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postive stress test
I was wondering if anyone out there has had a positive exercise stress test and a negative stress echo test. My cardiologist said since my stress echo was negative there is a low probability of me having heart disease. I have been have chest pain with left arm and jaw discomfort on and off for 1 1/2 weeks. I am a non smoker, no high blood pressures, no diabetes, and good cholesterol. I am a 43 year old female. My father had his first heart attack at 50 and died at 60 so I have a family history. I am still having chest pain and wondered if I should suggest further testing. I see my cardiologist for a follow up on Monday. I am very, very anxious about all this and am having trouble trusting the negative stress echo. Any advice appreciated.
Well, the best solution is "Dont let him close the case". Tell your cardiologist things like "well, obvisouly there is something wrong because I feel the symptoms, but you have so far not found the problem. What do you suggest we do next".
Keep him/her aware there is a problem and you know there is a problem. Keep the ball in their side of the court.
You could also of course make him realise you know more than you actually do, simply say in a calm fashion "well, we all know that stress echo tests do not always reveal underlying problems, even coronary artery occlusions can be unnoticed". He will have to agree to this because it is a fact. If he/she knows you are on the 'ball', more action will be taken.
Keep him/her aware there is a problem and you know there is a problem. Keep the ball in their side of the court.
You could also of course make him realise you know more than you actually do, simply say in a calm fashion "well, we all know that stress echo tests do not always reveal underlying problems, even coronary artery occlusions can be unnoticed". He will have to agree to this because it is a fact. If he/she knows you are on the 'ball', more action will be taken.
I do not want to scare you and your condition could be entirely different than mine.
In my case I used to have tests every year as a requirement of my company. The tests included stress test (not stress echo), lipid profile and other relavant tests. In 2007, 15 days after this routine examination, which was -ve, I suffered a heart attack. One artery LCx 100% blocked and another LAD 90 % blocked. My heart suffered severe damage which reduced my heat function to 30% (normal is 55-65%). I had no symptoms. My lipid profile was always below normal limits.
If you have symptoms, which are similar to cardiac in nature, please get appropriate tests. I am not a doctor and may not be correct. But some of the forum members are very knowledgeable on these issues. May be they will also respond.
You may like to go for stress thallium or CT angiography. These are non-invasive tests and also more reliable as compared to stress echo. Consult your cardiologist.
I hope that everything is fine with you. Wish you good luck.
In my case I used to have tests every year as a requirement of my company. The tests included stress test (not stress echo), lipid profile and other relavant tests. In 2007, 15 days after this routine examination, which was -ve, I suffered a heart attack. One artery LCx 100% blocked and another LAD 90 % blocked. My heart suffered severe damage which reduced my heat function to 30% (normal is 55-65%). I had no symptoms. My lipid profile was always below normal limits.
If you have symptoms, which are similar to cardiac in nature, please get appropriate tests. I am not a doctor and may not be correct. But some of the forum members are very knowledgeable on these issues. May be they will also respond.
You may like to go for stress thallium or CT angiography. These are non-invasive tests and also more reliable as compared to stress echo. Consult your cardiologist.
I hope that everything is fine with you. Wish you good luck.
If your chest pain (angina) is related to an ischemia (lack of blood flow) to the heart muscles, almost always the symptoms can be treated with mediction. The medication will dilate coronary vessels and increase blood flow. If there is symptom relief that would be very good indication of an occlusion(s).
Keep up with documenting your signs and keep a journal of all tests etc. I've had positive stress tests, negative echos, three NEGATIVE cardiac caths for any blockages but had continuous chest pain and SOB especially on exertion. My final problem was cardiac syndrome 'X' and I take regular nitro to live with this. It is most common in women in pre,peri and post menopausal despite great lipids, non-hypertensive, non-smoker etc. Read my journal here at 'joanincarolina'. This is difficult to diagnose and MANY doctors are not aware of it. Hope this helps. Joan.
" If there is symptom relief that would be very good indication of an occlusion(s)."
Obviously not a conclusive method and I would say as unreliable as many other tests which say people are fit. I can tell you that with the total occlusion in the top of my LAD, taking nitrates had no effect whatsoever on my angina. All I ended up with was angina PLUS chronic headaches. I believe the reason is that not enough nitrate could get into my LAD to make a difference.
