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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should I Have Angioplasty If EKG Report Shows Heart Attack?

Dr. Gopi, I recently had an EKG for surgery clearance that showed I had a heart attack. The EKG was repeated four times to be sure. Same result. I was sent for a stress test that showed no blockage, no damage and OK'd for surgery. Should I have an angioplasty to be sure???? I am terrified. Could I have a heart attack that left no sign of damage and no blockage???
Mon, 22 May 2017
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Pulmonologist,  's  Response
Hello
Welcome to HCM.
As per your description, your ECG suggests that you have already sustained a heart attack. But only ECG cannot be relied upon since your stress test is normal and you have had no symptoms. Stress test is normal but it has only 70% sensitivity that means it will catch only 70% of cases with blocks. Some people do have ECGs that suggest heart attack but end up having normal results.
I recommended and you undergo a 2D echo which will show if there has been any damage caused to the heart by the attack. The damage if present should correspond to the area in which ECG suggests a heart attack. If the echo shows abnormalities, then you must undergo a coronary angiogram. If 2d echo is normal then you need not worry about the ECG findings. Also important here is to do a 2d echo from a reputed centre, because it is an observer dependent test and details may be missed if done at non experienced hands.

I hope I have answered your query satisfactorily.
Wishing you good health.
regards.
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Should I Have Angioplasty If EKG Report Shows Heart Attack?

Hello Welcome to HCM. As per your description, your ECG suggests that you have already sustained a heart attack. But only ECG cannot be relied upon since your stress test is normal and you have had no symptoms. Stress test is normal but it has only 70% sensitivity that means it will catch only 70% of cases with blocks. Some people do have ECGs that suggest heart attack but end up having normal results. I recommended and you undergo a 2D echo which will show if there has been any damage caused to the heart by the attack. The damage if present should correspond to the area in which ECG suggests a heart attack. If the echo shows abnormalities, then you must undergo a coronary angiogram. If 2d echo is normal then you need not worry about the ECG findings. Also important here is to do a 2d echo from a reputed centre, because it is an observer dependent test and details may be missed if done at non experienced hands. I hope I have answered your query satisfactorily. Wishing you good health. regards.