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Heart Disease (Expert Forum)
Questions on my Stress Echo Test
Answered by
Cleveland - OH
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Questions on my Stress Echo Test
by jerry1978, Jan 16, 2005 12:00AM
I am a 44 year old male, and had a StressEcho Test (asymptomatic-just wanted one to check for CHD and before starting an exercise program.)
I reached Stage 3 of the Bruce Protocol, and stopped due to sciatic leg pain. I reached a Peak HR of 169 (96 % of Max)
Here is what the report says:
BASELINE EKG: Normal sinus rhythm. Possible anteroseptal MI of
indeterminite age. Diffuse non-specific ST-T wave
changes.
EKG CHANGES: No ischemic ECG changes.
ARRHYTHMIA: Occasional VPD's.
HR AND BR RESPONSE: Normal.
ECHO STUDY: Normal left ventricular internal dimensions and
wall thickness.
Normal left ventricular systolic function.
STRESS ECHO REVEALS: Normal augmentation in left ventricular
function.
SUMMARY: Normal stress echocardiogram, without clinical, ECG,
or echocardiographic evidence of inducible ischemia.
I was told by the attending MD and my Cardiologist that this is a normal test; and told not to be concerned about the baseline EKG finding of a possible past MI.
My Questions:
(1) Can a baseline EKG give a false interpretation of a past MI, as my Doctor suggests?
(2) What does non-specific ST-T wave changes mean?
(3) What about the "Occasional VPD's?" What are they, and are they dangerous to me?
(4) Is a Stress Echo as good as a nuclear stress test?
p.s.: I am on Hydrochlorothiazide,Zoloft,Klonopin, and Toprol XL (with-held the Toprol for the test)-can any of these meds be the cause for the abnormal EKG?
Thanks-Jerry
I reached Stage 3 of the Bruce Protocol, and stopped due to sciatic leg pain. I reached a Peak HR of 169 (96 % of Max)
Here is what the report says:
BASELINE EKG: Normal sinus rhythm. Possible anteroseptal MI of
indeterminite age. Diffuse non-specific ST-T wave
changes.
EKG CHANGES: No ischemic ECG changes.
ARRHYTHMIA: Occasional VPD's.
HR AND BR RESPONSE: Normal.
ECHO STUDY: Normal left ventricular internal dimensions and
wall thickness.
Normal left ventricular systolic function.
STRESS ECHO REVEALS: Normal augmentation in left ventricular
function.
SUMMARY: Normal stress echocardiogram, without clinical, ECG,
or echocardiographic evidence of inducible ischemia.
I was told by the attending MD and my Cardiologist that this is a normal test; and told not to be concerned about the baseline EKG finding of a possible past MI.
My Questions:
(1) Can a baseline EKG give a false interpretation of a past MI, as my Doctor suggests?
(2) What does non-specific ST-T wave changes mean?
(3) What about the "Occasional VPD's?" What are they, and are they dangerous to me?
(4) Is a Stress Echo as good as a nuclear stress test?
p.s.: I am on Hydrochlorothiazide,Zoloft,Klonopin, and Toprol XL (with-held the Toprol for the test)-can any of these meds be the cause for the abnormal EKG?
Thanks-Jerry
Doctor's Answer
by Cleveland Clinic, Jan 16, 2005 12:00AM
, Jan 16, 2005 12:00AM
(1) Can a baseline EKG give a false interpretation of a past MI, as my Doctor suggests?
The ecg diagnosis of MI can vary in some people and must be interpreted in the context of all a patients data. The best marker form your data was your echo which showed no evidence of abnormal wall motion which would occur from damage from an MI. Position and body habitus can effect the readings on an ecg. In some patients we see minor variations of ecgs done during stress and ecgs done routinely due to changes in heart position during stress.
(2) What does non-specific ST-T wave changes mean?
Exactly that. There are changes in the area between your QRS and T wave. In the context of the data you mention, they probably mean nothing. Frank drepression and elevation are specific markers for ischemia, minor variations of this portion of the ecg are seen commonly and reported.
(3) What about the "Occasional VPD's?" What are they, and are they dangerous to me?
They are occasional extra heart beats. In the context of the rest of yoru study they don't mean too much. An increase in the frequency of these beats in patients with structural heart disease can be associated with an increased mortality risk.
(4) Is a Stress Echo as good as a nuclear stress test?
It depends. There are factors that can cause problems with interpreting the images in each one. However, if they are able to get good quality images in both studies then they are essentially equivalent.
good luck
The ecg diagnosis of MI can vary in some people and must be interpreted in the context of all a patients data. The best marker form your data was your echo which showed no evidence of abnormal wall motion which would occur from damage from an MI. Position and body habitus can effect the readings on an ecg. In some patients we see minor variations of ecgs done during stress and ecgs done routinely due to changes in heart position during stress.
(2) What does non-specific ST-T wave changes mean?
Exactly that. There are changes in the area between your QRS and T wave. In the context of the data you mention, they probably mean nothing. Frank drepression and elevation are specific markers for ischemia, minor variations of this portion of the ecg are seen commonly and reported.
(3) What about the "Occasional VPD's?" What are they, and are they dangerous to me?
They are occasional extra heart beats. In the context of the rest of yoru study they don't mean too much. An increase in the frequency of these beats in patients with structural heart disease can be associated with an increased mortality risk.
(4) Is a Stress Echo as good as a nuclear stress test?
It depends. There are factors that can cause problems with interpreting the images in each one. However, if they are able to get good quality images in both studies then they are essentially equivalent.
good luck
To be honest with you I'd rather not have the oppertunity to get a copy of my results because I'd have less to worry about. I wish the Internet were never invented because of tons of pages about medical stuff which in return most doctors don't want to hear about and get mad for not trusting them (happened to me), and yes, they can refuse to treat you over stuff like that, happened to a friend of mine.
The bottom line as you can see we are allowed to get copies of our tests, but most of us still worry because most doctors just don't have enough time to sit down with us and answer all our questions and our concerns and worries. This might be the case with people who have high priced insurances or private patients with lots of money, but the average people who have an HMO insurance get a few minutes to cover the basic problem maybe get an answer or two while the doctor is showing you the door saying "see you in 6 weeks."