Re: cad

Posted By CCF CARDIO MD - DLB on January 12, 1999 at 18:01:24:

In Reply to: cad posted by will Trout on January 12, 1999 at 16:17:55:






Dear Doctors,
   My question concerns coronary artery disease. I had a stress test two
months ago that was unremarkable and an echo last week that they said was'
normal. I've had constant discomfort in the middle of my chest below the
sternum near where my stomach meets my chest for about a week. I didn't
get it checked because I thought my negative stress test would rule out
blockages. Are stress tests accurate? If you pass one how long should you
wait until you have it repeated?  I have low HDL 34 and low LDL 99. Do
you think I should get anymore heart or stomach tests.  Thank you very
much for helping so many people.   Will Trout
Dear Will
Exercise stress tests are accurate. If images are obtained at the time of a stress test, then it is even more accurate. However, stress tests are not perfect. They can sometimes miss severe disease. They can sometimes also be wrong in the other direction - they can say that there is disease when in fact there is none.
I do not believe in routinely performing stress tests in young, healthy people.  I have had patients that had a normal stress test one week, and a heart attack the next week.
I cannot tell from a distance whether you need more heart tests, a cardiac catheterization, or just gentle reassurance. The doctors that know you are in the best position to make that decision. If your doctors do not feel that your symptoms are due to the heart, I think it would be sensible to investigate the esophagus (food pipe) and stomach - these can be a source of pain very similar to heart pains.
I hope this has been useful. I wish you the best of 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.