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weird EKG


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so yesterday I had to go to the GP for a physical. I, personally, do not like this office. I had to leave a great DR due to insurance changes. I have not had many "good" doctor experiences so i was pretty nervous about going. I had been in the previous week to get prescription refills, among them was Xanax. We takled at length about my anxiety. During that visit i had normal blood pressure. So last night i go and they make me pee in a cup and then hand me a gown and tell me to take off my shirt and bra.. this freaks me out b/c ive NEVER had to remove clothing for a regular physical. The nurse then takes my blod pressure which at this point is up a bit 130/80 - NOT normal for me. last time i had a read like this i was preeclampic with my 1st pregnancy. then she has me lay down on the table and hooks me up to electrodes. Ive had an ekg before but i was getting upset b/c i am allergic to the stuff they use to stick teh electrode on your body plus some strange woman is fishing around in my open paper gown all around my boobs... so she does the SHORTEST ekg ive ever had. The Dr comes in and doesnt like it. He starts rapid firing questions at me ive explained my past expereiences with heart monitoring - all turned out to be false and unneeded testing. He repeats the EKG, the results are a tad better but still "weird" I warned him that i would get an itchy rash from teh electrodes but he brushed it off till he came back in teh room after the 2nd one and saw my arm was already broken out and itching. So i think this is all tied to panic but they are trying to force me to see the cardiologist. I JUST had an extensive EKG done in feburary when i blacked out and sprained my hand. It was completely normal and the fainting episode was caused by Paxil. All of this is making me more uncomfortable about entrusting this office with my care. Due to my insurance i can not change docs and i need to make a return appointment to have a mole biopsied. I also have to see a dermatologist about a spot on my face.. more docs UGH. I'm tempted to take my Xanax before my next visit but if he tries to repeat the EKG wont it monkey with the results in a bad way and make him think i have some OTHEr heart problem??? have any of you ever had blood pressure or ekg  read weird b/c of anxiety?

gah, at this point i'm so worked up remembering this that i'm starting not to make sense

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Dear Fidget,

It just goes on and on doesn't it.  Poor girl.

I haven't had any abnormal heart stuff, though I've had EKG's annually for work for about 25 years.

Blood Pressure:  130/80 is a bit elevated, but not a worry.  It isn't considered high and require treating till 140/90.

Short EKG:  The newest computerized EKG machines can do an accurate run in about 20 seconds. I was stunned last year in how fast it was.  I'm used to taking 5 -15 minutes.

Did the doctor tell you what he was seeing wrong? Like an elongate QT or whatever.  The heart stuff is very confusing, I know.

I'll do a med effect search for you if you let me know what you are taking.

Could it be anxiety? Again, not knowing what he thinks is wrong its hard to say. I can tell you that before I got into the MI game I used to have chest pains and heart palpitations, where it felt like my heart skipped a beat.

But whether you like the doc or not, he isn't going to make up stuff about your heart.  We all like to think we are bulletproof when young, but as we get older things do start to happen our bodies.

Get the consult with the cardiologist. He's the expert and will quickly know whether something is really wrong or whether it is a medicine or anxiety.  It won't hurt I promise.

Please follow through on this, for your families sake.

A.M.

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im not on anything other than the occasional xanax. The DR office used to give me serious panick attacks as being in a place where they could theoretically stab me with a needle at any given point FREAKED me out. I had to take 2 shots a day during my second pregnancy so im not AS bad about needles but they still freak me out. All he said is that my heart was not beating in a normal pattern. He asked if i had ever had an issue with irregular heartbeat - ewhich i did while pregnnt with DD #1 That incident turned out to be "nothing" but my current OB thinks it may have been an overlooked blood clot b/c i have vericous veins. The reason i am trying to avoid following up with the cardiologist is

trying to find a babysitter

the COST involved

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(I am not a doctor)

Ok, as I understand, you did have irregular heartbeat during a pregnancy, which they thought at the time was not significant.

Your OB/GYN now thinks that incident may have been from a blood clot due to vericose veins.

You are having irregular beat again, on this latest EKG.

****************

Ok, I'm going to throw out some maybes and what if's.

You have varicose veins, where blood tends to pool.  That increases the risk of blood clots developing, which can either stay in place or travel thru the circulatory system causing things like stroke, pulmonary (lung) embolism, heart attacks.

Your OB thinks a clot may have formed and traveled to your heart, were it blocked a small blood vessel that feeds a portion of the outer part of the heart that conducts the electrical signal that makes the heart beat.

I don't know how long your irregular rythm lasted, but two things may have occurred.  A. The clot dissolved and there was no lasting damage.  B.  There may have been some minor damage (a scarring of the tissue) but things cleared up and the heart was able to compensate for the scarring, returning to normal rythm.

What could be happening?

- You could have had another blood clot which has done more damage.

or

- The heart can no longer generate enough signal to overcome the area that was scared previously.

So why is it important to find out what's going on?

- If you are throwing clots from the varicose veins, it is dangerous and could kill you, or cause strokes.   

This can be prevented by taking a blood thinner.

- If your heart is beating irregularly, blood clots can form there as well, killing you, or causing strokes. 

This can be prevented by taking a blood thinner and a heart regulator that increases the strength of the electrical signal and makes the beats regular and strong.

Again, I'm not a doctor, but those are some possible explanations of what could be going on.

And, remember a cardiologist is 10 times better than a family doctor at reading EKG's.  Really. So it's possible you might not need anything more than an office visit.

Be well, and take care of yourself. 

A.M.

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Tonight i decided that i am going to go to the cardiologist. I was sitting thinking about when I was taking meds and the number of meds i have tried since my last through EKG in february. I am now wondering if perhapse one the the antipsychotics i tried may have caused me a problem. I am not really worried about a blood clot at this time. I work out regularly, take an 81 mg asprin a day and have had no trouble breathing or anything. My aunt died of a pulminary embolism due to a blood clot from her vericous veins so i know its  possibility. If it was a clot I would be in the ER right now. The episode i had lasted only 2 hours but it was scary and felt like my heart was going to jump out of my chest. In any event Monday i will pick up my refferal and try to make an appointment. DH is just going to have to take off of work or something to watch the kids

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Yes, please go the cardiologist - just tell DH all the fun he'll have staying home playing with the kiddies! ;)

The reason I say that is because I've had non-specialists try to do some goofy things over the years, not with heart stuff, but other things, so I always try to see specialists if I can.  One of the worst was having a GP trying to get the right mix of crazy meds.  Not a good idea!!!

Also, if it's any consolation I have very mild hypertension, but when I'm in the doctor's office I have major "white coat syndrome" and get ridiculously high b.p. readings.  I don't know if you can get "white coat syndrome" while having an EKG or not, but it's worth mentioning.  I ended up buying a wrist b.p. monitor with a memory and taking readings at home.  Now I bring it along and show the doc the memory so he can see that my b.p. is fine and that there's no need to change meds.   

As far as breaking out in a rash, why not ask the cardiologist if they can stick the electrodes on with vaseline and a piece of adhesive tape or something?  I think the main idea is to make sure there's no air space between you and the electrode.  Won't hurt to ask, anyways.  Like A.M. I was also astounded at how fast the new machines are.  And since the whole routine is unsettling, do you have a friend or family member that you'd be comfortable having stay with you during the exam?  That way if the doc has a crappy bedside manner at least you've got someone on your side to speak up if the need arises.

Hope you get everything sorted out and wish you could find a way to sidestep your insurance and get another GP.  Good luck!

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