ST depression

[Bozzer]

Dear All,

I am 38 year old, male, non-smoker. My father had a MI at the age of 43 and this was complicated by heart failure.

I started going to the gym about two months ago. I started to get chest pain (left side - not central) after 4.5 mins of running. This was reproducible.

I had an exercise tolerance test done in which I had upto 1mm of ST depression (upsloping) at peak exercise that disappeared in recovery. This result was equivocal so I had a Thallium myocardial perfusion imaging test. This came back normal. I still get chest pain - what does 1mm upsloping ST depression mean? Do I have anything to worry about or do I need further tests. Thanks

[Bozzer]

Hi Anacyde - thanks for the reply. Yes, I guess I should do something - but I feel a bit guilty about wasting the time and money of the NHS (National Health Service - in the UK). From what I understand, 1mm ST depression (upsloping) is borderline. Coronary Angiography is meant to be the "golden standard" for identifying atherosclerosis/ischemia..but that sounds a bit scary too. There's a 1:1000 chance of things going "pear-shaped" ...

[anacyde]

Well, your testing sounds fairly normal, but with the chest pain and family history I would probably press for more testing.  My father had a negative stress test (normal) and weeks later was receiving a triple bypass.  He's fine now, but this is because the problem was identified - but not before they did a catherization.  He was 47 at the time, lost his dad to CAD at 55, so he pressed the issue when the stress test showed nothing but the pain kept up.

[Bozzer]

Additional info: BMI 27, Pulse 70 regular, Total Cholestrol 3.9, LDL 2.3, Completed Stage 5 of Bruce Protocol (12 mins) which equates to 13.8 METS.