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follow up question for ryan about false positive stress test

by lisaloo820, Jun 14, 2007 12:00AM
ryan,
you mentioned the liklihood that my test came back FALSE POSITIVE.  please explain what that is and why you think so in my case.  i have my appt. on monday with the cardiologist.  
thank you so much.
Member Comments (1)

by RCA7591, Jun 14, 2007 12:00AM
There are three possible outcomes from a stress test:

(A) Normal, with normal perfusion (blood flow) at rest, and on exertion.

(B) Positive, with decreased perfusion to one or more areas of the heart on exertion, and improved perfusion at rest. OR decreased perfusion on rest and worsened by exertion.

(C) False-Positive, indicative of decreased perfusion to an area of the heart during exertion, when no such perfusion defect exists. The indications almost always suggest that the perfusion defect involves the inferoapical region of the heart, which is supplied by the right coronary artery. Thus the test indicates narrowing of the RCA.

You didn't mention which artery was thought to be affected, but my bet is the RCA.

The rate of false-positive results in women has been reported to be as high as 40% (but sharply declines past age 50). Certain physical features can impede imaging quality (known as "attenuation artifact"). The breasts and diaphragm (muscle that controls respiration) are the more common causes of attenuation artifact. Artifacts can block certain views of the heart, leading to false-positive findings suggestive of ischemia or a reduction in perfusion to an area of the heart. This is why I think your stress test is a false-positive.

The other reason(s) why I think the test is a false-positive is because the ECG portion of the test was apparently normal (no ST segment decline or elevation), and you were asymptomatic (no chest pain, lightheadedness, shortness of breath). Plus, I'm assuming you reached your target heart rate, which is 85% of (220-your age of 53), or 142 bpm.

-Ryan





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