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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does ECG Explain The Cause Of Chest Pain, Dizziness And Nausea?

I went to the ER on Sunday. I was having chest pain, dizziness, shortness of breath and slight nausea. They performed a ECG and found sinus rhythm with frequent premature ventricular complexes and possible complexes with aberrant conduction. Prolonged QT were found. (QT/QTc 466/524) The second ECG found sinus rhythm with occasional premature ventricular complexes and prolonged QT. (476/510) Two sets of blood work was performed and the first found a .11 troponin level and the second was .13. I was admitted and my symptoms improved and was released. The doctor who released me said I did not have a heart attack, but could not explain why had happened. He also did not give a reason why a heart attack was ruled out, but did mention my age in my report. (I am only 29) Could someone explain this to me?
Wed, 29 Apr 2015
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Diabetologist,  's  Response
Hi,
After going through your case, I want to know-
1) Family history of heart disease.
2) Habits like smoking, alcohol.
3) Taking any medicines for any current illness or other long term medicines.

Your ECG changes suggest abnormalities of electrical activity of heart with occasional abnormal conduction.
There may be following reasons for it -
1) Prolonged QT in ECG it is usually associated with use of certain medicines (some antibiotics, drugs for nausea vomiting), hypocalcemia (low calcium level).
2) Other metabolic causes like kidney dysfunction.
3) Heart attack.
4) Degenerative changes in heart (this is usually present in old age group)

I will advise you to do following tests:
1) 2DEcho of heart : it will give more information about pumping capacity, any findings of heart attack (regional wall motion abnoramlities).
2) Kidney function test (serum creatinine, urea, electrolytes, serum calcium, magnessium.

Though your age is 29 and cardiac enzymes (Troponin) are normal coronary angiography may be needed if there is family history of heart disease, 2DEcho finding of heart attack.

Avoid use of medicines causing prolonged QT interval.
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Does ECG Explain The Cause Of Chest Pain, Dizziness And Nausea?

Hi, After going through your case, I want to know- 1) Family history of heart disease. 2) Habits like smoking, alcohol. 3) Taking any medicines for any current illness or other long term medicines. Your ECG changes suggest abnormalities of electrical activity of heart with occasional abnormal conduction. There may be following reasons for it - 1) Prolonged QT in ECG it is usually associated with use of certain medicines (some antibiotics, drugs for nausea vomiting), hypocalcemia (low calcium level). 2) Other metabolic causes like kidney dysfunction. 3) Heart attack. 4) Degenerative changes in heart (this is usually present in old age group) I will advise you to do following tests: 1) 2DEcho of heart : it will give more information about pumping capacity, any findings of heart attack (regional wall motion abnoramlities). 2) Kidney function test (serum creatinine, urea, electrolytes, serum calcium, magnessium. Though your age is 29 and cardiac enzymes (Troponin) are normal coronary angiography may be needed if there is family history of heart disease, 2DEcho finding of heart attack. Avoid use of medicines causing prolonged QT interval.