False positive EKG

Specialties Cardiac

Published

I don't generally ask questions about my own health but I worked for two years on an observation unit and never saw a false positive quite like my own and am wondering if this is even normal. As a nurse, this experience has left me quite shaken. I don't really know who else to ask about such a bizarre experience other than a group of nurses....

Two weeks ago I received an albuterol treatment at an urgent care due to a bad case of bronchitis. An hour or two later my heart was pounding while driving and my pulse was about 200. After wasting a bunch of time believing it was not true, I returned to the urgent care casually asking them to take my pulse and reorder my rx they didn't end up sending. My pulse was 214 and my stat EKG showed SVT. I received 6, 12, & 12 of adenosine in the ambulance with my hr only decreasing into the 150s. At the ed I was discharged once my pulse remained in the 110s (I'm tachy normally and was in pain due to recently oral surgery). I followed up with a cardiologist one week later. At my cardiologist appointment my EKG was showing both left and right atrial enlargement, right ventricle strain and an axis deviation. I am 25 and the cardiologist asked me many questions about my support system and care related to my daughter as I am a single mom. He specifically ordered my echo and echo stress to be taken days apart. He also started me on diltiazem (no beta blockers because I have asthma) due to my 100+ resting rate. A week later and my echo and stress were beautiful aside from my hr staying in the 130s post stress (my norm). The cardiologist who read my results didn't believe what that the other cardiologist said those things to me until I showed him the EKG with the md's sig. He was shocked at what the other md interpreted structure wise. The nurses at the practice also were shocked at the difference between my EKG and stress echo.

My main question is, has anyone ever seen an EKG shows these sort of findings without there being any issues? Does it seem normal for an MD to break news like this to someone (both your atria are enlarged and your ventricle is strained and we need to find out why) without saying it might be a misreading based solely on an EKG? As a patient, it was horrible and the scariest week of my life....especially being a nurse, it was worse knowing the causes in someone who is healthy and young. Has

(I am not looking for health advice or diagnosis. This is based solely on nursing curiosity as I have worked with cardiac pt.s and this is the first real false positive I've seen even though it is in me.)

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

I hope you continue to feel better and that all body parts continue to behave within your normal parameters.

What a scary time you have had!

And thank you for specifically NOT asking for medical advice.

To all who may respond: per the Terms of Service, please respond to the questions asked at the END of the original post, and do not respond with medical advice.

Thank you!

Now back to our original program:

All the cardiac diagnostics -- ECG, MPI (Nuclear Imaging stress test), ETT (exercise stress test) -- can show false positives AND false negatives.

Ongoing correlation of modalities used (including echocardiogram) is essential, PLUS continued monitoring of how the patient is doing under current medication and exercise regimen. Is the patient's quality of life being affected by symptoms, and if so, what will improve this?

I cannot address the issue of the MD's comments r/t the ECG reading.

Sometimes as nurses we respond with gut intuition (which can be correct!) to situations.

Perhaps you can ask your Cardiologist or PCP about "the norm" pertaining to informing patients of conditions?

I hope you continue to do well!

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Specializes in CTICU.

You cannot accurately assess structural heart issues by EKG alone - it merely shows electrical activity. This is why you were ordered the echo, which subsequently showed no chamber enlargement or structural issues, if I understand your post. I am not sure what your confusion is regarding. If you're asking do physicians (or other providers) ever state things in a manner which is not completely clear to the patient and causes undue worry, the answer is yes, often.

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@ghillbert. Some structural heart issues actually can be seen on EKG such as right and left atrial enlargement and hypertrophy

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Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

It cannot be confirmed without an echo, an EKG alone is not diagnostic of structural problems.

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Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

Especially after receiving a stimulant!!!

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