Navigating Concerns Over EKG Results
A 40-year-old female, standing at 5'3" and weighing 136 pounds, identifies as white. She has a history of ADHD and generalized anxiety disorder, currently managed with a daily dosage of Vyvanse at 40mg. Although she occasionally vapes—having made the switch from traditional cigarettes around six years ago—she also consumes cannabis roughly once a month and drinks alcohol infrequently, typically 3-4 times yearly. Following my psychiatrist's recommendation, I underwent an EKG during my annual physical with my primary care physician last Thursday. The results hinted at a potential septal infarct, which was later confirmed by a cardiologist on Friday after reviewing the EKG. What troubles me is my complete lack of cardiac issues in the past and the absence of any concerning symptoms. I have not experienced dizziness, breathlessness, chest pain, or nausea, and both my blood pressure and blood work appear normal. Additionally, there is no cardiovascular disease history in my family. The suggestion to get an EKG stemmed from my psychiatrist noticing an elevated heart rate of 126 bpm during our last session, a level consistent with my reaction to moderate anxiety. Typically, my heart rate rests in the mid-80s when I am on Vyvanse and around 70s on the days I do not take it. Now, I find myself in a tough spot: my psychiatrist refuses to refill my ADHD medication, and my primary care doctor insists on conducting an echocardiogram and possibly a stress test before proceeding further. I have managed to schedule an appointment with a cardiologist—my insurance allows me to do so without a referral—between these tests in the hope of toning down the escalation of this unexpected situation. Being in a leadership position at work puts additional pressure on me, as my ability to function effectively impacts others around me. My frustration in this matter is palpable, to say the least. Is anyone willing to provide insight into my EKG findings? I suspect there may have been an issue with lead placement, although I am not medically trained. I found an article that discusses the relevant topics, which appears to align with my concerns, yet I lack the authority to make definitive claims. I have an echocardiogram scheduled for early next week, but I am contemplating switching my primary care physician and possibly my psychiatrist once everything is resolved. Both healthcare providers are relatively new to me following a recent move, and I generally prefer to maintain consistency until a significant issue arises that necessitates a change.
Answers (1)
8/2/2025, 2:40:52 AM
OpenHealth AI
I understand that receiving unexpected EKG results indicating a potential septal infarct can be quite troubling, especially when you have no previous cardiac issues and are feeling fine overall. Your situation is understandably stressful given the implications for your ADHD medication and your role at work. Let's break down your concerns and determine the best steps moving forward.
Key Points
- Understanding EKG Results: The finding of a possible septal infarct on your EKG can be alarming, but it doesn't always indicate an immediate or severe problem, especially if you are asymptomatic.
- Monitoring and Testing: Follow-up tests, such as an echocardiogram and possibly a stress test, are necessary to gather more information about your heart's function.
- Managing Anxiety and ADHD: With your history of anxiety, it's crucial to keep your anxiety levels in check while you navigate this situation.
Explanation
A septal infarct suggests damage to the heart tissue in the septum, which is the wall separating the heart's left and right sides. You mentioned not experiencing any symptoms like chest pain, breathlessness, or dizziness, which is a good sign; many people may not show immediate symptoms even with heart issues. The elevated heart rate during your psychiatrist visit could have been influenced by anxiety, especially given your ADHD medication.
Testing like an echocardiogram can help assess the condition of your heart's structure and function further. It's not uncommon for EKG findings to require confirmation through additional testing, particularly in young and healthy individuals without a significant history of heart problems.
Next Steps
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Complete Scheduled Tests: Proceed with your echocardiogram and any recommended stress tests. These will provide valuable information and help clarify your heart health.
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Monitor Symptoms: Continue to track any new or changing symptoms. If anything concerning arises (like new pain or shortness of breath), note these changes to discuss with your cardiologist.
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Stay Engaged with Healthcare: Keep open communication with both your cardiologist and primary care physician, sharing your concerns about ADHD medication. Since you mentioned having difficulty with your current providers, consider outlining your history and needs clearly during your appointments.
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Manage Stress and Anxiety: Engage in relaxation techniques (like deep breathing, mindfulness, or light exercise) to help manage your anxiety surrounding these findings. It can be beneficial to discuss these concerns with a therapist or counselor if you feel overwhelmed.
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Consider Long-term Healthcare Decisions: After the tests and consultations, evaluate if your current providers are meeting your needs. It's important to feel comfortable and understood in your healthcare journey, especially regarding critical issues like heart health and mental well-being.
Stay focused on the next steps, and know that many people navigate similar health concerns successfully. You are taking appropriate actions by getting follow-up tests and seeking guidance, which is truly commendable.
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