ECG Results: Blood Supply Issues After a Car Accident

The electrocardiogram shows insufficient blood supply?

Hello Dr.
He, I was involved in a car accident on July 7th of this year, resulting in fractures of the third and sixth ribs on the left side.
After more than two months of follow-up with the thoracic surgeon, the doctor assessed that the bones are healing well and there are no complications such as pneumothorax or hemothorax.
However, since the accident, I have been experiencing pain under my left breast (approximately below the nipple, towards the inner side, near the outer edge of the breast).
The pain is not constant; it feels like a dull, stabbing sensation.
I suspect that it may be due to fascial injury from the accident, so I visited my family physician.
The doctor believed that the location corresponds to the heart area and arranged for blood tests and an electrocardiogram (ECG).
The results showed elevated cholesterol levels (total cholesterol 226, low-density lipoprotein 164) and the ECG indicated insufficient blood supply.
My blood pressure was recorded at 123/88, and the doctor noted that the diastolic pressure was too high.
Consequently, I was prescribed an antithrombotic medication (Dipyridamole 25 mg), to be taken once daily.
My questions are: (1) Is it too soon to start medication based solely on one ECG result? (2) Is it possible that the car accident caused changes in my heart function? Prior to the accident, my blood pressure was consistently in the 110s/70s, and my heart rate was in the 70s.
After the accident, my blood pressure has increased by about 10 points, and my heart rate has noticeably increased to around 90.
I do not have significant discomfort, only occasional chest pain and mild dizziness.
A friend mentioned that her mother developed sympathetic nervous system dysregulation after a car accident, leading to heart issues.
Could this really happen? I would appreciate your clarification, thank you!

Lala, 50~59 year old female. Ask Date: 2017/09/23

Dr. He Dongjin reply Cardiology

Hello, I don't believe it's cardiac ischemia.
I suspect that the car accident caused fascial injury, leading to dull, stabbing pain.
Any stimulation could potentially trigger sympathetic nervous system dysregulation, but it shouldn't cause heart problems.
Starting medication based solely on one ECG result may be premature.
The likelihood of the car accident causing changes in cardiac function is low.
I recommend further evaluation at a cardiology clinic.
Take care from Changhua Hospital.

Reply Date: 2017/09/23

More Info

Hello! Thank you for sharing your concerns regarding your health after the car accident. It sounds like you've been through a lot, and it's understandable to have questions about your symptoms and the results of your tests.

Firstly, let's address your concerns about the ECG results and the subsequent treatment. An ECG (electrocardiogram) is a valuable tool for assessing the electrical activity of the heart and can indicate issues such as ischemia (insufficient blood supply to the heart muscle). The fact that your ECG showed signs of inadequate blood supply, combined with your elevated cholesterol levels, suggests that there may be underlying cardiovascular issues that need to be addressed.

1. Starting Medication Based on ECG Results: It is not uncommon for doctors to initiate treatment based on ECG findings, especially if there are indications of potential heart problems. In your case, the combination of high cholesterol and the ECG results likely prompted your doctor to prescribe Dipyridamole, which is an antiplatelet medication that helps prevent blood clots. While it may seem quick to start medication based solely on one ECG, your doctor is likely considering your overall risk factors, including your history, symptoms, and the potential for cardiovascular disease. It’s essential to have a follow-up plan to monitor your response to the medication and any changes in your symptoms.

2. Impact of the Car Accident on Heart Function: It is possible that the stress of the car accident, both physically and emotionally, could have contributed to changes in your heart function. Trauma can lead to increased sympathetic nervous system activity, which may elevate heart rate and blood pressure. Additionally, pain and anxiety can also affect heart rate and blood pressure. However, it is crucial to differentiate between symptoms caused by physical injury and those that may indicate a more serious underlying condition. If your heart rate has increased and your blood pressure has risen since the accident, it could be a response to stress or pain, but it’s essential to rule out any cardiac issues.

Regarding your concerns about sympathetic nervous system dysregulation, it is indeed possible for trauma to lead to changes in autonomic nervous system function. This can manifest as symptoms such as palpitations, anxiety, and changes in blood pressure. However, each case is unique, and it would be best to discuss these concerns with your healthcare provider, who can evaluate your symptoms in the context of your overall health.

In summary, while it may feel premature to start medication based on one ECG, your doctor is likely considering your overall risk profile. The changes in your heart rate and blood pressure could be related to the stress of the accident, but it’s essential to continue monitoring your symptoms and follow up with your healthcare provider. If you experience any new or worsening symptoms, such as severe chest pain, shortness of breath, or fainting, seek medical attention immediately.

Make sure to keep an open line of communication with your healthcare team, and don’t hesitate to ask questions or express any concerns you may have about your treatment plan. Your health and well-being are the top priority, and understanding your condition is an important part of managing it effectively.

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