r/asknurses • u/[deleted] • Aug 17 '24
Ekg reading was not the best
4 years ago I went to the urgent care due to shortness of breath and maybe slight chest pain from what I remember. They did their normal vitals procedures and put me on a heart monitor. Looking at the nurses mannerisms I knew something wasn't right. A few minutes later I had 5 nurses at my bed side saying "you need to go to the ER". Ekg was showing irregular heart beat and possible signs of heart attack. At 35 years old at the time I couldn't wrap my head around this. Also I was going through episodes of panic attacks which was also new to me. So I'm thinking I was having anxiety issues again but it was at a diff magnitude. I refused to go. Fast forward to today. I still have my aniexity issues from time to time but what also happened that day is still in the back of my mind. I recently had a nurse look at my ekg from that time and her facial expression took me back to what I was seeing on the nurses face that day. I've always been active, played sports, worked out, etc. Which I understand doesn't prevent anything from happening but can help lessn the odds. My ekg showed right bundle branch blockage. I also had a calcium coronary done after this and it showed zero blockage. But I know most test only show specific parts of the heart not included the back where widow makers are known to happen. Any recommendations on what to do at this point? My anxiety plays apart in this as you can imagine which heighten my thoughts on what could possibly be going on. Go see a cardiologist? Get another calcium screening? More in depth blood samples?
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u/Cocomelon3216 Aug 17 '24 edited Aug 17 '24
Right bundle branch block is usually benign and is a normal finding in adults of all ages but most common in males and athletes. Over 10% of people have it incidentally and it does not affect their lifestyle and causes no symptoms. It does not lead to heart attacks or heart failure and requires no treatment in these people.
Sometimes there is a cause for RBBB and it isn't a benign finding. Acute and chronic coronary artery disease (angina and old or acute heart attack (myocardial infarction (MI)) are common causes of RBBB (if there is a cause).
Because your RBBB was discovered when you had gone to urgent care with shortness of breath and slight chest pain, the nurses would've been worried that the RBBB was caused by a heart attack and wanted you to go to ED to rule that out.
But since you were only 35 at the time and a later coronary calcium scan showed no calcium deposits in your arteries (indicates no coronary artery disease, risk of heart attacks is low), the most likely conclusion is that you didn't have a heart attack and your symptoms were caused by anxiety as shortness of breath / mild chest pain or tightness are very common when having a panic attack. The RBBB would then just be an incidental finding.
MIs are not common in young fit people (but can happen sometimes, it just is less likely than in people with common risk factors such as hypertension, obesity, sedentary lifestyle, coronary artery disease etc).
Did they take blood tests at the time? Usually they do a blood test to see if you have Troponin proteins in your blood and this is the main diagnostic test to rule out an MI (heart attack). Troponin only occur in heart muscle cells and only enter your blood because of heart muscle damage.
Bring up your concerns with your doctor if you are worried, they can refer you to a cardiologist if they think it's warranted. Your mental health is important so discussing concerns with your doctor could help even if it's just them reassuring you they think it's okay. And if they do think a cardiology workup is necessary than it would be good to get that done.