and the pain is still there and my local practice is still doing tests. I've had three blood tests all came back with no action required, but today she told me my ECG was somewhat unusual.
She said and I quote: "We are not really trained to diagnose people from ECG's and when I see them, they are always of elderly patients". She said the pattern was "regular" but something was not right or she could not tell if something was wrong.
I mentioned I had had heart flutters and the occasional ectopic beat which is supposed to be fine, and she then mentioned something about conductivity or something to do with the hearts electrical signals.
I always forget to ask enough questions because I don't want to be rude, and now I regret it because I'm absolutely bricking it.
I've always been a healthy eater, never drink or smoke, used to work out and cycle 6 days a week and now my life feels like it's on hold with no visible outcome, which I can't stand. But it has been suggested to me that many of the symptoms I had can and are sometimes caused by high levels of stress and anxiety - and I have always been a worrier, but at the same time am usually very forward looking. This ECG thing seems to have convinced me there may be something up.
She said she is sending the ECG results to the Hospital cardiology unit by fax and that she will call when they ring back. That could be a week or two away.
Do I have to worry about what she said? I'm petrified it's some underlying issue that has never been noticed before and that they're going to drop a bomb on my life by saying you can never exercise do sport or ride a bike again, and I can't get it out of my head. If there are any doctors in the forum it would be great if you could give me your opinion on whether her worries seem to have foundation or whether she simply didn't understand the ECG results. Because as I said before, a month earlier and having seen 4 or 5 doctors, my ECG's have been given the green light consistently, but there has been this lingering possibility of an arhythmia which hasn't been confirmed or denied in simple terms.
Sorry for the long post. Ta 🙁
Edit: I'm 21, 6ft, 10 stone (dropped over a stone and a half in just under 4 weeks due to illness). And no other known medical issues.
Another thing I forgot to mention is that she told me that "paramedics are not trained to diagnose any heart issue from an ECG other than a heart attack". That seemed odd to me as the bloke seemed very knowledgeable and even told me he felt an often irregular heart beat as he had one himself.
She also mentioned that my symptoms could be caused by an overactive thyroid gland. I have no idea what that is or what that would entail.
I'm leaning towards (and hoping) that the pain symptoms have triggered some sort of anxious response which is giving me an irregular/fluttery heart sometimes. But I've been told it needs to be investigated further and a week long event recorder ECG is needed to be safe. For which I will have to wait 6 to 8 weeks for on the NHS.
So ultimately I guess I just feel confused and really want a very knowledgeable no nonsense doctor to take all the tests i've done and say "it's 99% this. It will mean this. You will have to change this. This will happen. Take these." Etc.
Very difficult and wrong to give a diagnoses over the net without seeing your ECG, however if there was any major concerns you'd shipped off from the Dr's straight away not waiting. It is worrying I went through similar last year, Mrs made me go to the Dr's I was just going to do my own ECG when I got to work that night. Mine is caused by an extra atrial beat, I never get too much bother with it and it's settled right down.
Another thing I forgot to mention is that she told me that "paramedics are not trained to diagnose any heart issue from an ECG other than a heart attack".
Yeah that's bollocks, Ok so we can't really say what is causing it but neither can many GPs that's why you get sent to see cardiologists.
Good luck and sure you'll be fine.
Forgot. If you have any questions ring your GP and ask for an appointment or a phone conversation.
Well I'm not a doctor (although I am married to one) but I do have an annual ECG for work, and it occasionally gets referred on because 'something doesn't look right' but nothing ever comes of it.
I seriously wouldn't worry too much about it. Wait for the result to come back. You have to accept that the GP isn't an expert and only a cardiologist will be able to interpret your ECG accurately. The fact that the GP has seen something does not necessarily mean that there is anything wrong or if there is, that it is serious. I know it is easy to say, but you just have to chill and wait.
If anyone even thought you where seriously likely to be ill, you would now be in the hospital, wired up to various bleeping machines.
Stress causes chest pain as does a few other things.
