Suggest Treatment For Chest Pain And Septal Infraction

Posted on Mon, 27 Apr 2015

Question: I am a nurse and I work for an Internal Medicine doctor. Back in 9/2014 I went to work with some sob and slight chest pain going through to my back(I know better but continued working) the next morning the something happened again but slightly worse. My doctor came in and I spoke with her about it, we have an ECG mach so she ran one one me and DX me with septal infarction and set me to the ER. They ran all kinds of tests and said nothing was wrong and kinda pushed me out the door. Since that time I have had some chest discomft through to my back and now my left arm goes numb sometimes. The last couple of days I have had the sob again and just didn't feel right so when Igot to work I did another ECG this time it said I had an anteroseptal iinfarction with sinus tachycardia. I have a strong family history of triple bypasses and quadruple bypasses. I showed the new ECG to the doctor was told not to worry its not acute...having a hard time with that answer...need some answers on what needs to be done, how serious is this...etc and to top everything off my doctors office does not offer health ins. please help I'm only 45..Thanks in advance.

Answered by Dr. Benard Shehu (30 minutes later)

Brief Answer:
Can you upload your ECG for me?

Detailed Answer:
Hi XXXXXXX and thank you for asking!
I read your query and understood your concerns.

First of all i would like to give a look at your ECG, and than I would give you a more accurate opinion. Can you upload your ECG for me?

Your symptoms are suggestive for ischemic heart disease (coronary arteries blockage) and you should do further examinations in order to find out the right diagnosis and to evaluate the future risk.

If you were my patient i would recommend to do the following examinations:
- Blood work to exclude recent heart infraction (including heart enzymes; CK-MB and troponine levels).
- Cardiac ECHO, (that exclude any previous heart infarction).
- Stress test (that serve to diagnose any coronary arteries blockage and to evaluate the future risk).

If there will be evidence of previous or recent heart infarction, or you are in great danger to develop a heart attack (a positive stress test), you should do angiography and eventually coronary stenting if needed.

Hope this was of help!
Wish you health!
Dr. Shehu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (1 hour later)

I attached 2 ECG"s 1 from yesterday and 1 from 9/2014 sorry for multiple files. In 9/2014 the er did labs and checked the cardiac enzymes and all others but nothing showed up now each one of my family members that have had the bypasses never had anything show up on labs and had to demand that further test be done and the test came back with blockages and some had to have immediate surgery is this common?

Would like to know what you think pretty nervous waiting on your answer

Answered by Dr. Benard Shehu (3 hours later)

Brief Answer:
Following answer to your query.

Detailed Answer:
Hi back,

After reviewing your ecg my opinion is, that your ecg show nonspecific dynamic changes for coronary arteries blockage.

This is why you should run the above mentioned exams ( cardiac echo and stress test). Only if those tests result positive for coronary artery blockage you should do angiography.

Otherwise you should continue with regular follow up with ecg echo and stress test every year.

Hope this was of help!
Dr. Shehu

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar