Heart Disease Community
Positive Stress Test Results - Asymptomatic 37 yr old male
About This Community:

This patient support community is for discussions relating to angina, angioplasty, arrhythmia, bypass surgery, cardiomyopathy, coronary artery disease, defibrillator, heart attack, heart disease, mitral valve, pacemaker, PAD, stenosis, and stress tests.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

Positive Stress Test Results - Asymptomatic 37 yr old male

I had an exercise stress test today as part of a thorough physical. I am a 37 yr old male with no known cardiac risk factors. The stress test was "abnormal" or positive. The findings were elevated ST that continued or got more elevated as my heart rate increased.

I am completely asymptomatic, but now very worried about these results. The Cardiologist wants to do a nuclear stress test as a next step. I am really concerned about the radiation of this test, which I understand is very high (up to 20mSV+).

Are there other cardiac tests that will yield similar or better results as this test, but without the radiation dosage at such a high level?

I can't help but think that this is much to do about nothing given my age, low risk profile, no symptoms. Therefore, the large radiation dosage is just not something that I am comfortable with.
Related Discussions
9 Comments Post a Comment
Blank
63984_tn?1385441539
Did the doctor or health professional tell you how many mm's the elevated ST wave climbed?  Also, did you request a copy of the procedure report?
  
I understand your concern very well.  I've had a number of stress tests as well as at least five Angiograms, plus a pacemaker inserted.  I should glow in the dark.  Given your age, you are smart to think about these issues.  I'm much, much older than you, so I'll qualify my response with that caveat.

An elevated ST wave of 2 mm's or more could indicate a number of heart issues.  It's a marker for me that I had serious heart blockages, and nuclear stress tests have led to eight stents.   Given your concern, I'd make sure I have a copy of the procedure report.  If you have questions, post it on this site, there are very educated people here who can interpret them.  I personally think the radiation level is low enough that the risk factor is minor, but that is a personal issue, but believe me, if you have a heart issue starting, you will want to get on top of it asap.  In my opinion, heart health trumps these radiation concerns.  It's a great question, keep us informed.
  

Blank
Avatar_n_tn
Thanks for your response. I definitely dont want to mess around with this. I just want to know if there is another test that will yield the same diagnostic evidence, but without the high radiation. I.E. stress echo, or cardiac MRI, PET, EBT, etc. thanks!
Blank
367994_tn?1304957193
Elevated ST segments are strong indicators of a heart attack in patients with symptoms and other indicators.  An EKG is not a very reliable source, if I remember correctly the sensitivity rating is 30% and a correct dx requires supporting evidence from other test, history and symptoms (you are asymptomatic and no history).  

ST elevation during exercise testing suggests extremely tight coronary artery stenosis or spasm (transmural ischemia), but ST segment elevation has numerous possible causes. It may be a variant of normal or be due to cardiac or non-cardiac disease.  It could suggest that an artery to the heart is blocked and that the full thickness of the heart muscle is damaged.

When physicians recommend a stress test, they are usually referring to an exercise electrocardiogram (EKG). Apparently, your strss test measured the heart's electrical activity before, during and after exercise. However, technically speaking, a stress test is any test that is performed in conjunction with exercise. So, a nuclear stress test usually refers to stress testing that is performed in combination with a nuclear imaging test, such as SPECT scan or a PET scan. In general, a nuclear stress test is more accurate and provides more information than a standard exercise EKG. However, these tests do have drawbacks. They are more expensive and require more time, and there is exposure to a small amount of radioactive substances.

An echocardiogram would provide evidence of any heart muscle damage and wall dimensions, but the most probable cause is coronary artery stenosis (narrowing), and that diagnosis may require angioplasty preferably with ultra sound, or imaging technology.  

Blank
Avatar_n_tn
My primary care doctor preferred we take an intermediate step, a stress echo test, before jumping to nuclear/ct based tests. The stress echo came back dead cold normal after 10+ minutes on the treadmill. No changes in ST, not a single change or finding.
The cardiologist feels that no further testing is necessary, that since I am a relatively young person with atypical symptoms and no risk factors, we are done. I must say that the experience has me still concerned. What do we know about the accuracy of the stress echo test...i.e. what is it's false negative profile?
Blank
367994_tn?1304957193
An echo test uses ultra sound and appropriate for wall dimensions (estimates...probably a margin of error of 10%) and degree of viability of heart walls (some impairment... hypokinesis, dead cells...akinesis) and accurate.  ST wave interval (EKG tracing) is not associated with an echo other than an elevated ST wave can cause hypokinesis and/or akinesis.  False negative regarding heart wall dimensions and viability to probably nil, an EKG specificity is about 30% for elevated ST.
Blank
Post a Comment
To
Top Heart Disease Answerers
976897_tn?1379171202
Blank
ed34
watford, United Kingdom
159619_tn?1318997813
Blank
erijon
Salt Lake City, UT
63984_tn?1385441539
Blank
Flycaster305
97303, OR
612551_tn?1247839157
Blank
Jerry_NJ
NJ
Avatar_f_tn
Blank
skydnsr
212161_tn?1391090750
Blank
heartfluttersflyawayplz
hoschton, GA
MedHelp Health Answers
Blank
BloodPressure Tracker
Monitor Your Blood Pressure
Start Tracking Now
Blank
HeartRhythm Tracker
Track your Heart Condition
Start Tracking Now
Recent Activity
Avatar_f_tn
Blank
neato1 is ... Comment
Jul 24
5268376_tn?1406183312
Blank
Navywife21113 worried Comment
Jul 23
Avatar_n_tn
Blank
kmlksl66_ commented on An Insider’s Guide to...
Jul 21
Heart Disease Community Resources
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank
Top Heart Disease Answerers
976897_tn?1379171202
Blank
ed34
watford, United Kingdom
159619_tn?1318997813
Blank
erijon
Salt Lake City, UT
63984_tn?1385441539
Blank
Flycaster305
97303, OR
612551_tn?1247839157
Blank
Jerry_NJ
NJ
Avatar_f_tn
Blank
skydnsr
212161_tn?1391090750
Blank
heartfluttersflyawayplz
hoschton, GA