Its really hard to say too much from what you have said because we have no details about the pain or nature etc. Sounds unlikely to be cardiac from what you have said though. The ecg being normal doesn't rule out a cardiac cause of the chest pain - although I would presume the probably did serial troponins (markers of cardiac dysfunction) if the doctors felt that the story sounded cardiac in origin. There is a very small chance of having had an MI with normal ecg and normal troponins.
The pain could well be pleuritic - inflammation of the lining of the lungs - can be very painful.
If the previous ecg's you have had are normal its unlikely that you have suddenly developed one of the underlying syndromes such as long qt, wolf parkinson white or hypertophic obstructive cardio myopathy which could make you suddenly drop dead - so I wouldnt worry about that.
Overactive thyroid normally causes a fast heart rate but can also cause ectopics - there are other signs such as being hot, brittle hair, excess sweating, loads of energy etc Diagnosed through a blood test, normally relatively easy to treat with drugs, or possibly a small procedure. More common in women that men though.
Paramedics are trained to rule out acute MI on ecg's mainly and also certain fast heart rythmns - there not taught to look at all the minutiae that Doctors are. Gps should know most of the minutiae but may have forgotten alot of it - hence why sending you to a cardiologist 🙂
Bottom line is - dont worry its likely fine - problems in the heart that cause you not to be able to ride a bike again are pretty rare, common things are common i.e. pleuritic chest pain following viral illness but I cant comment specifically as i dont know the history.
DrP on here is good at plumbing (he only looks 15 btw).
If the previous ecg's you have had are normal its unlikely that you have suddenly developed one of the underlying syndromes such as long qt, wolf parkinson white or hypertophic obstructive cardio myopathy which could make you suddenly drop dead - so I wouldnt worry about that.Overactive thyroid normally causes a fast heart rate but can also cause ectopics - there are other signs such as being hot, brittle hair, excess sweating, loads of energy etc Diagnosed through a blood test, normally relatively easy to treat with drugs, or possibly a small procedure. More common in women that men though.
Thanks for all the replies. Are long qt, wolf parkinson white and hypertophic obstructive cardio myopathy things that can just develop, or are you born with them or a susceptibility to them?
As far as Thyroid is concerned I'm normally very energetic but recently have just felt totally drained most days.
A pleuritic infection was mentioned to begin with, and I believe that is their official line on the cause of the pain, but my heart hasn't yet been totally ruled out I guess.
Not sure what a serial troponin is?
There is a very small chance of having had an MI with normal ecg and normal troponins.
Whats an MI and what would trigger it if you were believed to be healthy?
Very difficult and wrong to give a diagnoses over the net without seeing your ECG, however if there was any major concerns you'd shipped off from the Dr's straight away not waiting
Yeah I totally understand that. I suppose my worry was that I had been bounced around by so many doctors that something was missed early on and that something is now going to become apparent despite being told twice my ECG was fine with a possibility of a slightly irregular heartbeat.
:/
Can someone confirm the implications of an irregular heartbeat/ectopic beats and how they affect you? Are they dangerous?
And is there a possibility of some sort of "electrical" fault in the heart suddenly becoming noticeable/a problem? My doctor mentioned conductivity or something...
Its really hard to say too much from what you have said because we have no details about the pain or nature etc
It's quite difficult to describe but I was having a mixture of pain symptoms. The first was a kind of dull aching pain that would last 10 to 20 minutes, and the second a sharper more instantly noticeable pain that lasted about 20 seconds max.
My pain symptoms have started to drop off without any medication, but the other day I got a new development which was that I went out in the cold not wrapped up very well and when I got home was having pain in the right side of my chest when I took a deep breath. That is still there to a degree but has dropped off significantly.
It seems to have been a total hodge podge of symptoms that don't quite provide any clarity on a definitive cause. I'm guessing that may have slowed down the process of diagnosing me properly quite a lot. The continual confusion of one doctor saying one thing, and another saying something else, then the paramedic saying something else hasn't helped my mental state much lol :p And my local practice keep telling me the soonest they can do anything is weeks away. I wait a week for an appointment hoping for some answers, get more questions then have to wait weeks for another blood test before getting another appointment without being referred to a cardiologist.
