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We have known that some cardiac problems are masked and do not show up in ECG. An interesting piece of medical information which came from a reputable local cardiologist was that abnormal ECG may not be an indication of cardiac problems especially among a small percentage of females.

Many medical journals are not available to public viewing and require subscription. I managed to gather some information on the internet. For whatever it is worth. If you are concerned, please consult the GP to get a specialist referral. If necessary and unsure, seek second and third opinions.

Misdiagnosis and Absent P waves on ECG

Heart attacks can be undiagnosed: Although the most severe symptoms of heart attack are hard to miss, there are varying degrees of severity. It is altogether too common for people to die from undiagnosed heart attack, or from delaying too long to call for emergency help.

Heart attacks can be overdiagnosed: Although many people die from heart attacks, there are also many cases where people fear that they have a heart attack, but actually have something milder. Some of the conditions which may be causes of chest pain, causing fear of a heart attack, including an anxiety attack, heartburn, and so on. See the causes of chest pain and the symptoms of heart attack.

http://www.wrongdiagnosis.com/symptoms/absent_p_waves_on_ecg/misdiagnosis.htm


Abnormal ECG (symptom description): For a medical symptom description of 'Abnormal ECG', the following symptom information may be relevant to the symptoms: Heart symptoms (type of symptom). However, note that other causes of the symptom 'Abnormal ECG' may be possible.

http://www.wrongdiagnosis.com/symptom/abnormal-ecg.htm

ECGs are not 100 per cent accurate because some heart conditions are not detectable at all times. People with suspected heart disease or who have had a heart attack may need more than one ECG, but there is no need for regular testing in healthy people unless there is an inherited risk or it is needed for work or life insurance requirements.

http://www.mydr.com.au/tests-investigat ... iogram-ecg


The Abnormal ECG in the Absence of Cardiac Disease Part I: The T Wave
Electrocardiogram
Charles Fisch MDA, *

Technology Series
A Indiana University School of Medicine; Krannert Institute of Cardiology, Indianapolis, Indiana, USA

February 1998.
Fisch, MD, Indiana University School of Medicine, Krannert Institute of Cardiology, 1111 West 10th Street, Indianapolis, IN 46202.

ACC Current Journal Review
Volume 6, Issue 1, January-February 1997, Pages 69-73

http://www.springerlink.com/content/l174472888h74113/

Heart rate and rhythm differences between men and women

Women and men are similar when it comes to the basic heart rate and rhythm. However, while the basic electrical system is the same (impulses originating in the SA node, traveling to the AV node, through the HIS-Purkinje, and then starting over), there are differences:

Women tend to have a faster baseline heart rate
Women’s ECG readings may be different
Women Have a Faster Baseline Heart Rate Than Men

First of all, on average, women tend to have a faster baseline heart rate than men. This difference is seen in girls, on an average, as young as five years old. There is also a shorter sinus node refractory time – this means that it takes a shorter time for the SA node to recover and become ready to fire an impulse again 1.

Women’s ECG Readings may be Different

The ECG (also called EKG or electrocardiogram) is a test used to record on graph paper the electrical activity of the heart. The picture, drawn by a computer from information supplied by electrodes placed on the skin of the chest, arms and legs, shows the timing of the different phases of the heart rhythm.

Certain types of arrhythmias are more prevalent in women than in men. These include:

Supraventricular Tachycardia (SVT) or Paroxysmal SVT (PSVT) – a rapid heart rate that originates above the AV node, in the atria. SVT is common in both men and women, but more women have AV node reentrant tachycardia and atrial tachycardia 1.

Sinus Node Dysfunction (also called sick sinus syndrome) – a slow or irregular heart rhythm that originates in the SA node. The signal starts in the SA node but may be slow or delayed in progressing to the atria, causing a very slow or irregular heart beat.

AV Nodal Re-entry Tachycardia (AVNRT) - a type of SVT with a fast heart rate that originates in the AV node. Instead of the AV node sending the impulse down one pathway, there are two pathways through the AV node. The impulses travel through one pathway as well as back up through the second pathway. This allows the impulses to travel around the AV node very quickly in a circular fashion, causing the heart to beat unusually fast.

Long QT Syndrome - a QT interval longer than normal. This increases the risk for life-threatening forms of ventricular tachycardia.
Postural Orthostatic Tachycardia Syndrome (POTS) - a condition that affects 500,000 Americans, primarily women. Those with POTS have an abnormal response to change in position, related to the autonomic nervous system, causing drop in blood pressure, raise in heart rate and sometimes syncope (passing out), dizziness or lightheadedness 2.

These arrhythmias occur more often in men, but may present differently in women:

Atrial fibrillation - one of the most common irregular heart rhythms. It is a rapid irregular heart rhythm originating in the atria. Men have atrial fibrillation more often than women.

Women who have paroxysmal atrial fibrillation, a type of atrial fibrillation that is intermittent (or comes and goes), may have a faster heart rate response than men, and tend to have longer episodes.

http://my.clevelandclinic.org/heart/women/conditions_arrhythmia.aspx