What Causes Discomfort And Numbness In Chest Area With Normal ECG And EKG Reports?

Posted on Wed, 29 Jul 2015

Question: Hi, I went to the ER yesterday because I felt a striking discomfort on or near my heart followed by numbness over my chest. This is my 2nd visit , the 1st visit I was told I had anxiety and nothing was wrong. Since then ive been suffering from panic attacks. Only Sinus Tachychardia which is controlled by relaxing so I could get down my heart rate. Now on this visit, I was given anxiety pills I forgot which exactly. But it lowered my hr from 150 to 114. Eventually i felt better and they told me i could go. I did an EKG and a catscan/xray. However, today I had an appt with a cardiologist. She did another EKG and told me I had an arrythmia and right atrial enlargement. I was shocked because wouldnt they have seen that yesterday ? So once I got home I compared both of the ekgs. The one at the ER said: SINUS TACHYCHARDIA , RSR IN V1 OR V2, RIGHT VCD OR RVH
NONSPECIFIC REPOL ABNOMALITY DIFFUSE LEADS
PROLONGED QT INTERVAL QT315 QTc504

Now the one i took today says:
SINUS TACHYCARDIA , RIGHT ATRIAL ENLARGEMENT. VOLTAGE CRITERIA FOR LVH S(aVR) exceeds 1.40mV)
NONSPECIFIC ST DEPRESSION
seen with left vintricular hypertrophy (strain)

Now my question is , why would they let me go home from the ER if apparently I have all these issues ? Some of them ive seen are dangerous. But another thing is when they took my chest xray the write up was: FINDINGS: LUNGS NO MASS OR PNEUMONIA
HEART: NO ENLARGEMENT
UPPER OBDOMEN : MILD GASEOUS DISTENTION OF SPLENIC FLEXURE OF COLON
IMPRESSION: MILD GASEOUS DISTENTION OF BOWEL
NO EVIDENCE OF PNEUMONIA OR ACTIVE CHEST DISEASE.

Now this xray reading makes me feel much better. Now im wondering is is possible that these ekgs have both given positive negatives ? Im still getting chest pains and palps but im hoping its only my anxiety. Please help, to put my mind to ease.

Answered by Dr. Rajesh Teli (53 minutes later)

Brief Answer:
please get echocardiogram done to clear confusion

Detailed Answer:
Hello,
I am Dr.Rajesh Teli,MD.
I have gone through your query.Thanks for using HCM.
First of all let me tell you that your symptoms are due to anxiety .so first you must take anxiolytics like Clonazepam.The confusion of ECG findings has increased your anxiety further.
Many a times we come across non specific abnormalities on ECG Like IRBB etc.
most of the time they are not serious.Besides there is computerised self reporting of ECG by machine! this may give erronous interpretatiion like enlargement.In your case there is some paradox created which i presume must be due to machine reporting the ECG.so do not get panic and i suggest you to get your echocardiography done.If that is normal you should ignore this ECG finding and focus on your anxiety.
My best wishes
Dr.Rajesh Teli,MD

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

Follow up: Dr. Rajesh Teli (33 minutes later)

Thank you for quick response. I forgot to mention that Ive gotten an Echo done twice. Once at the first ER episode , secondly at a cardiologist afterwards. Both came back fine no problems. I did another one today and those results will come in Wednesday. Regardless the write up of the xray saying my heart size is fine is a relief. All my tests until today have been normal. All the other things ive mentioned in the ekg are they dangerous? Or they could also be computerized mistakes.

Answered by Dr. Rajesh Teli (2 hours later)

Brief Answer:
It looks like computerized error

Detailed Answer:
Hello,

Can you please scan and attach ECGs for my review?
Did you discuss with the cardiologist about this difference of interpretation in 2 ECGs. If the cardiologist were not concerned about it, I think you may ignore it.

Regards
Dr.Teli.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rajesh Teli (11 hours later)

Yes I uploaded the reports. I also added my bloodwork and I noticed something odd, my White blood count is abnormally high compared to my bloodwork from a month back, it was in the normal range. Does this mean theres an infection? And if there was why did they let me go, doesnt makes sense theres always something new. If the EKGs didnt upload could you please leave your email so I can contact you? I believe this is my last response before I have to pay again... Thanks very much

Answered by Dr. Rajesh Teli (9 hours later)

Brief Answer:
i have reviewed your ECG

Detailed Answer:
hello,
I have gone through your ECGs. I am sure it is only mechanical computerized reporting which has mentioned Right atrial enlargement,also there is some paradoxical difference between 2 ECGs. when u go to your cardiologist again ask him to compare both. However irrespective of this difference there is nothing serious ,so you may ignore it is as it is not significant.
coming to your high WBC,yes you may have infection.even sinus tachycardia on ECG could be due to infection,but it is not indication of retaining you in emergency.
so better consult an internist who will review your case as a whole and treat your infection if present.you may contact me on YYYY@YYYY ,if admin of the site permits.
My best wishes
Dr.Rajesh Teli,MD

Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.

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