Obviously not a conclusive method and I would say as unreliable as many other tests which say people are fit. I can tell you that with the total occlusion in the top of my LAD, taking nitrates had no effect whatsoever on my angina. All I ended up with was angina PLUS chronic headaches. I believe the reason is that not enough nitrate could get into my LAD to make a difference.
I will modify my statement to say nitrate can provide relief to esophogagism as well so it is not consclusively related an coronary occlusion. It is true that some people find no relief and/or have headaches. It does very well for me and I have a totally blocked LAD and circumflex is last known to be 73% blocked. If there is symptom relief its a good indication there are coronary occlusions involved with exception.
Thanks for the information all tests are not conclusive. We should all add that statement to any test information response to a post lest we worry, confuse and cause anxiety to all the readers. Do you think we could say instead of that long statement that a result can/may happen?
Thanks for the information all tests are not conclusive. We should all add that statement to any test information response to a post lest we worry, confuse and cause anxiety to all the readers. Do you think we could say instead of that long statement that a result can/may happen?
COMMUNITY LEADER
I just don't follow this thinking, why should we go for tests at all if we're to doubt every outcome. Seems like a waste of time and money.
Or....... we can actually believe the results within reason?
Or....... we can actually believe the results within reason?
"Obviously not a conclusive method and I would say as unreliable as many other tests which say people are fit. I can tell you that with the total occlusion in the top of my LAD, taking nitrates had no effect whatsoever on my angina. All I ended up with was angina PLUS chronic headaches. I believe the reason is that not enough nitrate could get into my LAD to make a difference".
The first sentence doesn't make much sense! And I don't follow the logic with the final sentence either! There are known theraputic regimens for angina, but it may be possible the effective dose goes largely to the brain. I can't think of any other explanation!
The first sentence doesn't make much sense! And I don't follow the logic with the final sentence either! There are known theraputic regimens for angina, but it may be possible the effective dose goes largely to the brain. I can't think of any other explanation!
What we are trying to say is that if a single test doesnt show a problem, this is not adequate for a cardiologist to dismiss you. Let's say you go to ER with chest pains. They do an EKG and it's fine. They do a chest xray and its fine. They discharge you. The next day you die of heart attack. This is a common occurence and this can be prevented with more tests. One test is just one piece of information, if you want a complete picture you need lots of tests. This is what we are saying.
To put it another way, not all tests reveal the problems associated with an individual.
To put it another way, not all tests reveal the problems associated with an individual.
QUOTE: "Obviously not a conclusive method and I would say as unreliable as many other tests which say people are fit".
What is the connection of that statement with the suggestion to take nitro and see if there is relief from chest pains? It would be an indication of angina if there was relief and evidence with very little expense. What part of that statement implies not to follow up with further testing? It seems you miss the point that it is EVIDENCE and not a CONCLUSION. You are new to this forum and have very little experience, so I can tell you no one's post I have ever read (and there are thousands) has ever told anyone to accept a single test as conclusive of any medical problem on this forum or any other forum which I have been associated. In fact it has been the opposite, and sometimes a suggestion to get another opinion.
What is the connection of that statement with the suggestion to take nitro and see if there is relief from chest pains? It would be an indication of angina if there was relief and evidence with very little expense. What part of that statement implies not to follow up with further testing? It seems you miss the point that it is EVIDENCE and not a CONCLUSION. You are new to this forum and have very little experience, so I can tell you no one's post I have ever read (and there are thousands) has ever told anyone to accept a single test as conclusive of any medical problem on this forum or any other forum which I have been associated. In fact it has been the opposite, and sometimes a suggestion to get another opinion.
COMMUNITY LEADER
That's why I said "believe within reason". I certainly understand that one test may not be conclusive in the presence of the symptoms presented, but at some point, if the results support the presentation, when do you stop?
I know this is an open forum, but there is just so much discussion about how tests can be wrong, they are not definitive or just are not adequate. The more one is tested, the higher the possibility of a false positive that will lead to more invasive testing where the benefit may not justify the risk. Just my opinion...........
