What do these tests rule out?

[dawnms]

I have had 2 holter moniters, numerous ekg's, stress test, and an echo done. Everything turned out fine. What heart diseases do those tests rule out? I wasn't having any of the chest pains that I had been complaining about during those tests, so were they pretty much pointless? And also, when I had my stress test, it was done with a stationary bike, not a treamill. Does that matter? Thanks for your time. Dawn

[MacyMaid]

Thanks for this information on Coronary Artery Spasm.I too am short of Breath and had Stress Echo's  and holter monitors for PVC's and have been brushed off with a diagtnosis of Anxiety and this comes from a Cardiologist. After reading your post, I e-mailed the head of this cardio clinic and asked about the E____
Challnge test to rule this in or out. I do respond to Nitro and had to beg for a prescription for this last year. I am also taking Ecrotin (coated 81mg.aspirin).  I hate being my own doctor but I know something is wrong.  These spasms can occur right out of the blue. Cold can even bring them on and they are horrible.  Labor pains were easier.

Thanks again and I wish you all the best.

[dawnms]

To answer your question about why I had the tests done, I have had chest pain since I was around 12.I was in school the first time I has the spasm type pain. It kind of feels like a sudden charlie horse/cramp/pressure. It comes on with no warning and hurts so bad that it stops me in my tracks and doubles me over. It lasts at the most 5 seconds, and then its completly gone, almost like labor. I did that off and on for a few days and then I was fine. Since then I always have little episodes of different types of chest pain. But last year I started getting those really bad pains again. I don't get them often, and nothing brings it on. I can be working or sitting, and once I did think it may have been what I ate, but I don't know. It really feels like my heart.I have been tested for gerd too, and they find nothing. It is so frustrating because this much pain has to be caused by something.I am 28 now. Other wise I am pretty healthy, a little over weight. I am working on that though- 30 lbs. off and 30 to go!!By blood pressure is normal, sometimes my pulse races at night. Do you have any ideas what may be going on?  Thanks for responding, its nice to have someone to chat with about it.

[dodgybeats]

Can you please describe the pain you feel with coronary artery spasm? I get occassional chest pain which I find very worrying - it is tearing or ripping in nature and is extremely painful but only lasts for about 3-5 seconds.
Thanks

[itsa4847]

what i get with cornory artery spasms is angina! it can be many things mine is first i notice that i get short of breath, i can talk to people on the phone and they ask me what are you doing, cause i'm so breathless, then i began to get a sense of pressure right in the middle of my chest like someone is squeezing me and won't let me take a deep breath.  and if this continues (which now it does not with my meds and my nitro spray) i would continue by getting sometimes neck pains, shoulder pains and my left arm would get heavy, and my pinky and ring finger would get numb.

the only real pain i get is a little pain under my left breast, which i noticed more frequent with the less dosage of the toperal that they are trying to take me off of.

I do now take for the cor. art. sps. cardizm 240mg (this is calcium channel blocker) and imdur 120mg 2x (this is nitrate)and i carry nitro but i have not had to use it in a while.  and once he takes me off the toperal he will up the cardizm. plus i take a daily 81mg asprin.

good luck to you
don't give up when i first had the problems i would notice that i was having a hard time catching my breath, or i would get dressed for work and be out of breath!  my first primary dr. said i had anxiety....go figure, iam lucky now i didn't have a heart attack!

its been since jan since i was diagnosed, and it has taken two more hospital trips to get my meds to the right dosage! so if you find that you have any cornary artery problems read up on all you can and be patient.
i also have three mild blockages in two arterys (one is the one with the cas.....

[itsa4847]

i wanted to ask why were you having the test?  i had problems with atrial tachardia, i also was having many pvc's and then started having chest pain (angina) couldn't catch my breath felt the pressure and the list goes on.

i just wanted to tell you that i had allllllll of the tests event monitor which did show my artrial tachardia and nothing else, until i was taken by ambulance in a full blown cornary artery spasm, which we didn't know at the time i had this...until that got me stable and did a heart cath in the morning and did a test called echovine challenge study and found out the the artery was spasming to 50% close so...that was the cause.  I now take cardiaz and nitrates to keep that from happening and carry nitro spray in case i get an attack.  So I do beleive that you can have all the tests and still have a problem.  

So if you are having any chest pain pressure (that was my biggest feeling) then i would investigate further.  all my ekg's were negative even when they did the test on my heart.
good luck to you

[CCF-M.D.-RCJ]

Dawn,

Very few tests can completely "rule out" anything.  Holter monitors are used to pick up irregular heart rhythms.  The monitors are most effective for patients who have very frequent symptoms.  EKGs are used to diagnose many conditions; they are usually only in diagnosing heart disease in patients who are having chest pain at the time of the exam.  Stress tests are used to as an overall health assessments.  In patients in whom a doctor suspects obstructing coronary artery blockages, stress tests can help determine if a blockage is present, and if so, if that blockage is likely to lead to a poor prognosis.  Echos are used to evaluate function and structure of the heart.  Echos can only find the footprints of coronary artery disease, not the blockages themselves.

If all those tests were normal, your likelihood of having obstructing coronary disease as the cause of your chest pains is low, but not zero.  So those tests were not pointless.  They help reassure us that you have a relatively low likelihood of blockages.  To find out for sure whether you have blockages or not would require a heart cath -- which entails some risk.

Stationary bikes are less effective at getting patients to the target heart rate of 85% of max.  If your heart rate reached target, then the test results should not be altered by the fact that you performed it on a bike.

Hope that helps.