Advice needed soon

Interpretation of stress echo showed .5mm ST segment depression in anteroseptal lead(s) and regional wall motion abnormalities (the report mentions anteroapical hypokinesis w/exercise).  Resting EKG was normal and there was no chest discomfort during exercise but report also notes that dyspnea during exercise was observed (hr was 98% of maximum - wouldn't ANYONE be breathless with that rate of exerertion?)  Normal bp and cholesterol levels, recently became non-smoker, 7 years post menopausal (surgical).  Based on this test three options were given:  1.  Catheterization  2.  Nuclear stress test  3.  Do nothing but monitor    
What would you do?
Thank you so much!

[erijon]

I don't know what others will think, but I would start with the nuclear stress tests. The test has an 85% accuracy rate and a much higher negative predictive value meaning that someone with a normal nuclear stress test results will have a .6% chance of a cardiac event each year over the next 10 years. It is less expensive and much less invasive than a cath, which also carries anywhere from a 1% to 3% risk of complication, depending on who you are listening to.

I have had two nuclear stress tests, one two years ago when I felt some chest pain and one last year as a followup with a new cardiologist, thankfully both were normal.

The cath is the thrue gold standard of testing and is close to 100% accurate and the nuclear stress test does sometimes have a false positive result on women, which would most likely lead to a cath anyways, but I would start with a nuclear stess test, nothing to them. And I agree, although I'm not a doctor, if you reached 98% of your max heart rate without pain, that's pretty good unless they saw a change in your EKG.

Good luck.

Tony

[surfgirl]

I give up..what are your symptoms/complaints?  Chest pain?  SOB?  Tachy? Fatigue, lack of endurance?  PVCs?

[viennaustria]

Wha are you looking for?

[viennaustria]