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Can An Abnormal ECG Cause High BP And Breathlessness?

Posted on Tue, 3 Oct 2017

Question: Hi I'm a 31 year old female. I went to ER for high blood pressure and shortness of breath. They did a 12 lead ECG and it was normal. My blood pressure was 210/110. They referred me to a PC physician but they couldn't see me for 3 weeks. A couple weeks later I went in again for the same thing and because I was about to run out of the blood pressure pills they gave me and had an abnormal (15 lead) ECG. It said abnormal t wave consider inferior ischemia. My primary care doctor has referred me to a cardiologist. The second time in the ER they said nothing about my ECG results being abnormal. I didn't know this until my doctor pulled my records. Should I be worried? I've had chronic hypertension that has not really been addressed for several years. I feel very tired and weak all the time, headaches almost daily, I get rapid heart rate and shortness of breath with little exertion and when I lay down to sleep. I'm getting very anxious worrying that there may be something wrong with my heart and it will be weeks before I see cardiologist :(

Answered by Dr. Ilir Sharka (54 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that every ECG finding should be considered in correlation with the clinical symptoms of the patient and cardiac enzyme levels.

Did they perform cardiac enzyme levels in the ER?

I would like to directly review your ECG report if you can upload if you can upload it for a more professional opinion.

Anyway, considering the fact that you suffer from high blood pressure, which is a known cardio-vascular risk factor, I would recommend consulting with your cardiologist and performing a cardiac ultrasound and an exercise cardiac stress test to investigate for possible coronary artery disease.

Besides, it is very uncommon at your age to suffer from high blood pressure values.

For this reason, it is necessary performing some tests to investigate for other secondary causes of high blood pressure:

- a chest X ray study and pulmonary function tests
- complete blood count for anemia
- thyroid hormone levels for thyroid dysfunction
- cortisol and aldosterone plasma levels for adrenal gland dysfunction
- blood electrolytes
- kidney and liver function tests for possible dysfunction
- fasting glucose for diabetes
- urinary metanephrines for possible pheochromocytoma.

You should discuss with your doctor on the above tests.

If any possible underlying cause of secondary hypertension is found, it should be treated properly, in order to help manage your blood pressure values.

Some changes to your anti-hypertensive therapy are also necessary to avoid these spikes in blood pressure values.

Hope you will find this answer helpful!

I remain at your disposal for further questions, whenever you need.

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (2 hours later)

I do not have an actual image of the ecg, i only have a page with some numbers. Not sure if that would be helpful. I did get several blood tests including troponin and thyroid levels and they were normal. The only blood test that was abnormal said i had slightly low potassium

Answered by Dr. Ilir Sharka (7 hours later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again dear,

Thank you for the additional information.

In fact, I would like to review the ECG images for a more professional opinion.

From the other hand, considering the fact that your potassium levels were low, this could contribute to the changes in the ECG.

Anyway, as your troponin levels have resulted normal, this means that no cardiac ischemia was present and those ECG changes have no clinical significance.

But, considering these high blood pressure values, I would recommend performing further tests (besides thyroid hormone levels ) to investigate for possible metabolic disorders, which may lead to secondary hypertension:

- cortisol and aldosterone plasma levels for adrenal gland dysfunction
- urinary metanephrines for possible pheochromocytoma
- PCR and ESR for inflammation
- a chest X ray study and pulmonary function tests to exclude a lung disorder.

Hope you will find this answer helpful!

Let me know about everything!

Wishing good health,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (59 minutes later)

Thank you! That makes me feel a lot better. I hope my cardiologist is as thorough as you and tries to help find out whats going on! Theres got to be something. I shouldnt be feeling the way i do just from high blood pressure.

Answered by Dr. Ilir Sharka (9 hours later)

Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

I am glad to have been helpful to you!

You should discuss with your cardiologist on the above issues and tests.

Wishing all the best,

Dr. Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar