What should I do

[Senia]

I would like a second opinion regarding an echo-stress test that I had.  The stress report showed 1 mm of horizontal ST depressions, in leads V4, V5 and V6 with maximal exercise.  The echo showed stress induced hypokinesis in the anterior apical and apicoseptal walls.  Due to this, the cardiologist rushed me in for a cath.  When he finished the cath, he told my husband that nothing showed up and that the echo/stress was a false positive.  I have continued to have chest pains in the middle of my chest, going through to my back, along with jaw pain at times.  I am confused, at this point and wonder if I should go to another cardiologist or just ignore the pain, which is hard to due, when it is happening.  Please advise.

[kenkeith]

There is much information of what constitutes a significant ST segment depression during stress test.  It is generally acknowledged tht ST segment depreciation greater than (1 mm) that persists for more than .08 seconds is suggestive of CAD.

If the depression of (2 mm) is used as a criterion the number of false positives is greatly reduced, BUT the number of false negatives results increase.

The cardiologist made a decision based on the 1 mm depression criterion with fewer false negatives with the EKG.

An EKG is not very reliable for a dx, but a cath is more reliable (but not 100%) and would almost always rule out ischemia (blocked vessels).  However, you do have the symptoms (angina) that can be related to a heart condition, and you should get another opinion...you shouldn't ignore the pain!