ECG Interpretation

[JerB23]

If I had 2 ECG/EKG an hour apart in the ER, how are they clinically interpreted if they are both different? I am a 23 yo male. 5'6" and 140 pounds, BMI 22.64. I presented with chest pain, I was hyperventilating, my B/P was 156/91 and I was dizzy. There wasn't really any precipitating event; I was sitting down after eating lunch and my breathing was strange like it was being determined by my heart beat instead of the other way around. Also, my left hand went into trousseau's sign during the initial b/p reading -cmp reported calcium as 10.7 and the lab uses 10.4 as upper threshold, so it was 0.3 above normal. Only other abnormal labs were elevated anion gap 21 when limit is 0-16, 1+ hemolysis, glucose 114 when range is 74-106 (I am not diabetic), serum albumin 5.4 range is 3.5-5.2, urine protein 30 mg/dL, and urine ketones 60 mg/dL.

1. The diagnosis on the one I had first says: sinus tachycardia, rightward axis, T wave abnormality (consider inferior ischemia), abnormal ecg. The accompanying data for ECG #1: Ventricular rate 116, PR interval 124ms, QRS duration 92ms, QT/QTc 314/436ms, and P-R-T axes 74-92-55.


2. The second ecg I had an hour and 6 minutes later lists the diagnosis as: sinus rhythm with marked sinus arrhythmia, rightward axis. The accompanying data for ECG #2: Ventricular rate 93, PR interval 120ms, QRS duration 92ms, QT/QTc 334/415ms, and P-R-T axes 68-92-59.

[itdood]

If your doctor was concerned about it, they would order more tests.   bad news travels very fast in healthcare.

If you search around, you'll find a lot of perfectly healthy hearts with T-wave inversions of irregularities per the test machine.  These turn out to be nothing, just particular to the person's heart.  Communication with your healthcare provider is very important, so ask.  Give them a call.

[JerB23]

I do understand that sinus arrhythmia is a completely normal finding. My main concern is the T-wave abnormality, because as far as I've been able to find on my own people having panic attacks present with either a normal ECG or other NORMAL variations, but never any T-wave abnormalities. My question then I guess is are T-wave abnormalities always pathologic? And if not, why would it show up on my ECG?

[rimeol]

What did the doctors say? ECG machines are just that, machines. It's up to doctors to confirm or not the diagnosis.

[itdood]

Looks like you had a panic attack.    Sinus arrhythmia is perfectly normal.  Google it for more info. EKGs can vary from day to day.   They are are a cheap gateway test to see if more tests are required.