Keith Roach, MD, Syndicated Columnist
Dear Dr. Roach: I am a 79-year-old man in relatively good health. I don't take any medicine. I recently visited a cardiologist regarding the palpitations I was experiencing. After reviewing lab tests, medical history, physical exam, and electrocardiogram, the doctor said everything looked fine.
A month after this visit, I accessed the patient portal to review my EKG. To my surprise, it showed that there was an infarction in the septum. I read online that this could be a silent heart attack. My cardiologist never mentioned these results, so I called his office and talked to the nurse, who relayed my concerns to him.
The nurse replied that when the doctor re-examined the electrocardiogram, the result was a false positive. He said there was nothing to worry about and no need to repeat the EKG. What do you think? — Anon.
Answer: An electrocardiogram is a very convenient, inexpensive, and noninvasive way to find out information about your heart. Unfortunately, the results are not always conclusive.
When I checked the electrocardiogram that was sent to me, there was a pattern called QS in leads V1 and V2 (wires connected to the chest). This could indicate a heart attack in the septum (the part of the heart between the ventricles), but about 80% of the time this is not the case.
I agree with the cardiologist that the chances of you presenting with a serious condition like a heart attack are very low, especially considering your overall good health. But if you were my patient, I would probably re-check the EKG on your next visit, paying close attention to lead placement. If the abnormal findings disappear, you can be 100% sure that this ECG finding does not represent a heart attack.
Dear Dr. Roach: Is it true that hospitalizations and emergency department visits increase on full moon days? — NDG
Answer: As many as 40% of medical staff believe the moon affects ER visits and hospitalizations, but the final answer is no. Large studies have shown that there is no correlation between the number or type of emergency department visits during a full moon. One of my girlfriend's ER colleagues told me that she doesn't think ER staff really believes this word, and that it's just an expression people say when they're busy. I don't think it applies to everyone.
Humans are very good at finding patterns, so good that we can find them even when they don't exist. I can attest to the fact that on particularly busy nights in the ER, someone will often say, “There must be a full moon today.” When there is an actual full moon, that belief tends to be reinforced, but when there is no full moon, it tends to be forgotten.
Proving or disproving this hypothesis requires careful observation using objective endpoints. It's ironic that even people who use science all the time can still make this mistake.
Editor's Note: Dr. Roach regrets not being able to respond to individual letters, but will incorporate them into his columns whenever possible. Readers can email questions to him at ToYourGoodHealth@med.cornell.edu or mail him at 628 Virginia Dr., Orlando, FL 32803.
