Understanding stress test results

[elrav]

Just had a stress test here are the findings, but I"m not sure what they mean, can anyone help?

Baseline ecg revealed inferolateral ST sagging - there is one further mm of ST depression at peak exertion being 7.7 METS.  This test was positive for inducible ischemia, however, baseline ECG abnormality makes predictive value of this test less.

They are now sending me for nuclear perfusion test in a couple of weeks.

Any input would be appreciated

[kenkeith]

You are welcome.  Take care.

[elrav]

THANKS VERY MUCH, KENKEITH, FOR YOUR HELP WITH THIS!

[elrav]

Yes, I was short of breath, and developed a horrible headache (which went away about an hour after the test).

[kenkeith]

Yes, that would be the issues to further investigate.  An EKG is not a very reliable soruce for cardiovascular disease (better for rhythm issues), and it has a low selectivity and sensitivy rating so other tests, symptoms, etc. is necessary to support before there can be a reliable diagnosis.

Typically during a Bruce Protocol Heart Rate and Rating of Perceived Exertion are taken every minute and Blood Pressure is taken at the end of each stage (every three minutes).

Bruce Protocol Stage Minutes % grade km/h MPH METs
  stage 1   3   10   2.7   1.7   4.7
  stage 2   6    12  4.0    2.5  7.0
The test was terminated after a little more than 7 minutes.  A successful test is 15 minutes and 15 METs.  Were you short of breath, fatigue, chest pain, etc. and couldn't continue or was the test terminated due to monitor readings?  

Thanks for your response, and if you have any further questions you are welcome

[elrav]

Okay, just to make sure I have this clear - I am not on digitalis, so that's not an issue with the ST depression.

My abnormal baseline ecg, which indicated ST sagging, and then a further mm of ST depression during exercise could be indicative of prior heart attack or CAD?!

Have I got that right?

Thanks.

[kenkeith]

ST segment of an EKG is usually isoelectric (flat) but may vary by approximately 1mm above or below. If there is a 2mm depression or elevation it could mean there has been a prior heart attack or ischemia (occluded coronary vessels).

The mediation of Digitalis effect can be a sagging ST segment depression with upward concavity. The perfusion test is to determine any occlusions and to what extent.

Hope this helps, and if you have any further questions you are welcome to post.  Take care and thanks for your question.