Whats an MI?
Myocardial Infarction or a heart attack.
serial troponin
Proteins found in heart muscle, an increase is an indicator for MI(heart attack)
Can someone confirm the implications of an irregular heartbeat/ectopic beats and how they affect you? Are they dangerous?
It's endless but as they can be both harmless or harmful, if they were harmful in your case you'd been referred more urgently.
And is there a possibility of some sort of "electrical" fault in the heart suddenly becoming noticeable/a problem?
Possible, yes of course but sounds not too likely.
serial troponinProteins found in heart muscle, an increase is an indicator for MI(heart attack)
Would this show up in a normal blood test? I've done three and no mention of serial troponin. Just a raised white blood cell count which seems to have corrected itself.
Would this show up in a normal blood test? I've done three and no mention of serial troponin. Just a raised white blood cell count which seems to have corrected itself.
It would have been done as part of the investigation, it's almost fail safe on ruling out a heart attack.
My pain symptoms have started to drop off without any medication, but the other day I got a new development which was that I went out in the cold not wrapped up very well and when I got home was having pain in the right side of my chest when I took a deep breath. That is still there to a degree but has dropped off significantly
Sounds more and more like pleuretic pain but that's forum diagnoses. Pleuretic pain is caused by the lining of your lungs rubbing against each other.
You're gonna die, Fact™
It would have been done as part of the investigation, it's almost fail safe on ruling out a heart attack.
I never had a specific test done where they mentioned serial troponin. Just had regular blood tests I believe. Although they may have done the test and not told me?
I suppose when they say blood test it's actually a number of blood tests on one sample for different things? Or is troponin more specific?
if they were harmful in your case you'd been referred more urgently.
I don't see how they could tell the difference between harmful and non harmful without seeing one on an ECG though. I've never had one during an ECG, so I've just described them.
DrP on here is good at plumbing (he only looks 15 btw).
Win. Dougie Howser was 16.....
Back on track.
One can neither refute nor confirm ANYTHING based on what you've said. However, the fact you are alive and at home (rather than in hospital or, you know..) IS in a way reassuring.
My suggestion - speak again with the GP, ask the questions of them that you've asked of us, and be prepared to accept that as yet, a diagnosis can't be given, but it's likely they are going through a process of excluding serious and common causes of chest pains and irregular heart beats.
What's left are the 'safe', but unexplained causes.
Pains and dicky hearts can be anything form a heart attack, to a panic attack.
DrP
Edit: Oh, i can pretty much guarantee you would have had tests performed to rule out a heart attack in A&E (the troponin people have mentioned). It's often taken before you are even assessed by a doctor.
PS, can I have your stuff if you do, you know.....
I suppose when they say blood test it's actually a number of blood tests on one sample for different things? Or is troponin more specific?
Yes they do more than one test.
I don't see how they could tell the difference between harmful and non harmful without seeing one on an ECG though. I've never had one during an ECG, so I've just described them.
Well there you go that's one of the reasons why it's likely to be less harmful, not having them constantly.
Is very good but don't read it too much or it will scare the crap out of you.
I must seem like a right old paranoid fool but I'm not used to being ill and I've never had such ominous feelings/worry about being ill before. I suppose it is being exaggerated by me feeling that though. I suppose I can take reassurance from the fact that having had the sharp pain in my chest and left arm on a number of occasions and still being OK must mean they weren't MI's. riiiight? :/ surely 10 or so of them in a month would put me on my arse for a long time?
The paramedic did tell me as well that I was not having an MI when they arrived, and when they got me calmed down and everything that my heart rate dropped crazy fast back to normal. But I did wander if he was insinuating I may have 'had' one, without wanting to stress me out.
