Any nurses/doctors around..

[OneTwoStep]

Please can you tell me how accurate an ECG is. Could is be abnormal but be both wrong?

I had an ECG last week and it came back abnormal, indicating possible mini heart attack! I'm young, no family history, don't smoke/drink and exercise. I'm waiting for further tests but going out of my mind with worry...could the ECG be wrong?

Why did you have an ECG?
Who told you there could have been a 'mini heart attack'?

ECGs are like a photograph. They capture that moment in time that they are taken. They can be very sensitive to movement.
Having a cardiac event can leave 'scarring' which can be picked up by an ECG, and interpreted by its reader. There are many nuances to ECG interpretation.
You need a raft of bloods and possibly an echo to definitively tell you if you've had a minor cardiac event.

Not a medical professional, but 18 yr old DS had chest pain last year and was sent to A&E for an ECG. It showed he’d had a heart attack, but when a senior Dr came to review, he said the machine wasn’t on the right settings for someone his age and hen he changed the settings, ECG was normal.

*when

The further testing will give you your definitive answer.
Interpretation of an ECG is everything. I am a cardiac patient and my husband is a GP. Last year, the paramedics ran an ECG on me in the ambulance which was normal. I went into cardiac arrest 8 minutes later... so their interpretation was way off.

Thank you so much for replying.

I had ecg because I had covid back in august and since have been getting out of breathe when exercising. The nurse told me that it could indicate a mini heart attack, sent me for a chest X-ray and bloods. Bloods have come back completely normal. GP said bloods couldn't have been more perfect. I'm waiting for an echocardiogram now but I am so anxious so just thinking could the ECG be wrong. I feel fine in myself

If the ECG has certain changes in it, but the bloods are normal, then it can show there has been a cardiac event, but it's already happened, and no longer showing up in the enzymes- however, I also don't think that without all the appropriate tests completed, included the echo, that you should have been told anything other than it's a potentially abnormal ECG and further testing is required- giving a diagnosis without all the appropriate information isn't particularly professional

@SD1978

If the ECG has certain changes in it, but the bloods are normal, then it can show there has been a cardiac event, but it's already happened, and no longer showing up in the enzymes- however, I also don't think that without all the appropriate tests completed, included the echo, that you should have been told anything other than it's a potentially abnormal ECG and further testing is required- giving a diagnosis without all the appropriate information isn't particularly professional

Exactly what I have thought. I was told it is likely a mini heart attack and just left. I was obviously upset and anxious and I still am now. I'm not sleeping. I have just been told to wait for X-ray results and appointment for echo scan, so I'm thinking if it was that urgent they would not have let me home

I do ECG’s as part of my job and I can see what is normal however I never say anything to the patient without a CNS or doctor reviewing it first exactly for the reasons that you’re concerned.
If I am wrong then I can seriously upset someone, that’s why I wait for it to be interpreted correctly.

There is a correlation between heart attacks and covid, OP. It is not a usual presentation of the virus but this article is a very interesting read. elemental.medium.com/coronavirus-may-be-a-blood-vessel-disease-which-explains-everything-2c4032481ab2

They should explore the possibility of a link between asymptomatic covid and heart attack. If you really want to find out how your heart is doing, I'd push hard for an MRA. You're young and let's assume you have an undiagnosed heart problem. It will not easily be detected because of your youth. You will not have plaque build-up or age-related heart disease/coronary artery disease, which is more easily detectable through standard testing.
Yours is not a standard situation. Push for the non-standard testing. Make sure you're referred to a cardiologist and get that MRA. You want to rule out any genetic vascular issues.

A week before I went into cardiac arrest, my GP ran a well-woman blood panel on me. My cholesterol, as usual, was enviably low. I am a cyclist and dog walker/non-drinker-non-smoker. My ECG in the ambulance, a week later, was normal. Yet, I crashed, minutes later, and nearly died. Here I am, a year later: a cardiac patient with stage 2 heart failure. But once I was in A&E and then Hammersmith hospital's heart attack centre (huge shout out to that amazing unit!) I had an angiogram that evening and a cardiac MRA later in the week during my stay which gave me a clear picture of why my seemingly healthy heart and cardiovascular system broke unexpectedly.

My story is certainly not your outcome, OP. And I hope I don't scare you. But get to the root of this so that you're not left wondering and worrying. If it's nothing, at least get that confirmed so you can carry on living without the anxiety of all of this hanging about. Good luck.

With covid blood clotting can be affected and some people can be at risk of heart attacks, strokes etc. Equally covid can cause inflammation of the heart muscle (myocarditis). There has been research suggesting that even those with mild covid can develop it and that a fairly high percentage of people with covid get it. Symptoms of that can be breathlessness amongst other things.

But a good ecg trace is dependent on the skill/experience of the person doing it and accurate lead placement. The ecg machine will suggest reasons for any abnormalties detected but to get a formal diagnosis the clinicician will look at blood results (often time sensitive) and order other investigations.
like an echo or treadmill test. No one knows if you've had a 'small' heart attack on the basis of 1 ecg without other tests. Equally if you've never had an ecg before no one can tell if the abnormalities are new....
I was exactly like this. I'd had mild chest discomfort for a few days and put it down to a muscular skeletal injury (had ironically been on a course that involved alot of prolonged cpr). Ended up having an ecg 'just to be on the safe side,' which to my surprise was abnormal. Lots of debate in a/e. My blood tests were all normal, echo normal, treadmill normal, even had a ct cardiac angiogram which was normal. My cardiologist felt the abnormality was normal for me. In the run up to all these tests I was petrified though !
Did the gp think you'd had a heart attack, did he explain why your ecg was abnormal ? Sometimes an abnormality can have many reasons so as an example a person can have t wave depression on their ecg but depending upon which lead it's in it can be normal ! Echo would certainly be the next investigation to rule out any damage/explain your breathlessness and see how efficiently your heart was pumping. Why not ring your gp again and they can explain why the ecg was abnormal ?

You can also myocarditis from a cold. It is not unique to covid.

@TheVanguardSix thank you for sharing your story and the link - I will have a read of that. I will definitely be ringing the GP and chasing up

@Victoriacres thank you for sharing your story - how scary but glad that everything turned out okay.

Nurse said the results were indicating a mini heart attack, she then got the GP who sent exactly say that to me but looked at results and ordered bloods (which have come back normal) and urgent echo. This was 3 days ago. I called hospital today and GP has not even sent referral yet so it can't be that urgent - which makes me think maybe it's not that bad.

@zen1

Not a medical professional, but 18 yr old DS had chest pain last year and was sent to A&E for an ECG. It showed he’d had a heart attack, but when a senior Dr came to review, he said the machine wasn’t on the right settings for someone his age and hen he changed the settings, ECG was normal.

That's reassuring, I'm glad your son is okay. I wonder if it's worth asking for another ECG