Concerned about automated ECG result. Please help !

[BOK2Bjan]

I have mild pulmonary hypertension, an aneurysm all septum, mild valve regurgitation  (nothing to worry about), and a recent CT showed cardiomegaly. I saw my cardiologist last week due to continual severely uncomfortable heart palpitations and recent SOB with lowered pulse ox. He said the cardiomegaly might not be real  (I know), and I had sinus rhythm on ECG, but then Sunday I got the automated result which said "consider anteroseptal infarct and myocardial infarct findings are now present". I called the office Monday to ask about it and the Dr was out. Nurse said she'd give him a message - that he hadn't reviewed it yet. It's Wednesday and I haven't heard back.

An echo is scheduled in a month, but it seems like they should do it right away. Even if it isn't accurate - given my history and symptoms - I feel it's irresponsible. He spent 3 minutes with me - ordered no other tests. I've seen him before and have had many echos - heart cath  ('08 when diagnosed PH), and one echo showed LVDD), but a subsequent one didn't). I really could use advice! I have Systemic Sclerosis and MS too. The Systemic Sclerosis has damaged my lungs and I think caused the aneurysm.

Thank you for any help - feeling alone!

[coffee101]

The standard for dx a heart attack is having 2 out of 3 of the following features 1) Typical chest pain or equivalence (i.e SOB), 2) ECG changes 3) Biomarkers. As such, if you are symptomatic particularly with chest/jaw/armpain, SOB or diabetic (silent MI), I would definitely be concerned given potential changes in the ecg (that gets you 2 out of 3). Otherwise, automated ECG has a very high false positive rate almost intentionally by design.

Since you mentioned having SOB, if that is progressing and/or not resolving (sign of a failing heart) I would see a doctor right away to confirm if there are true changes on ecg, alternatively a simple blood test looking for troponin would do as well.  

Echo can pick up potential heart attacks particularly in the acute setting where you can have wall motion abnormality, but that's not its purpose here as there are easier way to dx MI as mentioned above. Echo will be useful to assess the progress of your PHTN and confirm if you have cardiomyopathy - what was called "cardiomegaly" on CT.

I hope everything works out.      

[Rosemary349]

Where in the world are you?  I just saw a brilliant cardiologist today, but I'm in the UK....I would recommend him...

[Rosemary349]

Sorry that's not helpful, I see now you're not in the UK.  I wish you well.