I don't know. Something doesn't feel like its adding up. But thanks, advice so far has been reassuring. (bar all the you're going to die, can I have your stuff comments lol) ESPECIALLY FROM A DOCTOR! :p
Would there be any symptoms beside ECG proof of an underlying heart condition?
And would someone mind telling me a little bit about the Gland in my neck that might be the culprit/a contribution to my symptoms? Is an overactive thyroid easy to treat/dangerous?
What I can't work out is how this pleuritic infection would cause pain in my left arm either. Sorry for all the questions but it's nice being able to remember things I keep telling myself to ask my GP but forget.
I can't help you with the ECG stuff but I have and still do suffer with anxiety and stress. I've had anxiety pains for over 20 years. When they first started in the chest, they were quite short but very sharp pain, painful enough to stop me from wanting to breath in. Fast forward 15 years and the pain is like someone jabbing a dagger into your chest, just right of the left breast looking downwards! I can breath in ok when the pain is there now. It's very painful and caused me to go to my doctors. I had an ECG and there is nothing wrong. It is anxiety pain. It is so painful it will convince you, you are having a heart attack. Sometime the pain will last for days, depends on the how stressed I feel. I took a life style change to calm everything down, but even now I still get chest pain. Hope this is helpful, try not to worry too much. I'm still kicking around and riding my bike with a long history of chest pain!
Would there be any symptoms beside ECG proof of an underlying heart condition?
Changes in bloods.
What I can't work out is how this pleuritic infection would cause pain in my left arm either
Referred pain it's called, there's theories why it happens but if you imagine 2 going to different locations but meeting at the same junction box. At this junction box the wires are exposed and not covered. One of these wires carries a current the other doesn't but when they meet the junction box some of the current transfers over triggering the other wire.
Does that make sense?
It's the nerves meeting close together in certain areas, particularly the spinal column.
Can I have a tenner on it being nowt?
(Or your stuff if you kark it?)
😉
PS, can I have your stuff if you do, you know.....
Been a secret fan of DrP for a while, love his bed side manner. 😛
This time last year I started getting chest pains - put it down to a strained rib or bruise.
It didn't go away, so eventually I went to the docs.
It's surprising how quickly you can get an ECG done when you present to the docs with mysterious chest pains - especially if you are over 40 and over weight. Also blood tests, urine tests and various other tests.
ECG (and the rest) showed nothing, so the doc decided it was probably reflux, gave me a months supply of posh rennies or something. No change, still got the pains, so he gave me another months supply.
Still no change, so I decided I couldn't be bothered with it, stopped worrying about it and the chest pains disappeared almost straight away....
So you will probably be absolutely fine, which is handy, cos I'm too short for any of your bikes if you...y'know....
Changes in bloods.
You mean it would show up in a blood test?
Re referred pain - that makes a lot of sense but Damn human body - you complicated.
So the general consensus is that the ECG will come back fine like the others, but possibly with a slight irregularity, and my GP just doesn't understand the one she was given?
Hopefully an all clear on the ECG from the Hospital will mean I can forget all about it and accept that the viral thing will have to go at some point 😐
I've had anxiety pains for over 20 years.
Jester, that is very very interesting. A previous doctor said she thought me stressing/being anxious about being ill was making my symptoms worse.. so we shall see. I know that if I get an all clear on the ECG that I will be a lot less worried.
Can I have a tenner on it being nowt?(Or your stuff if you kark it?)
You sir, are on. Hang on that doesn't work for me either way though does it.
Ill certainly buy you a beer if you live anywhere near close lol.
Had a funny turn on a business trip in September and ended up being rushed to Prague A&E with a suspected heart attack.
They couldn't find anything wrong and put it down to stress / anxiety. But when I got home work insisted I went to see a cardiologist. I've so far had 24h ECG monitoring, 24 Blood Pressure monitoring and an echocardiogram.
They all came back normal.
Doesn't stop you worrying, but it's good to know the tests are pretty reliable. I guess it was frightening at the time as I'm a ripe old age and a tad fat.
