Im a 24 year old male that has hypertension since 21 and recently began having shortness of breath and chest pain which my doctor determined were panic attacks, however I was concerned whaf I suffered from was angina or coronary artery disease. So he did an echo stress test, the results wee mailed to my house and i'd like your opinion
Stress ECG interpretation- Patient exercised for 10 mins according to Bruce protocol and achieved a heart rate of 189 BP , which is 96% of predicted maximal heart rate, and a peak BP of 180/60 (Baseline 158/82). Patient achieved a workload of 11.7 METS. Patient with normal HR and BP response to stress. Test was terminated due to shortness of breath. EKG showed sinus tachycardia without any ischemic changes. Patient demonstrated excellent functional capacity.
Stress Echo Interpretation- Normal maximal exercise stress contrast echocardiogram
Pericardium- No significant pericardial effusion
RESTING EKG- NSR at 88 bpm with nonspecific ST-T wave changes.
STRESS ECHO- Images acquired within one minute after peak exercise Images revealed: Hyperdynamic left ventricular systolic function with appropriate increase of LVEF. No regioonal wall motion abnormalities noted suggestive of myocardial ischemia.
1. Please provide your honest opinion on this test.
2. How unlikely is coronary artery disease with the results?%
3. My doctor has suggested my hypertension is white-coat and not necessarily actual hypertension. Does anything in the test suggest he may be correct?
Interpreting just the report you provide, your stress test was negative for any inducible ischemia (decreased blood flow to your heart). The study was adequate because you were able to achieve > 85% of your maximal heart rate, and your functional capacity is good (11.7 METS) which is a good prognostic indicator. Stress tests are not able to say definitively whether you do "not" have coronary artery disease as this can only be done via coronary angiography where your coronary vessels are viewed directly. However, this is a "functional study" which assesses whether there is any supply-demand mismatch, which in your case, was normal. Your relatively young age puts you at low risk for coronary artery disease at this point. With your negative stress test, your symptoms are very unlikely to be related to your heart.
Regarding your last question, a stress test is unable to determine whether you have high blood pressure or not. A true diagnosis of high blood pressure is made when your resting blood pressure is > 120/80 on 2 separate occasions separated by at least 2 weeks.
I've been a heart patient since I was 26- and on meds for it since. I'm not a doctor, but I'm pretty good at reading reports like the one you quoted. Until a real doc answers, I'd like to ease your mind- the report is great. Totally. I have no clue what your chest pain and shortness of breath are from, but it looks like your heart function is super. Hope the doc that does answer does so soon so you'll feel more confident. Regards- Norma
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