I know this is an open forum, but there is just so much discussion about how tests can be wrong, they are not definitive or just are not adequate. The more one is tested, the higher the possibility of a false positive that will lead to more invasive testing where the benefit may not justify the risk. Just my opinion...........
This is why there are so many people still misdiagnosed as having heart problems. It wasnt long ago that a famous british actor was due to return to his holiday home in spain. He went for a complete medical checkup first and this included an ECG. He arrived in spain and two days later had a fatal heart attack. This is by no means an isolated case. Three years ago my Mother phoned me asking me to go round to see her because she didnt feel good. On arrival she was panting heavily and clutching her chest. Her GP has recently diagnosed a chest infection and she was on antibiotics. I called an ambulance and she was rushed to emergency. Six doctors examined my mother and they took xrays, ecgs and even an echocardiogram. They ALL said there was nothing wrong with her heart, it must be a chest infection. Even blood tests showed normal. I went home agreeing to visit her the following morning. I had a phone call the following morning saying her heart had stopped during the night and although they tried, they could not revive her. A post mortem revealed severe athersclerosis in the coronary arteries.
So lots of tests and six doctors plus her GP misdiagnosed this problem. Like I said, there are many who unfortunately experience this.
Some people are lucky, a single test points to the problem immediately.
In 2006 I went to ER with very bad chest pains. After an xray, blood tests, ecg, echocardiogram I was sent home diagnosed with stomach problems. I spent a whole year on Gaviscon. In 2007 I had several MI but I didn't go to the hospital until about the fifth episode because I beleived it must be my stomach. On arrival, they emergency stented me and said if I'd left it any longer I would not have made it.
Knowing my LAD was totally blocked apart from a couple of tiny Collaterals, I passed a treadmill stress test, nuclear perfusion test, ecg, echocardiogram. The only revealing test was an angiogram. Cardiologists couldn't believe all the results being normal.
So, I guess this is why we have 2 schools of thought on this forum. There are those who have had no problems and are happily having treatment which is working. These have seen no real contradictory results and believe everything is non fallible.
The other school has experienced the opposite and has experienced mistakes and seen tests do not always reveal problems. Some have even seen death as a result from tests not revealing true problems.
I continually kick myself now because if I knew then what I know now, I would have demanded they do an angiogram on my Mother. Just maybe a couple of stents would have meant she could be here now.
From what I have witnessed and experienced, I'm sure you can understand my pessimism and why my outlook on the medical profession isn't very good. When I hear people on here say they have chest pains but certain test show no problems, I get scared for them.
So lots of tests and six doctors plus her GP misdiagnosed this problem. Like I said, there are many who unfortunately experience this.
Some people are lucky, a single test points to the problem immediately.
In 2006 I went to ER with very bad chest pains. After an xray, blood tests, ecg, echocardiogram I was sent home diagnosed with stomach problems. I spent a whole year on Gaviscon. In 2007 I had several MI but I didn't go to the hospital until about the fifth episode because I beleived it must be my stomach. On arrival, they emergency stented me and said if I'd left it any longer I would not have made it.
Knowing my LAD was totally blocked apart from a couple of tiny Collaterals, I passed a treadmill stress test, nuclear perfusion test, ecg, echocardiogram. The only revealing test was an angiogram. Cardiologists couldn't believe all the results being normal.
So, I guess this is why we have 2 schools of thought on this forum. There are those who have had no problems and are happily having treatment which is working. These have seen no real contradictory results and believe everything is non fallible.
The other school has experienced the opposite and has experienced mistakes and seen tests do not always reveal problems. Some have even seen death as a result from tests not revealing true problems.
I continually kick myself now because if I knew then what I know now, I would have demanded they do an angiogram on my Mother. Just maybe a couple of stents would have meant she could be here now.
From what I have witnessed and experienced, I'm sure you can understand my pessimism and why my outlook on the medical profession isn't very good. When I hear people on here say they have chest pains but certain test show no problems, I get scared for them.
QUOTE: "So, I guess this is why we have 2 schools of thought on this forum. There are those who have had no problems and are happily having treatment which is working. These have seen no real contradictory results and believe everything is non fallible.
