PLEASE help me understand my heart tests (I am confused!!!)

I am a 36 year old male (non-smoker) that had an abnormal Echocardiogram and stress test 2 months ago. Here were the results:

1) Echocardiogram: Mild Hypokinesis of base and mid septum. Ejection Fraction of 55%.

2) Exercise Stress Test: Anterior and inferior ischemia. Normal Electrocardiogram response. Ejection Fraction of 45%.

At that point the Cardiologist was sure that I had blockages so I underwent a Cardiac Catheterization the following day. The results were normal coronary arteries. Normal left ventricular function with no wall motion abnormalities. Ejection Fraction of 50%. No blockages. No underlying disease. The cardiologist actually told me that my arteries were so clear that he could "ski" through them.

The only explanation that he could give me for the abnormal Echo and stress test were that they were "FALSE POSITIVES". I am a bodybuilder and he stated that my larger chest size could have possibly given inaccurate readings on these types of tests. The only medications that he has me on are Lisinopril for slightly elevated blood pressure and Lipitor for slightly elevated cholesterol. Otherwise, he sent me home with no restrictions. He stated that my heart is just "slightly" weaker than normal but that I can improve it with aerobic exercise and good blood pressure/cholesterol control. He did not seem concerned in the least.

Have you guys ever heard of having "false positives" on the above tests and then being cleared with the heart cath? I have been stressing over this for the past 2 months.

Thanks in advance.

[Jayden716]

Anyone?

[degrassi]

Yes, I have had the same thing............the cath is the gold standard.  Do you already do cardio with your body building?  I think that is important.  Good luck.

[Tarheelguy1967]

I had a similar thing happen, just in the opposite direction.  I passed the echocardiogram and stress test, but had 90+% blockages in my LAD, and over time have had 5 stents put in.  I would recommend to people that either have symptoms but pass the EKG, or don't have symptoms but fail one, to have at a minimum the nuclear stress test since it has been very accurate for me in identifying problems.  And degrassi is right, the cath is the gold standard.  If I'm having symptoms now, the cardio's usually recommend I go to the cath lab because of my history (I've had 8 caths over the past year or so), but I think I'll push for them to send me for a nuke stress test first from now on, because my last cath was clear, and I prefer a non-invasive, but still fairly accurate, test before going right to the cath lab.  Be glad that all was clear - that is great news!  False positives and negatives aren't rare w/ the EKG - I personally don't pay too much attention to that test since it's not really worked for me.  May be okay in determining if you had a MI, but not so great at finding blockages.  However, the heart cath is the most accurate, and if you were clear w/ that, you shouldn't worry - again, that's great news.  Take care!

[Jayden716]

Thanks alot guys. I feel alot better. I also had the following response from another Echo-Tech which could explain my "slightly" weakened diagnosis:

"HI THERE, i do echocardiograms in a hospital (an echo-tech), now from what you are describing, your echo looks normal even though there is some hypokinesis of one of the walls, now as a bodybuilder your heart walls should be thicker than normal and therefore your heart is stronger and needs less motion to pump the blood thats why usually people who lift weights have a slightly lower ejection fraction than normal (normal ef is 55% and over), now if the cath went smooth and no evidence of blockage was indicated-then dont worry about it, a false-positive test is a way of saying that the test you have wasn't 100% accurate, which it could show some abnormalities but not do to an issue with blocakge or an MI (its basically a statistical parameter that determines the accuracy and efficiency of the test).
  

[Jayden716]

degrassi, I have just actually started doing 3 cardio sessions per week in addition to my 4 weight training workouts. Hopefully the cardio will really help. I have really neglected cardio over the years.