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Chest pain with ATRIAL FIBRILLATION after ablations in heart.

Resolved Question:

Hi Doctor, I am a 35 year old male with a history of Atrial fibrillation. I have done 2 ablations and since have had runs of AF no longer than 20 seconds.

I frequently get chest pains. I have had a stress test, stress echo, CT Angiogram and Calcium Score done and all were fine (I had a calcium score of 0). I also did a test to check for inflamed arteries and that was negative. I do not have cholesterol or high blood pressure.

I recently went and did an ECG (please find attached) as I had chest pains. The doctor who first reviewed it said I may be in AF, than said it isnt AF but the reading in line II is a but funny as it a bit "bumpy" and maybe an issue in my atrium. He than said it seemed within normal limits but didnt seem quite sure.

I took it to another doctor who said it was normal, and all is ok. But I just wanted another opinion. Can you please review and advise if all is ok? I had to scan it over 2 pages.

Thank you.


Category: Cardiologist

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Category: Internal Medicine Specialist
Dr. E. Satish Kumar is online now

Expert:  Dr. E. Satish Kumar replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I have gone through your case history and the EKG and it doesn't seem to be related and also your stress test were all normal.
To give a brief information about the characteristic features of angina

  • Chest pain or discomfort
  • Pain in your arms, neck, jaw, shoulder or back accompanying chest pain
  • Nausea
  • Fatigue
  • Shortness of breath
  • Sweating
  • Dizziness
The chest pain and discomfort common with angina may be described as pressure, squeezing, fullness or pain in the center of your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. For others, it may feel like indigestion.
The severity, duration and type of angina can vary. It's important to recognize if you have new or changing chest discomfort. New or different symptoms may signal a more dangerous form of angina (unstable angina) or a heart attack.
ECG is normal and in case A Fib it should be seen in all leads rather then one lead.
Occasional chest pain may be muscular or due to Acid Peptic Disease which can be aggravated by Anti -Platelets which are given as a prophylaxis in A Fib to prevent Embolic episodes .
Regards
Dr Satish


Patient replied :

Thank you Doctor. I also had Atrial Flutter ablated on my second ablation. If it is atrial flutter would it also show on more than one lead? Or more than just lead II? is there any indication it could be atrial flutter by looking at my ecg? I understand you look at lead II and aVF?


Expert:  Dr. E. Satish Kumar replied 3 Days.

Dear Doctor, By looking at your EKG there is no evidence of Atrial flutter. It's in Sinus Rhythm that is a normal EKG.
Sometimes you have palpitations and you doubt about it , you can do Holter Monitoring so that chances of finding abnormal rhythm is more.

Regards
Dr Satish


Patient replied :

By looking at your EKG there is no evidence of Atrial flutter. It's in Sinus Rhythm that is a normal EKG.
Sometimes you have palpitations and you doubt about it , you can do Holter Monitoring so that chances of finding abnormal rhythm is more.

Regards
Dr Satish


Expert:  Dr. E. Satish Kumar replied 2 Days.

Any patients who have A Fib are at risk of embolism which may be transient because most of the time you may not be feeling the palpitations especially when a patient is on beta blockers when the rate may be controlled, so it's beneficial to be on anti platelets when you don't have any other risk factors
, but when patients are having multiple risk factors the patient should be on anti coagulants.

Regards
Dr Satish


Dr. E. Satish Kumar
Category: Internal Medicine Specialist
Experience: 
Fellowship, Cardiology - Tamil Nadu Doctor M.G.R. Medical University - DNB, Cardiology, 2002 – 2005Training in Germany in Complicated AngioplastiesMedical School - Maharaja Krushna Chandra Gajapati Medical college, MBBBS MD, Int Medicine, 1989 – 1999.
Trained in Rota Abalation for treating Calcific coronary artery disease in Japan
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