The other school has experienced the opposite and has experienced mistakes and seen tests do not always reveal problems. Some have even seen death as a result from tests not revealing true problems".
Sorry for your loss. I won't list my sad experiences that may or may not dwarf what you say happened to you. I try to compartmentalize all negative thoughts and don't let emotion govern my judgement or actions. I don't think it is in the a poster's best interest to be given advice from someone who bases a response on personal feelings from having a bad experience...can't be objective! It appears that is what you are doing. You are often over reacting and not being objective.
It is a mistake to think that those that are effectively receiving treatment are "happy" and unfamiliar with tragedy, not aware, and have a deficiency of will or purpose toward objectively helping individuals with a medical problem. And the other state of mind are individuals posting who have CURRENT problems, and from them it may be a mistake to give advice based on emotion, and I believe from what I have witnessed and from reading some of your responses there may be more defensive subjectivity in your responses rather than good objective guidance.
Going on 6 years, I reached out to forum...this forum to be exact, but do to an unfriendly reception and inability to answer my question "can an ejection fraction be increased?" I moved on to another forum. My baggage was an experience with an interventional cardiologist who gave me every indication I did not have much time to live subsequent to my 5 days in ICU. My ejection fraction was 13 to 29% and he lied to me stating the EF cannot be increased, and I needed a transplant, but I was too old. There is more to the story, but no need to go any further.
I was helped by the heart forum, in fact it may have given me a new life, and I am grateful for the help. The help was objective and I got the information I needed. Frankly, if the response was subjective and the guidence was based on unreasonable distrust and suspicion that would have feed into my current feelings at the time and possibly the end result would not have been favorable. People that have been with the forum for a significant time have the experience to recognize, understand, and guide objectively. That's my opinion.
The other school has experienced the opposite and has experienced mistakes and seen tests do not always reveal problems. Some have even seen death as a result from tests not revealing true problems".
Sorry for your loss. I won't list my sad experiences that may or may not dwarf what you say happened to you. I try to compartmentalize all negative thoughts and don't let emotion govern my judgement or actions. I don't think it is in the a poster's best interest to be given advice from someone who bases a response on personal feelings from having a bad experience...can't be objective! It appears that is what you are doing. You are often over reacting and not being objective.
It is a mistake to think that those that are effectively receiving treatment are "happy" and unfamiliar with tragedy, not aware, and have a deficiency of will or purpose toward objectively helping individuals with a medical problem. And the other state of mind are individuals posting who have CURRENT problems, and from them it may be a mistake to give advice based on emotion, and I believe from what I have witnessed and from reading some of your responses there may be more defensive subjectivity in your responses rather than good objective guidance.
Going on 6 years, I reached out to forum...this forum to be exact, but do to an unfriendly reception and inability to answer my question "can an ejection fraction be increased?" I moved on to another forum. My baggage was an experience with an interventional cardiologist who gave me every indication I did not have much time to live subsequent to my 5 days in ICU. My ejection fraction was 13 to 29% and he lied to me stating the EF cannot be increased, and I needed a transplant, but I was too old. There is more to the story, but no need to go any further.
I was helped by the heart forum, in fact it may have given me a new life, and I am grateful for the help. The help was objective and I got the information I needed. Frankly, if the response was subjective and the guidence was based on unreasonable distrust and suspicion that would have feed into my current feelings at the time and possibly the end result would not have been favorable. People that have been with the forum for a significant time have the experience to recognize, understand, and guide objectively. That's my opinion.
exactly the response I expected and I will let others judge for themselves. If others would rather I didnt respond to posts, please message me and I will gladly leave the forum. However, try to remember that the medical world isn't a fairy tale land always getting things right and not everyone is willing to live on a knifes edge using nitrates to get around the problems with a large blockage. You are 74 and there are people much younger who want to actually have something done to lower risks and improve their quality of life. Like I said, I will let others judge.
QUOTE: "using nitrates to get around the problems with a large blockage".
>>I suggested a nitrate for any beneficial relief to the OP, and if there be relief that would be evidence of angina. Obviously, the doctor would procede with further tests to determine the degree and location of any lesions. It is evidence not any conclusion that doesn't require further testing.
