I'm worried about an abnormal EKG I'm 68, female,

Patient

Q: I'm worried about an abnormal EKG. I'm 68, female, in good health, and have a lot of anxiety. I've had skipped heart beats for over 40 years--/ sometimes very debilitating. All cardiac work ups have always been normal. Recently I had yet another bout of debilitating skipped beats and went to the GP on a state of panic -- again. All I was told was the EKG was abnormal. The strip was sent to my past cardiologist who told me the change was insignificant. He said it could be anything from my position to a misplaced electrode. He was not concerned. But I am. I'm reading on the internet about all the bad things that could be wrong. Is it really possible that this is nothing to worry about? Please let me know. I'm extremely worried! Thank you.

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,

The fact that you have been suffering from anxiety since last 40 years but otherwise keeping a good health, then these missed / altered rhythm of heart if are associated with anxiety episodes only or have been regular. The EKG has shown an abnormality, so in my view A repeat EKG should be done after 3 days again to look for a similar pattern of skipped beats. There can be many causes for an arrhythmia to set in, but as you said that your blood work and tests are normal, so there is no organic cause for the same. There are a list of causes which can cause skipped beats but in your case the skipped beats have been irregular and not continuous, especially prone when anxiety is experienced.

This can be treated conservatively and if it worsens or if there is an obvious abnormality on EKG in form of ischaemic changes or worsening of arrhythmias, then you can be considered for anti -arrhythmic medications by your physician.

However, a close watch in form of regular EKG check ups has to be kept with regards to your condition. Presently there is no need to panic and it shall not lead to any heart attack, if that is the concern at your end, considering the non-serious nature of changes as commented upon by your physician after seeing the EKG.
i hope i have answered your concerns,
Wishing you good health,
Regards

Comments / Follow Ups

Patient: Thank you. I didn't have any skipped beats on the EKG. I was just told it was abnormal. But my cardiologist called the change from my last EKG as insignificant. Can there actually be changes that are not cause for concern? This is my worry. I'm kind of used to the skipped beats, but I've never had an abnormal EKG before.
I know my anxieties are getting the best of me. I'm going to have a stress/echo test later next week, but the doctor said he doubted anything would be found. But I'm so worried about the abnormal EKG. Can there really be changes that are not significant? Thank you for your information and patience.
Doctor: Abnormal EKG can be as your doctor said due to moving during the EKG graph or probably wrong placements of leads. If there has been no significant change in the resent graph as compared to the earlier one, then there is no real cause of concern.
Yes there can be changes which are not significant and which don't require any treatment per se. With the present scenario, you need not worry and raise your anxiety further. Please relax.
Regards
Patient: Thank you so much. You have eased some of my anxiety. I read too much on the Internet, and then I worry! I go for a stress/echo next week, and the doctor said that was basically for my own assurance. He didn't seem to be concerned about the EKG change. Thank you for your thoughts. Now maybe I can relax better until I go for my stress test next week. I didn't want to feel this worried until then. Thank you again. I appreciate your help.
Doctor: Thank you so much for using our services. Please be relaxed and do share with us the results of your stress echo.
Regards
Patient: I got the results of my stress/echo yesterday. The cardiology nurse called and said everything was normal ---- normal stress test and normal echogram. She said the doctor could prescribe some medication that might help but would rather wait to see if this reassurance helps some. In any case, he called my skipped beats a nuisance and benign. He suggested that the abnormal EKG at the local doctor could be due to a misplaced lead; however, he didn't see anything of significance. The follow up stress EKG was normal. I'm relieved and now am doing meditation every morning to see if I can calm my anxiety. Thank you so much for your help.
Doctor: I am happy to learn that your tests are normal and have eased you anxiety to a great extent. Thanks for using our services,
Regards

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