Stress Test Results - Please comment!!

[jan__0__0]

Posted by jan on July 19, 1999 at 09:25:19
I've asked you questions before. You've been very helpful. Thanks for the service you provide. I'm 38 years old, Female, 5'1" weigh 180 punds - grossly overweight I agree, trying to work on it. Had a cardiolite stress testing done, with imaging. My imaging , Dr says shows there is blockage in two sides of my heart. I get short of breath. Sometimes, I do experience pain in my left arm and funny stabs in my chest - never lasts for more than  a few seconds and sometimes happens again and again.
Exercise Stress test Report - Not the imaging result . I do not have that one yet.
Indications for study - Chest pain evaluation , palpitations
Current medication - Toprol 50mg for high BP.
Pulse : 66
Blood Pressure - 140/100
Pre Test physical : unremarkable
pre Test Electrocardiogram : Normal, except for PVCs
Protocol : Brue
Duration of Exercise : 9 minutes ( Nine Minutes )
Reason for Stopping : Fatigue - I was really stress out, Out of breath.
Target heart rate ( 85%) : 182
Peak rate : 196
% predicted maximum heart reate : 108%
maximum blood pressure : 150/80
Evaluation : subject did not have chest discomfort of any sort. No pulmonary rales or gallop were noted. There were no ST changes. No arrhythmias were seen during exercise.
Interpretation : NEGATIVE test
Comments : The patients heart rate response to exercise were appropriate, Blood pressure resonse to exercise was somewhat excessive. The blood pressure immediately after exercise was 160/105. There was no overt ventricular dysfunction.

I don't know much about these things. But these look quite normal. Can this part of the stress be normal and the imaging show blockages, which is my case. Which is more reliable, the imaging or the stress test. Which should I believe. Stress says negative, imaging says positive. Is this possible. Am I sure to have blockages, because imaging is more reliable.
A year back, my total cholesterol was 153 and triglycerides 221. Do not smoke.
Thanks very much for your help.
Posted by CCF CARDIO MD - DLB on July 19, 1999 at 12:08:20
Dear Jan
Yes, the exercise part can be normal, but there can still be an abnormality on the imaging part. The imaging part is more sensitive than the exercise part. However, even the imaging part is not a 100% accurate. Only a cardiac catheterization can determine if there are really blockages in the heart arteries.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. 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.
Posted by Kimberly on July 22, 1999 at 07:56:13

Dear Jan :
I am a 39 year old female.  I am overweight too.  I will be going for the thallium test on August 3rd because of occasional chest pains which start in the centre of my chest and radiate up into my shoulder and neck and down into my arm and can last for almost 20 minutes( always the same pattern although most occasions have been on the right side of my body the last two have been on the left). These have occured relatively far apart over the past 4 years.  I finally went to get a checkup. My stress test showed normal signs.  My cholesteral is excellent.
My husband at 38 had a coronary spasm.  His enzymes where up considerebly.  He had a stress test and EKG; both were normal.  His thallium test however showed some blockages.  He had an angiogram done, and with great and overwhelming relief, it was normal ( no blockages!).  The cardiologist told us that the nuclear imaging is a false/positive test.  In other words that the heart MAY not have any blockages, but if there is anything that is seen in the imaging that even resembles a blockage, it will show up, and the angiogram will show whether or not there are any.  I wish you the best and hope that your angiogram will show that all is well.  If you do have blockages, you will be in safe hands with all that can be done today.  You must be scared.
Kimberley

Posted by CCF CARDIO MD - DLB on July 22, 1999 at 08:58:14
Dear Jan
The stress test results sometimes do show a blockage when in fact there is none. Likewise, they can occasionally show no blockage, when in fact there is one. Thus, no test is 100% accurate and needs to be interpreted in context.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. 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.
Posted by jan on July 23, 1999 at 11:11:17
Thanks Kimberly. I'm hoping that the imaging was a false positive. I have posted the actual words from the test at a later time. You may have a read of that and tell me if that was similar to your husbands imaging results. Thanks to the doctor who replied to my questions. My doctor wants to do a cath. I might have one in the next couple of months. I would like to delay the cath if possible until the end of this year. But I don't know if this will have any problems.
Thanks.

Posted by CCF CARDIO MD - DLB on July 23, 1999 at 18:26:56
Dear Jan
I think that if you and your doctor have decided upon a cardiac catheterization, there is no good reason to delay several months. It will only increase your level of anxiety in the meanwhile, and if you do really have coronary artery disease, you would want to avoid having something bad happen.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. 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.