From your posts, are you implying that the result of your experience can be attributed to poor medical management? It appears to me there may have been a mixup of medical files...there may be someone who got treatment based on your tests, then on subsequent doctor visits your file had been returned to your chart. Can you sue there in the UK? From what you state there certainly are grounds here in the US.
There are people who have the wrong foot amputed because a nurse put a tag on the wrong toe! Seldom happens, but not grounds to indict the medfical profession's standard of care.
QUOTE: "You are 74 and there are people much younger who want to actually have something done to lower risks and improve their quality of life. Like I said, I will let others judge".
>>>Who can disagree with that statement?
Lets judge on the issue: The issue is rationality and when does it become irrational to continue testing? An individual may have an ideopathic medical condition...what then? Or the doctor is incompetent, and fortunately there is a remedy. Here in the US a patient can go to a doctor of choice or change doctors. That's what I have done going on 5 years and no regrets. The first cardiologist was incompetent.
You're childish to suggest a division of members to side with comments based on a wish everyone would like to have vs. something otherwise. Going on 10 years participating on forums, I have never seen such a proposal, scheme or outright foolishness!.
Are you willing to e-mail me with references and identify your prior forum participation. I promise I will keep the information private. . You can have my references going back 10 years! Lets see who is contentious and divisive...you attempted to be divisive at the very start of your membership, and that indicates to me you have a record with this type conduct. E-mail me! I'll be away for the weekend, so don't expect any quick reply. Take care!
>>I suggested a nitrate for any beneficial relief to the OP, and if there be relief that would be evidence of angina. Obviously, the doctor would procede with further tests to determine the degree and location of any lesions. It is evidence not any conclusion that doesn't require further testing.
From your posts, are you implying that the result of your experience can be attributed to poor medical management? It appears to me there may have been a mixup of medical files...there may be someone who got treatment based on your tests, then on subsequent doctor visits your file had been returned to your chart. Can you sue there in the UK? From what you state there certainly are grounds here in the US.
There are people who have the wrong foot amputed because a nurse put a tag on the wrong toe! Seldom happens, but not grounds to indict the medfical profession's standard of care.
QUOTE: "You are 74 and there are people much younger who want to actually have something done to lower risks and improve their quality of life. Like I said, I will let others judge".
>>>Who can disagree with that statement?
Lets judge on the issue: The issue is rationality and when does it become irrational to continue testing? An individual may have an ideopathic medical condition...what then? Or the doctor is incompetent, and fortunately there is a remedy. Here in the US a patient can go to a doctor of choice or change doctors. That's what I have done going on 5 years and no regrets. The first cardiologist was incompetent.
You're childish to suggest a division of members to side with comments based on a wish everyone would like to have vs. something otherwise. Going on 10 years participating on forums, I have never seen such a proposal, scheme or outright foolishness!.
Are you willing to e-mail me with references and identify your prior forum participation. I promise I will keep the information private. . You can have my references going back 10 years! Lets see who is contentious and divisive...you attempted to be divisive at the very start of your membership, and that indicates to me you have a record with this type conduct. E-mail me! I'll be away for the weekend, so don't expect any quick reply. Take care!
You really are a first class idiot Max and I sent that email to you to test my theory of your behaviour. I had a slight disagreement with Jon but that's all it was. I knew that you would eventually paste it into the public forum but Im simply suprised at how long it has taken you. In fact I blocked Jon for just 24 hours to make it look authentic, but since then I have been able to receive mails from him. My theory of your true colours has been confirmed and I'm pleased because I'm rarely wrong with peoples character.
Never have I come across someone so vindictive and childish.
Yet again you seem to show your face when someone argues with kenkeith and I still think this is more than coincidence.
Never have I come across someone so vindictive and childish.
Yet again you seem to show your face when someone argues with kenkeith and I still think this is more than coincidence.
COMMUNITY LEADER
I appreciate the sentiment and I'm past any issues that may have been out there. But we should be honest, I tried to send you an email 2 weeks after the first to make amends and I was still blocked. I tried again the first week of November, still blocked. When you send an email to a member that has you blocked, the message gets deleted when you hit send and it drops from your sent file.
Anywho, no issues here...............
Anywho, no issues here...............
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