Keep talking to your GP and try not to fret until they find something, which they may well not. My symptoms are decreased and almost gone now - so the ways see it I've had a good MOT 🙂
Oh, i can pretty much guarantee you would have had tests performed to rule out a heart attack in A&E (the troponin people have mentioned). It's often taken before you are even assessed by a doctor.
So can I definitely rest easy in knowing that if I did have a minor MI that night, that they would know from ECG and Blood test an hour or so after it passed?
You have to treat me like a human body idiot here... because that's what I am. I wouldn't get past the contents page on a cardiology for dummies book.
I've so far had 24h ECG monitoring, 24 Blood Pressure monitoring and an echocardiogram.
My doctor suggested a referral for a 24hr / week long ecg. No one has mentioned blood pressure to me, although it was checked on the day of my pain by paramedics and hospital and they never mentioned it as a problem.
No the blood test needs to have one taken and then another one taken 6 hers afterwards to rule out an mi. The doctors obviously didn't think the pain sounded cardiac.
Oh. that's a little worrying.
Nuke me old china. As I said, I'm not a doctor, but trust me on this one.
Chill. You are gonna be ok. 😉
Relax, you''l have a heart attack.
🙂 can you seriously give yourself a heart attack by being stressed? Or is that just an old phrase? I'm actually genuinely interested.
Nukeproof - I have been through a very similar experience in the last year, similar syptoms and test results, and I have ending up on a daily drug to control stomach acid. But the real cause of my problems turned out to be caused by health anxiety, there were two things that helped me beat it. firstly i saw a councillor who talked me through things and taught me ways to relax. And secondly and possibly just as importantly, [b]Stop looking on the internet for answers[/b] - the more you read the more possibilties you come up with - self diagnosis is not helpful. I found this difficult, I have a scientific mind and find it hard not to analyse and search for answers, but trust me, it is not helping you.
Trust what your doctors are telling you, and next time you see him ask if there is a counciling service available.
I genuinely hope you get through this, I have been where you are and its tough, but be strong.
Sneaky, thanks for that, genuinely nice to hear that. Im hoping that when I get a definitive diagnosis and an all clear on my cardiac concerns I will be able to just forget about it.
If my pain symptoms continue I will definitely go to see an anxiety specialist to see whats occurring.
I just can't wait to get back on my bikes. So fingers crossed the ECG's come back normal etc. 🙂
And yes I will definitely stop reading about shit my symptoms have nothing to do with on the internet lol 🙂 thanks man
Right let's get the facts briefly once again, your 21yrs 10 st and have chest pains, sounds to me like a case of too much cocacola...
Seriously though, best to get a 2nd opinion by a pro of course trained to deal with giving accurate information rather than funkin you bout all into a frenzy to inflict more chest pains from worrying wtf is going on.
I've been through this with much panicking. I have a very unusual resting ECG. This has prompted all sorts of investigations.
I've just done 30 mins on the turbo....
Try not to panic. Deffo don't hit search on google. Chase up the referrals from your GP.
Go and speak to your gp. We can't really help you over a forum. I agree chill out, its likely nothing.
she told me that "paramedics are not trained to diagnose any heart issue from an ECG other than a heart attack".
Funny that...
I seem to spend an awful lot of time going out to patients at the request of our local GP's to carry out and [u]report[/u] on ECG's??
Although Pook hasn't had chestpains I want him to have a ECG (for irregular heartbeat). Just to be sure.
Dammit. All those weeks studying and 2 weeks on CCU wasted, when all I needed to check was ST elevation. 🙄Another thing I forgot to mention is that she told me that "paramedics are not trained to diagnose any heart issue from an ECG other than a heart attack"
To the OP- as said above, stop worrying and it sounds very much pleuritic or anxiety related rather than cardiac.
Edit:
Quite. Not to mention the several I've attended left sitting in the waiting room (and one sitting on the wall outside the surgery) who were actively having an MI !!Funny that...
