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Heart & Cardiology/Ekg and enlarged lymph nodes

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Question
ER visit 9/9/2008 for chest pain
Black female 48 yrs old
70 inches/157lbs

EKG results

Vent rate 57 bpm
Pr interval 136ms
Qrs duration 76 ms
QT/QTc 424/412 ms
PRT axis 75 21 43
Sinus bradycardia
Minimal voltage criteria for LVH
Septal infarct on or before 9/8/2008


2/24/2012
ER visit for chest pain
Black female 51 yrs old
70 inches/150 lbs

EKG results

Vent rate 67 bpm
PR interval 136ms
QRS duration 72 ms
QT/QTc 402/424 ms
PRT axis 56 -33 25

Left axis deviation
Normal sinus rhythm
Possible anteroseptal infarct

Also had Cat scan

The visualized portion of thyroid gland is intact. The mediastinal vessels enhance normally. No evidence of filling defect to suggest pulmonary thromboembolic disease.  There is evidence of mediastinal lymphadenopathy; a Precarinal node measures 2.1 x 1.5cm. Shotty nodes occupy the AP window as well as an enlarged node measuring 1.5cm. Bone window reveal degenerative changes of the thoracic spine without evidence of expansile or destructive lesions. Lung window reveal no evidence of nodules or infiltrates. No evidence of hilar lymphadenopathy. Adrenal glands are normal in size.

Blood test results (only those listed as high or low)

RDW 14.6
MPV 10.3
Set 47.8
Sodium 148
Chloride 113
D Dimer 1050

November 21, 2012.

Chest pains continue with dizziness and at times, shortness of breath. Have had 2 passing out episodes while sitting up in bed. Neck and shoulder pain are present. I am uninsured and symptoms are becoming worrisome. Can you make out any cause or reason for symptoms. Thanks in advance.

Answer
Hi Faith,
I cannot give you a full answer w/o an in-depth consultation - impossible from here. You have an EKG that suggests an old heart attack, and I have no idea whether that might be true. The enlarged lymph node that can all sort of things or nothing and should be followed with more tests and CT scans.
Above all this requires an interview with a physicians who can make sense out of these things. Re: chest pains:
http://www.cardiachealth.org/chest-pain
http://www.cardiachealth.org/app/chest-pain.php
http://www.cardiachealth.org/app/risk-assessment.php
If this suggests you have heart disease you need to see a doctor for that and all these other reasons. There are free clinics every where!
Hope this helps,
Dr T
http://www.cardiachealth.org/

Heart & Cardiology

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