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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified MD
Category: Medical
Satisfied Customers: 63757
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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I have been having chest pains and "panic attacks" past

Customer Question

Hi I have been having chest pains and "panic attacks" past few months, shortness of breath. just had an ECG and results notes said/show sinus rhythm/arrthyhmia @91bpm
also borderline prolonged etc @440ms.
I had an episode last week where had to be taken to foreign hospital where heart rate was 140bpm for about 45 mins
Can you explain the results and if it is cause for concern? While i await my gp
Submitted: 8 months ago.
Category: Medical
Expert:  Dr Uzair replied 8 months ago.
Hi and welcome.According to the information you provided about ECG it seems like normal ECG as sinus rhythm means normal rhythm and border line prolong Qt of 440 is not of much significance. I would suggest you to get the ECG examined by your GP as well to look at all the parameters though it does not seem to have any abnormality. So relax as your chest pain is most likely related to your panic attacks instead of cardiac problem.Let me know if you have further questions.Please do not forget to leave a positive rating by clicking on stars on top right corner.Wish you good health.
Expert:  Dr Uzair replied 8 months ago.
.
Expert:  Dr. Thomas, MD replied 8 months ago.
HelloI am Doctor Thomas, a double board certified doctor in internal medicine and integrative medicine, with advanced training in several other fields. I am a clinician of over 20 years experience. I will give you an answer or ask you a question, but be sure to use reply to expert to communicate with me as needed.Standard of care answer follows:A heart rate of 140 warrants a home holter monitor for 48 hours. If the EKG was not done during this elevation, even more need to further investigate. This needs to be clarified.You could have a rhythm problem.A stress test is needed to rule out cardiac artery disease.Not one EKG. You are young for this, but just an EKG can not tell that you don't have bad arteries. It can show a heart attack, but not vessel disease, small vessel disease and other coronary syndromes.See a cardiologist, get a referral. At minimum, one cardiology consult is indicated...required in my view. Many heart conditions, typically mitral valve prolapse, are dismissed as "panic attacks."I am a double board certified clinical doctor.Find me anytime for correct answers.Please click a positive. The rating scale is at the top of this page.Come back as needed. I am here for accurate, safe, up to date and comprehensive answers.
Customer: replied 8 months ago.
Hi i am awaiting further blood tests to come back. One blood test i had last week for for only showed liver SGPT level high at 88. But my feet are swollen massive and fluid in legs, i had a doppler but no dvt. The radiologist said veins in lower legs are close together with valves not functioning properly to return the blood flow. I was born with heart murmur, but apparently this resolved by age of 4. I have family history of heart disease and attacks also.
Expert:  Dr. Thomas, MD replied 8 months ago.
HiMy answer is the same.One elevated liver enzyme does not tell us anything.It should be repeated with the whole panel.You need a holter and a stress test.Bad veins can be from obesity, but swelling can also be from thyroid disease, liver or kidney problems, right sided heart problems, and other causes.You need to pursue my answer above [please read it again, this is the second expert] with your doctor, and a cardiologist [at least one consult]. OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here daily.

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