Heart Disease Expert Forum
Depressed ST's during stress test
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Depressed ST's during stress test


  Last week on a stress test the computer generated notes stated "ST depression with slowly ascending ST slope in aVF (-1.0mm)" and "ST depression with horiz. or desc. ST slope in III (-2.6mm)".  This depression was seen throughout the test and at resting. I completed the stress test with max HR of 189 @ 10.5 minutes and felt fine.  My cardiologist said this was OK and reported only PVC's in his report.  My question is does "OK" mean there is no ischema or I'm too young (34YO male) too worry about it until symptoms occur.  Everything I read says depressed ST segments mean decreased blood flow or MI. My echo is all fine except trace mitral regurgitation. I don't know if it's important or not, but he is not board certified. Do I need a second opinion or should I forget about it? My PVC's worsen while I'm jogging at HR of 160-165, and lessen when I slow down. Is this related to decreased bloodflow?
  Thank you for a great service, your time is appreciated.
  David

Dear David,
If this ST depression was present initially at rest, and exercise ECG cannot be used to diagnose presence or absence of coronary artery disease. If the exercise echo was normal, it is very unlikely that you have coronary artery disease.
Board certification refers to having passed a particular written examination. There are good cardiologists that are not board certified.
As far as getting a second opinion, I cannot comment on that. It really depends on what your risk factors for heart disease are. A healthy 34 year old male with a normal echo is statistically-speaking very unlikely to have coronary artery disease. Any family history of heart disease?
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.





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