abnormal cardiolite nuclear stress test CTA

I'm 30/male, 5'10 240 lbs. I went to a cardiologist with:
New onset palpitations
atypical chest pain (heavy, tight, not worse with exercise)
feeling breathless
New onset exercise intolerance/fatigue
over-awareness of heartbeat (beating too strong)
Near constant lightheadedness

I'm about to have a CTA done (actually he gave me the option between CTA and cath. He said if I was 50 he'd say cath but due to my age he said CTA should be okay).
IF that is normal, then does that mean the stress test was a false positive?
How often do you see stress tests like this turn out to be "nothing"?
Would a normal CTA "over ride" this "abnormal" stress test?

(I should point out that at home I'm able to exercise 30 mins daily at a HR of 155-160, it's just the intensity level of the treadmill was too high for me; but I still do perceive far more fatigue than usual)

Max HR: 184
Exercise time:  7:30
Reason to terminate: fatigue
Left ventricle size/thickness normal. EF 61%
Perfusion: Abnormal
Ischemia: Mid anterior

FINDINGS:
1. Reduced nuclear isotope uptake in the mid anterior wall on stress imaging when compared with rest imaging. Findings may indicate ischemia in the distribution of the left anterior descending or branch vessel of the left anterior descending.
2. Soft tissue attenuation does reduce the sensitivity and specificity of the study.
3. Mild hypokinesis of the mid anterior wall with otherwise normal segmental wall motion and a calculated ejection fraction of 61%.
4. Normal left ventricular size and wall thickness.
5. Clinically negative and electrically nondiagnostic stress, exercising only 65%.

CONCLUSION:
1. Nuclear imaging suggests the possibility of ischemia in the distribution of the left anterior descending. Very poor exercise tolerance, as well. Clinical correlation recommended.

THANK YOU FOR YOUR TIME

[Douglas Bogart, MD]

The nuclear test could be abnormal because of you large body mass which may  lead to soft tissue uptake and a false postive study.  An alternative to having another test with radiation exposure would be to have a stress echo and if this is perfectly normal it would be unlikely you have coronary artery disease.  If the CTA or exercise echo is normal it means to me that the nuclear scan was a false positive.