To keep things brief, I am going to quote your most relevant questions and answer those:
"Fast forward to my Nuc med stress test results, my cardiologist said "you're young, ill do a bubble study, but I don't think it will be anything, if anything I might just write this off as anxiety related"...I can be sitting down, not doing anything and get hit with a palpitation or be walking around at the grocery store and they happen."
It would be useful to educate yourself more about palpitations and their significance, and there is good, general info about this here:
https://uihc.org/health-library/heart-palpitations-frequently-asked-questions
The article lists certain things that are thought to have an effect, but the bottom line is that the basic cause is unknown. However, it IS known that most palpitations are harmless--harmless--even if terribly annoying. It is also known that they can *cause* anxiety, and that anxiety does make them worse. It is also known that they are more likely to occur when the heart rate is slower, as when you are calm and resting. The physiological reasons for this are a bit complicated, but it's worth noting that exercise will often stop palps by speeding up the heart, so that's a good reason to keep exercising vigorously if your doc has told you it’s OK.
"I was able to obtain a copy of my results said "small fixed anterior wall defect noted in both images, ST depression consistent with ischemia, recommend do rest images"
Ask your cardio guy about doing the ‘rest images’ mentioned above.
The only other test I would sort of like to see, one you haven’t mentioned, is wearing a 24-hour Holter monitor. Its advantage is that it can pick up heart hiccups that are sporadic and might not be caught by brief EKGs. However, if, when you were in the hospital, you were hooked up to continuous monitoring, a Holter probably would *not* add anything useful.
"I tried speaking to my cardiologist about other symptoms ...like ...sharp pains...in my chest...in my neck, where you can feel the heart beat...legs go numb...my leg veins feel super tight...sharp pains in them...He just didn't seem to care."
You haven’t studied the heart, but if you had, you’d know that none of these symptoms is related to heart disorders. Your doctor knows that, but he doesn’t have time to give you a medical education. He is correct, though, in that that what you describe is related to hyperawareness of meaningless bodily sensations, which is very much related to anxiety disorder. This is also true for shortness of breath and chest pain, for although most people do know that these symptoms are often associated with heart disease, they *don’t* know that the *exact* location and the nature of the pains are significant if they really are heart-related. They often honestly describe symptoms that point more towards emotional problems and away from heart trouble, rather than towards it.
"...My great grandfather died of a heart attack, my grandpa had a heart attack and has other heart related issues, and my sister was born with heart defects."
The history of older, deceased male family members with heart trouble has very little bearing on the heart health of a young female descendent without other risk factors. As for your sister, some heart defects are hereditary, and others are simply not. You should ask what her precise condition is called. Unless a doctor told you or your parents that it’s hereditary, the chances are that it is not related to what you’re experiencing.
"I'm not sure what I should do at this point. Advice would be much appreciated."
Apart from the additional imagery recommended in your nuclear med report above, and perhaps a Holter monitor, it looks as though your heart has been well and truly checked out. If these two tests are done, then I would have to say that at some point, you are going to have to accept highly educated medical opinion that your symptoms are being caused by something other than your heart.
You do sound very anxious and as if you are flirting with what is called a ‘cardiac neurosis,’ a stubborn but unfounded fear about your heart’s health. You can google it. In addition, I suggest a small, inexpensive paperback by Dr. Claire Weeks, called 'Hope and Health For Your Nerves." It addresses many of your fears.
I would suggest that you ask your PCP about the need for any more medical tests. For the sake of your mental health, I believe you should also ask her what she thinks about anxiety or panic being the cause of your problems.
I’ve been there, and I can tell you that a good shrink and sometimes a good anti-anxiety medication can give you your life back, freeing you from spending your days in pointless obsession about your heart.
Also forgot to mention that I have been experiencing a lot of shortness of breath, which is why, for now, I am easing off from working out