Stress Echo Results

[DavesMom]

I had aortic valve replacement and aneurysm repair in 1999 - take
coumadin, Tegretol (for complex partial seizures) and Crestor.

I was sent for a stress echo last week following two episodes of near syncope, which my primary care doctor said was probably vasovagal syncope. I have been dealing with some pretty bad fatigue (and occasional SOB) for over a year now but all blood work is fine.  Cholesterol is slightly elevated but my "good cholesterol" is 105. I check my BP on ocassion and it's almost always fine. I walk every day.

The first part of the echo was normal, though the doctor noted
"borderline left atrium enlargement."  I was confused by this as the LA measurement was 3.1 and normal size should be less than 4.0.  The doctor also commented that there was "no evidence of exercise induced myocardial ischemia."  

The treadmill part, however, noted this abnormality: "Patient reached adequate heart rate. She developed 0.5mm horizontal ST depression and T-wave inversion in leads II,III,aVF and V4,5,6. In these leads there is baseline ST/T abnormality."

Nothing was really explained to me about what this meant and I can't get an appointment to see the cardio until late next month.   Has anyone else had similar results on a stress echo? Everything else looked so good I don't understand why the doctor concluded that the test was "abnormal."

Thanks in advance for any info.

[Sue4488]

I had a stress echo last week after having an abnormal EKG the week before.  The stress echo showed some damage to the heart muscle and  not getting enough oxygen.  I have been walking everyday and go up and down the stairs at my house 20 times a day with no shortness of breath or pain.  I have chest wall pain but was diagnosed with Lyme disease in March, when all of this started.  I have been very anxious since the Lyme because it hasn't seemed to clear up and I was hyperventilating when I took the test, which I didn't really mention to the Dr.  I go back and forth from believing to not believing.  He put me on Beta Blockers for a month and then we will discuss an angiogram.  Someone at work had a false positive stress echo, that's why I have hope.  Anyone else have a false positive stress echo?  

[finetilthree]

They did the nuclear images at the same time.  But it wasn't a stress echo test.  It was the test where they inject the nuclear dye and then you go on the stress test.  I guess it was a nuclear stress test, can't think of the proper term for it.

[DavesMom]

finetilthree -

Sorry to hear about your problems with anxiety.  I hope your docs can find a solution soon. Having a nine month is really stressful.

Did they do "nuclear images" at the same time as your stress echo?  Or was this a separate test?  Thanks.

[anacyde]

I had some ST abnormalities on a Holter Monitor.  Some of it was during sleep, because I was sleeping on the leads.  The other times it was apparently nothing.  I have a healthy heart and clean arteries, exercise tolerance is excellent and everything seems in order.  I am on the anxious side.  My cardiologist and his associate both assured me that the ST changes meant nothing in my case.  The same is likely true for you if they didn't find anything else and they don't seem concerned.

[DavesMom]

Hi,

Thanks! Have to say I'm feeling better about my results and I'm sure it's nothing important or they wouldn't have me wait six weeks to see the cardio.

I don't think the ST depression is a factor.  From what I've read it takes a depression of greater than 1 to be considered worrisome. The T-waves *could* mean ischemia but whether they were caused by other factors is something the cardio will have to tell me. I wasn't the least bit anxious during the test but I will say I have quite a bit of stress on my job. There was no "exercise induced ischemia" which is good.  However,when I'm at home I tend to totally CRASH after I've walked. You should feel invigorated after exercise but most of the time I immediately want to go to bed.  

Guess I'm just trying to find an explanation for the bouts of bad fatigue I've been having for over a year. I've been through two heart surgeries and fatigue was the only clue I had that anything was wrong. Thyroid and fasting blood sugar have always been fine. I know I'm getting older but at 50 I don't think I should be this bad. I also get SOB with very little exertion on occasion.  *sigh*    

[finetilthree]

I have been having daily pvcs and pacs since I had a baby 9 months ago.  So I had all the routine testing to rule out any heart disease.  I'm not dealing with it very well at all and I go to the doctor alot about it, so they've tested me to the ends of the earth and back again to try and relieve my anxiety.

[DavesMom]

Hi,

Thanks for your reply.  Were you having any symptoms prior to your test?  I've been dealing with a lot of fatigue and some SOB.

Thanks!

[finetilthree]

I had inverted t waves and st depression in those same exact leads and my test was also termed abnormal.  However, the nuclear images showed that I have no ischemia and no evidence of a prior heart attack, therefore the test was normal.  My cardiologist told me that alot of women my age have inverted t waves and st segment depression, especially anxious women, which I definitely am.  I read alot about it and from what I have read, some people have slight abnormalities that are just normal for them.  I have also read that things like anxiety and hyperventilation can cause those same changes.  Good luck to you.