Does an ekg stress test always show an angina condition?

[Vickie-Pape]

  My mother is 57 years old.  Her medical record is hypertension, diabetic and high colestrol.  She is taking medication for all the above conditions. Recently she had a stress test and blood work.  I know that the stress test wasn't a nucler, but am not sure of what type blood panels she had taken. I beleive the stress test was an EKG Stress Test.  Nothing showed up.  When ever she is phyically exerted, she begins having chest pain.  It seems to be getting more frequent as time goes on.  The last attack that she had the pain got so bad it ran into her shoulder and down her arm.  When the attacks occur she turns pale, begins breathing rapidly, complains of bad chest pains and breaks out in a cold sweat.  The longest attack she has had lasted approx. 1/2 hour.  It seems that if she feels herself getting an attack she can sit down and keep it from getting to severe.  She has not been diagosed with any type of problem at this time.  When the stress test and blood work showed nothing it didn't seem to be a concern with the doctor any longer.  This woman is really suffering with this problem.  My questions are.  Could she have had a stress test done and nothing show up to make them think angina was present. Could any other type of heart condition slide past this testing.  Her BP started getting high at the end of the testing but upon rest, began to drop normally.  She felt no pain at this time.  I am concerned that because she has little income and no insurance that we aren't getting all the answers.  Don't get me wrong her doctor has been very good to her, however I feel that we might be missing something very important and life threating.  Please any insight into this you could give me would be very helpful.  Thanks so much for your time.

[CCF Cardio MD - MTR]

Dear Vickie, thank you for your question.  I agree with your assessment that your mother may indeed have angina and this condition could be concerning.  Despite her negative exercise stress test, she still could have significant coronary artery blockages that could be causing angina.  Stress tests are never 100% accurate so a negative stress test could be a false negative.  A nuclear stress test is more sensitive at identifying blockages and would actually image perfusion to the heart muscle in an attempt to define where a blockage may be.  The other option would be to proceed straight to an angiogram/heart catheterization where the coronary arteries could be directly visualized to look for blockages.  Despite your mother's lack of insurance, she should not let these symptoms go unnoticed by her physician.   She may need to have one of these tests performed at the discretion of her physician.  I assume that a second opinion would be too expensive, so your best option may be to speak with her physician.    
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.  Good luck!
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.