I have a very strong positive family history for cardiovascular disease (father had first open heart surgery at age 39 ...same age I am...mother had silent infacts, both grandmothers died from heart attacks) but have always been fine. I have recently began feeling very fatigued and was unable to complete my work out at the gym last Saturday. I am obese but have lost close to 90 pounds via lapband surgery nearly two years ago. My cholesterol is very good, I avoid caffeine, have never had bp problems and try to eat reasonably healthy. My A1C is 5.5 Last Sunday I had no energy whatsoever and became spacey and felt disconnected. My lapband had gotten tight and I knew I was dehydrated so I went to ER. My heart rate was between 48-52. I had two EKG's that indicated sinus brady, inferior infarct of undetermined age, and left axis deviation. A third ekg the next day was sinus rhythm 61, old inferior infact, possible anterior infarct. My enzymes were fine. I did experience some chest pain and left arm pain during my stress test but was told there were no ekg changes. I was released. My lvh was 1.2 cm. I am no longer dehydrated but still feeling very very tired. My heart rate is averaging fifties. I have occasional palpitations and left arm pain. I will be seeing a cardiologist next week. Is there a need for further testing such as cardiac cath since my echo and stress test seemed okay?