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Dr. Andrew Rynne

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Dizziness And Chest Pain. EKG Showed Sinus Bradycardia With PACs Septal T Waves Changes. Explain?

I am a medical student and while doing EKGs i had discovered that it came up as Sinus Bradycardia with PACs Septal T Waves changes are nonspecific Borderline ECG . My teacher was concerened and so she did a patient assesment on my and i then old her that i have had chest pain since the age of 16. I have seen Cardiologist and other doctors to find the cause. Resently i have balcked out, passed out, and have dizzy spells along with the chest pain. I took my EKGs results to my family doctor today where she told me that while being on a Hulter monitor that my heart rate had dropped down in to the 20s. I aslo have high cholesterol and she told me that my heart is normal and that i have nothing to worry about,. I still continue to have the chest pain as well as passing out and ect. I would just like clarification
Fri, 5 Apr 2013
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Internal Medicine Specialist,  's  Response
Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here.

You do have a symptomatic bradycardia with escape extrasystoles (PACs) as well as dyslipidaemia.

Chest pain, dizziness, passing out is due to severe bradycardia and resultant low cardiac output.
If holter shows a severe sinus brady to 20/min or other brady-arrhythmias, and if this has been the age of 16, you have to be fully evaluated.

I would recommend a good comprehensive physical including auscultation for abnormal heart sounds.

A 2D echo should be done to look for any structural heart disease/ anomaly.

A conduction system defect should be thought of. May need EPS (electro-physiological studies) of the heart.

Rule out electrolyte disturbances (less likely) and congenital disorders.

Need to do a full lipid profile and treat the abnormal ones accordingly. You need consultation with a good cardiologist and a physician.

Lie flat when you get dizzy.
Do not neglect this. It can be dangerous.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Please ask for any clarifications before closing and rating this query.

Take care and please keep me informed of your progress at http://bit.ly/Dr-Prasad-Akole
Good Luck! Thank you!!
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Dizziness And Chest Pain. EKG Showed Sinus Bradycardia With PACs Septal T Waves Changes. Explain?

Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic! I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here. You do have a symptomatic bradycardia with escape extrasystoles (PACs) as well as dyslipidaemia. Chest pain, dizziness, passing out is due to severe bradycardia and resultant low cardiac output. If holter shows a severe sinus brady to 20/min or other brady-arrhythmias, and if this has been the age of 16, you have to be fully evaluated. I would recommend a good comprehensive physical including auscultation for abnormal heart sounds. A 2D echo should be done to look for any structural heart disease/ anomaly. A conduction system defect should be thought of. May need EPS (electro-physiological studies) of the heart. Rule out electrolyte disturbances (less likely) and congenital disorders. Need to do a full lipid profile and treat the abnormal ones accordingly. You need consultation with a good cardiologist and a physician. Lie flat when you get dizzy. Do not neglect this. It can be dangerous. I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Please ask for any clarifications before closing and rating this query. Take care and please keep me informed of your progress at http://bit.ly/Dr-Prasad-Akole Good Luck! Thank you!!