I seem to spend an awful lot of time going out to patients at the request of our local GP's to carry out and report on ECG's??
I'm willing to go up to £20....
If the A&E docs didn't do a troponin and then repeat it 6 hours later then they must have been very convinced by the history/examination that you were not having an MI. This is reassuring, honest.
(What bikes have you got?)
OK paramedics, let's see how good you are:
I have RBBB where the RSR' is almost completely positive (i.e. above the "base line") and deep and wide inverted t-waves in V1-V3.
What's wrong with me?
^
I'll play.
Despite T wave abnormalities typically being ischaemia related, inverted T waves can be a normal finding following positive RBBB, so I'm going to say [b]normal[/b].
However, Googling your ECG report, oddly, suggests "GAIDS"...
DrP
PS - If I'm wrong, can I have your stuff...
I think you doctors are paid quite enough.
If anyone gets his stuff it should be a nurse.
so I'm going to say normal.
Good call. But analysis is roughly along the lines of: in RBBB t-waves ought to be concordant. Mine are discordant. Inverted t-waves in v1-v3 suggest ARVC. So, after testing for Brugada* and ARVC, conclusion is "unusual, but normal for me". Resting and stressed ECG show the same pattern.
So, you can't have my stuff just yet.
OP - don't read any of this, or you'll get the fear..!
*As decided by a consultant cardiologist. Dismissed as "unnecessary" by consultant electrophysiologist. Doctor Wars!
That's what he said, "Normal"
The internet is becoming the leading cause of hypochondria in the Western world.
Hadn't read the initial post your 21 and ten stone. It would have to be a very convincing story to make me do troponins. Yours doesn't sound like that. If i had seen you i wouldnt done troponins either. Stop worrying get on with your life.
dr_death - Member
Can I have a tenner on it being nowt?(Or your stuff if you kark it?)
Don't fall for it.
molgrips - Member
The internet is becoming the leading cause of hypochondria in the Western world.
With enough time, I can convince myself that I have anything.
Don't listen to this buch of quacks OP, your diagnosis is easy; Bad aids.
I'm surprised no one else had point this out.
Quite. Not to mention the several I've attended left sitting in the waiting room (and one sitting on the wall outside the surgery) who were actively having an MI !!
I was under the impression that even the mildest MI puts people on their ass? Is this not true then?
I'd have thought someone having an MI would be absolute top priority!
OK paramedics, let's see how good you are:I have RBBB where the RSR' is almost completely positive (i.e. above the "base line") and deep and wide inverted t-waves in V1-V3.
What's wrong with me?
To be clear, we may not know what's wrong with but we will know that it's not an MI. We will recognise, I hope, that it's a RBBB. You can see why DrP and DrDeath are pain more than me now, they have done much more training. We can recognise more than a patient having an MI though.
I was under the impression that even the mildest MI puts people on their ass? Is this not true then?I'd have thought someone having an MI would be absolute top priority!
No it depends on many factors.
You'd think they would wouldn't you.
Terminal Hypochondria, that's what it is...
MTFU! If you were at risk, you'd be in a ward swapping grisly stories with other cardiac patients.
It's not skill or training.
I tell [b]everyone[/b] they're fine.
For the vast majority of the time, I'm right......
DrP
Terminal Hypochondria, that's what it is...
Thanks. It's not.
Nukeproof riding, switch computer on, and insert little finger into a spare usb port, and run a virus scan.
Easy. 😯
Can i borrow your bike,
You dont see many st elevation mi's these days.
And drs and paramedics get over yourselves we all get it wrong sometimes! I can think of 2 occasions in the last 10 years when i have done a housecall after the paramedics have left, only to admit the patient to hospital with symptoms suggestive of an mi with a " normal" ecg. If in doubt get the enzymes done!
Can i borrow your bike,
It's a scalp. Are you man enough? 
You dont see many st elevation mi's these days.
Surely that depends, we see quite a few hence why they setup PPCI direct admissions for Ambulance staff.