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I was in ER the other day with tachycardia that started

Customer Question
about 20-30 minutes after eating...
I was in ER the other day with tachycardia that started about 20-30 minutes after eating. It nearly the entire day and the next morning I went to the ER. They did some blood work and a chest XRay and said I was okay and discharged me. The only abnormality on the blood tests they ordered was a potassium level of 3.2.I noticed the ECG had non-specific ST-T wave changes and I told them I was concerned about it. They told me it's nothing it's not the type of T wave changes they usually worry about. I am not sure they compared with previous ECGs however.I saw their lab writeup later on that they posted and the comparison between the two ECGs as written worries me greatly.https://imgur.com/a/U72oH
This is the test result entry with comparison to previous EKGHere is the previous EKG:
https://imgur.com/a/vLolTThey didn't post the newest ECG but based on the little research I did it seems to me like 3.2 potassium could not cause this great of a shift in the ST-T Segment... What is likely going on here?I'm worried this could be ischemia that they neglected to thoroughly analyze because I am a repeat patient and they haven't discovered things in the past... :(Here's another ECG that happened a few days before the seemingly normal ECG (but not related to the recent two):
Study Result
ImpressionNormal sinus rhythm with 1st degree AV block
Incomplete right bundle branch block with reversal of normal rSR' to r'SR pattern
Left ventricular hypertrophy
When compared with ECG of 3/25/17 No significant change was found
Component Results
Component Your Value Standard Range Flag
VENTRICULAR RATE EKG/MIN 100 BPM BPM
ATRIAL RATE 100 BPM BPM
PR-INTERVAL (MSEC) 230 ms ms
QRS-INTERVAL (MSEC) 100 ms ms
QT-INTERVAL (MSEC) 348 ms ms
QTC 448 ms ms
P AXIS 72 degrees degrees
R AXIS 76 degrees degrees
T AXIS 49 degrees degrees
Submitted: 2 months ago.Category: Cardiology
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Answered in 3 hours by:
12/17/2017
Cardiologist: Vakul Aren, Doctor replied 2 months ago
Vakul Aren
Vakul Aren, Doctor
Category: Cardiology
Satisfied Customers: 4,348
Experience: MBBS,DTM&H,38 years of experience
Verified

Hello,I am Dr.Aren and I will help,with your query..Apparently your low Potassium levels need to be corrected by increasing your potassium intake by taking more citrus fruits and lemon juice.The nonspecific ST changes could be secondary to the low potassium levels and incomplete AV block and RBBB.It would be prudent to discuss this with your doctor and get a Holter mobile ECG recording for 24 hours or longer to rule out any serious problem.

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Customer reply replied 2 months ago
Hello,I read about ST Depression and T Wave inversion it seems these can refer to ischemia. Would this have been a possibility here?
Cardiologist: Vakul Aren, Doctor replied 2 months ago

A bundle branch block and a 1st degree AV block can change the ECG.Myocardial Ischaemia is highly unlikely at your age,the ST depression and T wave inversion are probably due to bundle branch block and AV block.

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Customer reply replied 2 months ago
I have an older ECG that was taken from me while I was in lactic acidosis in the hospital. The reason I bring this up is that on this ECG it also showed a similar T axis (11 versus 9) and "nonspecific ST and T wave changes".I'm wondering if this ECG:
https://imgur.com/a/lRnKUCompared to the normal one is similar to the other interpretation.Like comparing the ECG I Just linked here and the old normal one (https://imgur.com/a/vLolT), would your interpretation also lead to conclusions like "ST Depression in anterior leads" and "Inverted T waves in inferior leads" ?
Cardiologist: Vakul Aren, Doctor replied 2 months ago

THe electrolyte changes in Lactic acidosis,specifically the changes in potassium levels will cause ECG changes.Similarly RBBB can also cause ST segment and T wave changes.

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Vakul Aren
Vakul Aren
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Category: Cardiology
Satisfied Customers: 4,348
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Experience: MBBS,DTM&H,38 years of experience

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