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I'm a 58 y/o female, I've had hypertension for about a year but my BP is well controlled now. I had an EKG done today and one showed it was normal, and the second copy showed that there may be possible left atrial enlargement with the P waves. My doc said it was nothing to worry about, but I read differently online. Should I be worried?
2 Responses
20748650 tn?1521032211
That depends if the machine read correctly.. If you could upload a copy i could read it.
8 Comments
Appreciate the reply. We ran the EKG twice, the doc gave me a copy of one that had normal results and he kept a copy with the one that said "Possible left axtrial enlargement" "borderline etc". So I'm not sure if uploading the one with the normal results would help. But here it is: https://imgur.com/a/aU4dg
I can see the Machines confusion. There is some features consistent with LAE.. You have a P Mitrale pattern with exactly 40 ms peak to peak and 110 ms total in lead II and a small terminal deflection in V1, so yes, its possible..

BUTTT, based on gut instinct here I think its too narrow in lead II and too shallow in V1.. Morphologies all whacky in the reference strip.. other inferior leads aren't necessarily convincing either soo, my hunch and probably the hunch of the physician is artifact/contact/ lead placement issues. Technical problems, not the heart.

Additionally you don't have any LVH which would certainly be the most plausible explanation. Assuming no Murmurs on exam.. If it was LAE you'd be pretty much looking at Mitral Stenosis as a diagnosis.. so the odds are forever in your favor as they say.

That said I would have retaken it and maybe just done the echo anyways.. because that is just a tough determination to make based on that ECG.. and noones ever been faulted for being too careful.

P.S. You have an incomplete right bundle branch block though. Perfectly normal finding, but yeah..
Also to clarify shunting would make sense with the incomplete bundle, but I wouldn't expect to see LAE exclusively in a L to R shunt. IDK if anyone else has any opinions on this.

All in all I'd give it a.. maybe 5%-10% chance of being actual LAE, all things considered.
As for the ultimate question of "will i be ok?"

Yes i think even if they ran an echo and found some mitral stenosis or prolapse etc. I think electrically the ventricles look fine.

So regardless of the outcome its not likely that youd be looking at something crazy like a valve repair or heart failure anytime in the near future.
Wow thank you for the thorough review. I am not as knowledgeable so took some time looking up some words, but overall that seems like good news! Now the machine ran it twice, and the other copy that the doc has showed some "squiggly" lines in the P wave more than to the degree in which it showed in the image that I had uploaded for you. The 3 lines underneath it seemed pretty consistent tho. I really wish I had a copy of that result maybe I could request it if it was to make a difference?

I had a chest xray and CT maybe a couple months ago and it showed normal results except for a particular term used that said "persistent left SVC" I'm not sure if this is related to the heart but I was told it was nothing to worry about. I have not had a recent one done.

And in terms of LAE I guess the best way in preventing or at least in the worst case to ease the symptoms would be to control my diet and blood pressure to my understanding.

Originally the EKG was done because I was having random cold sweats in the middle of the day where I would just break out in sweat and become dizzy and feel very weak to the point of where I would have to stop cooking and go lay on the bed. Last episode was 2 weeks ago. Blood work such as CBC came back normal, thyroid tests were fine, only abnormality it showed was some high cholesterol and high liver enzymes (I am a frequent drinker) which I now have cut down on.

First the doc figured it may be related to post menopausal symptoms but I have never had those types of symptoms is why he made sure and did an EKG as well. He also said it maybe hormone related..An echo seems like something that I definitely need to consider tho and maybe even a stress test. My symptoms are still undiagnosed.
Definately echo.. Frankly gicen your elevated liver enzymes, hormone issues and your high cholesterol you are considered to be a "high risk" patient for a myocardial infarction (heart attack) in the future. You need to do everything you can to mitigate that.

Basically i wouldnt even say its a matter of 'if' you have a heart attack but 'when'. You need to be aware of all the symptoms.. Ive written alot of good replies about this in the 'angina' forum.. I also could forward you some info via private message if youd like.

The better you manage your lifestyle the more you can prolong such an incident.
Any information you could provide would be appreciated. I'd be interested in reading it! I do try to have my cholesterol and BP well controlled.

Do you think the symptoms that I were having may have been a potential warning of an upcoming heart attack? I do know that women differ from men in the symptoms. I don't have chest pain or difficult breathing during those episodes but it was just the sudden break down of sweat and lack of energy that got to me.
Those symptoms that brought you in could have been an ep (heart rhythm) issue..,a holter monitor, 24 hour ecg would be best at finding that.

As for cardiac chest pain i recently got a pm request where i included alot of info about cardiac chest pain, ill send it hy private message before the end of the day.
20748650 tn?1521032211
As for differences in men and women for chest pain, those differences are most pronounced at older ages, e.g. over 65.

Women are more likely to describe chest pain as a gastrointestinal issue, like a stomach cramp, or nausea or heartburn.

Like i said though the percentage of women presenting like that goes up with age. In most cases standard chest pain symptoms are standard.
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