cardiolite stress test - lead 3

[mzimm]

Hello,
I am a 37 yr old male, non-smoker, not overweight, with marked acid reflux. Was sent by the new Dr. I visited for echocardiogram, and cardiolite stress test, after my GERD had been giving me chest pains.
At times, recently I have been a little short of breath, and some pain radiates to hand on left; these things I have associated with the reflux.
I also had some shoulder pain and pectoral pain when I noticed that I was 'holding' my left shoulder oddly, (maybe order to relieve the chest discomfort).  Again, I cannot emphasize enough I have bad reflux.

During stress test, lead 3 'dipped' (meaning possible ischemia ?), all other leads normal.  Dr. that interpreted stress was not cardiologist. Was told later in day that cardiolite returned normal. Cardiolite was read by radiologist. Can you answer some questions?

1. should not a cardiologist read the stress test- my internal medicine Dr. was pondering over and over on lead 3.
2. thinking of having 2nd opinion because of stress test (echo did not come back yet)
3 Anxiety caused by chest pain, GERD and now stress test has been leading to irritability. Being told that lead 3 was probably a 'false positive' because of cardiolite results
is not reasssuring. I need to get back to exercising? but am reluctant. Is the cardiolite test as comprehensive as Dr. stated, so that we may ignore the stress test?

I still have some chest pain, but not as bad since switching to different reflux meds. Also, some recent problems with local hospital radiology and a cardio doctor not reading results is not reassuring.

[grey_cat]

I agree with CCF-M.D.-RCJ. I recently visited a new cardiologist for a second opinion.  I had a very positive experience with this new doctor and now I feel better about the care I am receiving. Try to obtain a referral from a trusted friend or relative. A medical student or resident physician meets many doctors during their rotations so they would be a good resource for referrals.  Chest discomfort can be difficult to diagnose so you're doing the right thing by having your heart checked out.

[CCF-M.D.-RCJ]

mzimm,
Sorry for your recent troubles.
(1) Internal medicine doctors frequently review stress tests; whether or not they should depends on their level of training. Some are very good at it, others are not.  Lead III(3) is the least specific lead for identifying coronary artery disease. IF this lead was the only positive lead, then the test was more than likely a false positive test as 37 year-olds infrequently have coronary artery disease.

(2) If anxiety is troubling you to the point of being irritable, I see little harm in obtaining a second opinion from a reputable cardiologist.

(3) The results of the stress test: ecg findings and total activity level obtained, are more important than the cardiolite portion of the test for determining your 5-year prognosis.  The cardiolite helps predict which portions of the heart are receiving blood, but the stress test is a true measure of "health" and how you are likely to fair in the future.

Bottom-line -- you sound troubled by the results and do not seem to have much faith in your doctor's ability to interpret the test. If this is true, then seek a second opinion from a cardiologist.

Hope that helps.