Stress Test ST Depression

Hi - I am 40 year old male that has always been in generally good shape. I had a stress test as part of my annual physical and was told that I did well, got my heart rate up to 193bpm (107% of the age predicted heart rate) Blood pressure went from 138/82 to 184/72 but at the peak of exercise I had a 1mm st depression in leads v5/v6, which resolved very quickly with recovery. The dr at the physical didn't seem too concerned about it but said I need to discuss it with my regular dr. How concerned should I be? Should I continue with regular exercise for now or do I need to go straight to a cardiologist? Thanks in advance!

[Michael J. McWilliams, M.D.]

I agree that you should talk to your doctor about it, but it is probably not significant.  If the ST changes resolved quickly and without you having any symptoms at peak exercise, it does not sound like a significant finding.  It is important to look at your global risk picture: smoking, overweight, cholesterol, diabetes, high blood pressure, family history.  If you have a lot of risk factors and especially if you have any exercise related symptoms, it is worth seeing a cardiologist.

Without seeing the EKGs, I don't want to comment on whether or not you should exercise.  If you don't have any risk factors and the only indication that something is wrong is 1 mm ST depression in V5-6 that quickly resolve with no symptoms, I doubt it is significant.

I hope this helps.  If your doctor looks at your studies and is not concerned, by all means, please keep exercising.