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Suggest Treatment Or Atrial Flutter And Myocardial Ischemia

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Posted on Thu, 7 May 2015
Question: I am a 63 year old white male.I am 5'10" tall and weigh 210 pounds.I am a former ice hockey player.I do not smoke or drink.I eat healthy.I am happily married and have a good management job.I ride an exercise bike a few times per week and walk a few days with no problems.I take vitamins.I take 10 mg Lisinopril for blood pressure,40 mg Simvastatin for cholesterol,1000 mg niaspan for HDL.My total cholesterol is 141,triglycerides 75,HDL 52.My blood pressure averages 123/72.My heart rate average is 68.I do not have diabetes.My A1C is 5.2.I do not have chest pains or shortness of breath. I have been having paroxsyminal atrial flutter for around two years.I went to a Cardiologist a few times and had a complete exam,extensive,blood work,chest xray,stress echo,ultrasound of aorta and carotid arteries,and nuclear perfusion stress test .They had me get an ablation done for the flutter.I was told the following;Normal size heart.Normal valves.Normal size aorta inside and out with slight calcification.Slight calcification of one carotid arterie.Ejection fraction of 65 on one test and 70 on another.Lungs ,carotid arteries,heart all sound normal.BNP blood test of 25 once and 18 another time.Slightly low magnesium and potassium[they have me taking Magnesium tablets and eating bananas].Normal wall motion.Normal left ventricular function.[They say I have some stiffening of the left ventricle which they called dystolic dysfuction]No reversible defects were seen.They said it was a negative electrocardiogram for myocardial ischemia.The nurse said I passed the stress test and would not have to come back for a year.They put me on 100 mg of Metoperol, and 325 aspirin for the atrial flutter issue.I was told both of my ECG's showed a 1mm horizontal ST depression 1 11 avf v3-6.The nurse could not tell me what the ST depression meant but that I passed the stress test. My question is should the 1mm ST depression be of concern to me after passing the stress test ok?

My horizontal 1 mm depression was 11 111 avf v3-6 .[not 1 11 avf v3-6 as listed above]
doctor
Answered by Dr. Lilit Baghdasaryan (47 minutes later)
Brief Answer:
It is not significant abnormally in case of negative stress test

Detailed Answer:
Dear Sir,

You have good tests results.
Horisontal ST depression can indicate ischemia if more than 1 mm. 1 mm is not considered ischemia yet. In case we see an ECG with slight ST depression we perform stress test, if stress test is negative, there is no ischemia.
You have negative stress test, so I think there is nothing to be concerned.

Hope I could help you

Wishing you good health

In case of further questions don't hesitate to ask

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

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

Cardiologist

Practicing since :2007

Answered : 1536 Questions

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Suggest Treatment Or Atrial Flutter And Myocardial Ischemia

Brief Answer: It is not significant abnormally in case of negative stress test Detailed Answer: Dear Sir, You have good tests results. Horisontal ST depression can indicate ischemia if more than 1 mm. 1 mm is not considered ischemia yet. In case we see an ECG with slight ST depression we perform stress test, if stress test is negative, there is no ischemia. You have negative stress test, so I think there is nothing to be concerned. Hope I could help you Wishing you good health In case of further questions don't hesitate to ask Regards,