AboutDavid Richardson Expertise Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.
Experience Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.
Organizations Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..
Publications Circulation, American Heart Journal, Hypertension.
Education/Credentials M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.
Awards and Honors Gold Heartt Award from American Heart Association in 1995.
Expert: David Richardson Date: 7/13/2008 Subject: heart palpitations
Question Hi, I'm a 22 year old female and have been having heart palpitations since i was about 16. They usually happen every other month, but sometimes there'll be a prolonged period of time where nothing happens. They usually last for a few seconds and are almost always accompanied by light-headedness. At my last appointment (6/22/2007), BP was 122/80, height 5'2.5", weight 134, and I am not on any medications. My PCP listened to my heart beat (which was normal) and ordered an EKG which she sent to be read by a cardiologist because she was questioning the presence of a delta wave. The EKG read:
Rate: 84 bpm
PR: 152 msec
QT/QTc: 360/403 msec
QRSD: 84 msec
P Axis: 41
QRS Axis 19
T Axis 29
Sinus Rhythm
P:QRS - 1:1, Normal P Axis, HR 84
ABNORMAL
OS pattern V 1-2, consider old ASMI
The cardiologist said it looked like there was an old anteroseptal myocardial infarction. My PCP then ordered a follow-up EKG 2 weeks later (done on Friday, 7/10), which came back with the same reading. She said the area between the V1 and V4 readings didn't spike as deeply as they should. Now I'm waiting for an appointment for an echocardiogram. Is it possible to have had a heart attack (especially at my age) and not even know you had one? I apologize if the question is confusing, I know it may be a bit hard to understand without the EKG in front of you. Thanks!
Ashleigh
Answer Dear Ashleigh,
No, it's not possible that you had a heart attack. The usual cause of QS in V1 and V2 is placement of the EKG leads too high on the chest, but in any case, QS in V1 and V2 is normal. Only QS in V1-V3 is suggestive of old anteroseptal myocardial infarction (ASMI).
I understand, and don't need to see the EKG. You can forget the whole thing, or go back to your PCP and ask that the EKG be repeated with the chest leads down toward you feet one more intercostal space, or wait for cardiologist. Please let me know if the PCP or cardiologist don't agree with me.
Please write back if this note doesn't answer all your questions.
