Question about interpreting ECG - it showed "ischemia"

In My Humble Opinion (IMHO)
#1

What does it mean to see an “ischemia” on an ECG? This probably is not the precisely correct way to state this, but I’m quoting the person it happened to, and she’s not one to ever ask a doctor what anything means. (ME: “What did the tests show?” HER: “The doctor said everything is fine.” :rolleyes: ) I googled, but the explanations were over my head.

Setup: Yesterday this girlfriend (age 67) was telling a group of us that she fell in her kitchen the other day. She hit her head and had a black eye to show for it. The door of her dishwasher was open and bent down, which made her think she fell on it or grabbed it as she fell, but she doesn’t remember. She doesn’t remember tripping or anything. She thought she might have fainted, but doesn’t know for sure. She didn’t have nausea. She didn’t go to the doctor (her regular doc) until the next day. She woke up and realized that something potentially serious had happened (which suggests some disorientation the night before). Her regular doc sent her for some tests. Among them was an ECG and “a bunch of other tests.”

She said, “There was an ischemia on the readout,” but she didn’t ask what that meant. (!) She’s going to be having more tests of some sort, which she didn’t/couldn’t name. (This lack of detail is normal for her and not a result of the fall.)

So, what does that mean? Or what might it mean? I will not be reporting back to the patient. I’m just curious. Thanks.

#2

Ischimia is lack of oxygen to the heart tissue. I wouldn’t think the dr. Would have called that “normal.”

#3

I wasn’t clear. She didn’t say that about THIS test. She just always said that when she came back from the doctor.* No, the ECG was not normal, and the doctor didn’t say it was. That’s why he sent her for tests.

Thanks for the info. Lack of oxygen…that’s not good.

*Example from doctor visits over the years:
Me: What did the doctor say about your blood pressure?
Her: He said it was fine.
Me: What was it?
Her: I don’t remember.
Me: And your blood sugar?
Her: It was normal.
Me: What was your fasting blood sugar? (Her daughter is diabetic, so I would expect her to be curious.)
Her: He didn’t tell me the number, but he said it was fine.

We worked in the same office for many years and shared much personal information over that time as women tend to do (not sure if guys do), so this level of interrogation was normal.

The willingness to take the doctor’s word for it that “everything is fine” fascinates and confounds me. I’m one to take my CBC report and look up all the terms on the internet (and in medical books at the bookstore before the internet). It’s not that I don’t trust doctors, I just want to be fully informed.

#4

Not a doctor, but in my experience, ischemia means the doctors identified a cardiac-related reason for chest complaints, rather than unspecified chest pain or syncope. The next question is to identify the cause of the ischemia - such as coronary artery disease, and whether it is reversible with nitro or whether other efforts should be taken.

But, like I said, not a doctor.

#5

Know that mostmodern EKG machines have a computer generated interpretation printed on it. I am not a fan of this, because the computer is not that bright. It often interprets minor changes which don’t mean anything as being significant. This includes ischemia. Or old MI. Or a ton of other stuff. Computers tend to over-read the damn things, then I have to explain to a panicked patient that they’re really ok.

#6

How is your experience with Dr Google?

#7

“A bunch of other tests”… I’ve got a couple of relatives who do that and it drives the rest of the family nuts. My Aunt From Hell has been known to tell a doctor “ah no, you give me a scrip, I want to be able to read it. Again, with stick letters!”

Since we have the docs here, what would those “other tests” normally be, for someone with the symptoms described?

#8

As a cardiac patient, I have some personal experience with diagnosing heart-related issues.
If her ECG (or EKG) is abnormal, the Dr. might order a stress test, or a Nuclear stress test, or a stress-echo test. A stress test is the simplest - it’s just a continuous EKG while the patient is put through increasing levels of exercise on a treadmill.
Nuclear adds an injected tracer to the above test - it can show, in broad terms, how much the heart muscle is deprived of oxygen under stress.
Stress-echo is an ultrasound imaging done after a stress test - it can show many parameters of heart function - ejection fraction, valve operation, the operation of the various chambers in the heart, etc.

If an artery blockage is suspected, a Angiogram may be ordered. This is the most invasive procedure, where a catheter is inserted and positioned up into the arteries that feed the heart, and radio-opaque dye is introduced to image the suspected blockage. It is the “gold standard” for determining the amount of narrowing of the cardiac arteries.

#9

Were you asking me? 'Cause I said in the OP

She did mention having or being scheduled to have a stress test.