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How Accurate Is Resting Electrocardiogram In Detecting Heart Attacks?

Posted on Mon, 20 Oct 2014

Question: How reliable and accurate is a normal resting echocardiogram and a normal CT Cardiac Angiogram Coronary scan at ruling out potential heart attacks and heart disease/angina?

Answered by Dr. Shailja Puri (4 hours later)

Brief Answer:
Negligible risk of angina or heart attack.

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

A normal CT cardiac angiogram is quite accurate in detecting ischemic diseases of heart.
Ischemic diseases include angina and heart attack.
All major blood vessels of the heart (coronaries) are clear and do not show any kind of obstruction.
With this kind of report, the chances of angina or heart attack are negligible.
A normal resting echo cardiogram is also a reliable investigation for detecting any obstruction or other lesions of cardiac wall and valves.

Thus, do not worry.

Thanks and take care
Dr Shailja P Wahal

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Shailja Puri (46 minutes later)

Thank you

So despite having central chest pain and pains/aches in my neck, upper back and both arms it's non cardiac and something like costochondoritis or a trapped nerve in my neck? My cardiologist discharged me without speaking to me so I never got anything explained

I've also had an endoscopy which showed I'm gastric so could that be causing my symptoms?

I'm frightened I'm going to have a heart attack in a few weeks or months because I have all the symptoms despite my tests being normal

Answered by Dr. Shailja Puri (12 hours later)

Brief Answer:
No cardiac problem, don't worry.

Detailed Answer:
Hello and welcome again,
Your tests are normal so no risk of cardiac disease at the moment.
The pain in the neck and upper back could be due to nerve compression or some skeletal pathology.
Gastritis can also cause pain in chest, neck and upper back.
So, treatment for gastritis is required.
Don't worry there is no cardiac ailment.

Thanks and take care
Dr Shailja P Wahal

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Shailja Puri (2 hours later)

The reason I had the cardiac ct angiogram is because my troponin T level was .44 back in May this year.
Six hours after the initial troponin blood test that showed .44 it dropped back down to below .10 so the hospital said I hadn't had a heart attack and my test results which I sent to you were normal

I've read that because my troponin was slightly raised I have a high chance of mortality within 1-3 years! I'm so frightened! My own gp said he can't explain why my troponin was raised so no one is explaining anything to me! I've still got heart attack symptoms and I can't understand why I had slightly elevated troponins in my blood with no explanation! I did have an agoraphobic panic attack at the time I felt pain travel from my heart down my arm to my thumb like a lightning bolt and that's why I went to hospital and they kept me in due to the raised .44 level and gave me the ct angiogram

Am I at risk of dying in the next 1-3 years because of that elevation in troponin t?

Answered by Dr. Shailja Puri (4 hours later)

Brief Answer:
Elevated Trop T levels inexplainable,TMT suggested

Detailed Answer:
Hello and welcome again,

Your cardiac investigations are within normal limits.
The elevated levels of Troponin T are in-explainable.
Since, you are quite worried about your cardiac health, I suggest you to go for treadmill test (TMT test).
In TMT test, the heart activity is monitored as the stress on heart increases.
Thus, consult your cardiologist for prescription of this test.
This test will detect whether there is any compromise to cardiac blood supply during stress.
You can stay on regular follow up with your cardiologist even if TMT test comes out to be positive.

Thanks and take care
Dr Shailja P Wahal

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Shailja Puri (1 hour later)

Thank you

My gp won't refer me back to a cardiologist he keeps saying my heart is absolutely fine and I have the test results to prove it and I should stop worrying so I won't be able to have a Tmt because I've tried to get one before but my gp refuses to refer me because he says my heart is fine

I also had an endoscopy which should I was gastric and have to take omeprozole could i be suffering from esophageal spasms or could the gastris cause my symptoms?

Answered by Dr. Shailja Puri (37 minutes later)

Brief Answer:
Gastric problem can cause pain.

Detailed Answer:
Hello and welcome again,

I too agree with your GP that your heart is absolutely normal according to your reports.
Gastritis and reflux can cause chest pain, pain in neck region and pain radiating towards the arm.
Omeprazole is effective in controlling the symptoms of reflux.
Persistence of symptoms in-spite of treatment suggests some other cause of symptoms.
Musculoskeletal cause is most probable cause of these symptoms.
Consult your physician for clinical assessment.

Thanks and take care
Dr Shailja P Wahal

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Shailja Puri (1 hour later)

Thank you

I think you're right it probably is Musculoskeletal I'm just so frightened of my symptoms despite having clear tests my partner is a nurse and he thinks I have prezmetal angina and I've heard people have a heart attack without having blockages from that variant of angina and the fact nothing is helping my symptoms I just want confirmation of what is wrong

I'm frightened I'm going to die I'm going to a different gp on Monday do you think I should mention prezmetal angina or Musculoskeletal problems?

Answered by Dr. Shailja Puri (10 hours later)

Brief Answer:
TMT and Holter can be done to r/o prez angina

Detailed Answer:
Hello and welcome again,
Prezmantel angina icab ve picked up by TMT test or Holter test.
Holter test is a test wherein the activity of heart is monitored over a period of time.
Thus, you can consult another GP and ask for these tests to rule out prezmaten angina.

Thanks and take care
Dr Shailja P Wahal

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

Above answer was peer-reviewed by : Dr. Yogesh D