Episodes of chest pain, sob, dizziness. during an active episode, hr 124bpm, bp 149/70. pcp said ecg was okay. but the ecg report signed off by cardiologist says st abnormality possibly digitalis effect, but i'm not on digitalis therapy. advice?

The findings are of concern and further evaluation is recommended. Your BP systolic is elevated, discuss salt reduction, maintain a normal weight for height. A chest x ray and ruling out angina/MI is recommended. Please discuss with your Cardiologist and obtain a Pulmonary referral if the symptoms persist. Watch for worsening shortness of breath, cough and fainting.

The ST abnormality may be secondary to the rapid rate in which case they would be depressed but upsloping back to baseline. If the ST depression is sagging as seen in digitalis effect it could be a sign of disturbance in coronary artery blood flow. Nevertheless it could still be nonspecific but, as has been recommended, get a workup by a cardiologist, which would include a treadmill stress test