stress test results

[mheintz02543]

I am a 47yo male in good shape, regular excersise, 6' 190 lb.  I had atypical symptoms of Angina, ie arm and chest pain not associated with excersize. I had two stress tests, one nuclear.  In both I went 13.5 min to attain the desired heart rate of 160, and scarcly broke a sweat. The nuclear test results.   'Abnormal left ventrical function by gated imaging. Evidence of mild LV dysfunction. Segmental wall motion abnormality of antrior and septal walls. Evidence of myocardial ischemia involving the anterior and inferior septal and apical walls'. MD comments; 'There is a relativly large area of anterior and moderatly sized area of inferior ischemia noted on this study'.    But all doctors, ie primary, the two stress test doctors and follow on Cardiologist suggest that it's not normal to do 13.5 min on treadmill w/o severe symptoms and or inabilty to complete the treadmill test.  The follow up cardialogist is suggesting it could be a bad test, and that if it's a good test, then I have serious problems, and may need a bypass. But the preforming doctor says it's a good test.  I have been put on low dosages of beta blocker and statin.  Follow up Cardiologist suggests that if the nuclear test images are correct then this is not aggresive enough.   They can't agree on why I did so well on the stress test.  Q.  Can some one do this well on a stress test, ie 13.5 minutes and still have major heart problems?   What's next?

[Cleveland Clinic]

What are your symptoms? These tests are usually performed in people with symptoms an dif you have none then given your findings there is probably no benefit in an aggressive approach ( e.g. left heart catheterization and possible stenting or open heart surgery). The only benefit in performing these tests are in people with low functional capacities or diabetics, because they may have ischemia and not have symptoms.
Of course if you ask a cardiologist who performs catheterizations and derives a great deal of his revenue from stenting he may have a different answer. The truth is that stenting people with your functional capacity and probable lack of symptoms has never been shown to improve a patient's survival.

[mheintz02543]

I should add that my father died of a heart attack at 52yo.  

[mheintz02543]

Thanks for your response.  My symptoms are left arm, upper shoulder pain and tingling occasionally in the upper chest as well.  It's not a feeling I've had before and is difficult to describe. It seems like a numbness, with tingling and pain that eminates from inside. This has been happening for about 2 months.  It happens at rest, or with exertion.  I can't say that it's related to exercise.  I had minor symtoms during the nuclear stress test, but they went away during the test.  The doctors are unsure if it's related to the heart.  But as I said they did not like the ECG during stress in the tests, and the images apparently may show ischemia as I describe above.  I am scheduled to have a cath by a doctor whom does perform many stents.  But the plan is to use the cath to diagnose and only stent if neccesary.  There is another option, that I have a different doctor do the cath, this Dr can't stent, and would have to refer me to the orther one.  via ambulance.  I picked the one that could stent to avoid haveing to be transfered.  Perhaps I should re concider and either wait or use the Dr that can't stent for the Cath.  What do you think?