Wednesday, August 10, 2011

Exercise inducible myocardial ischaemia?

Did they do any imaging with your stress test, such as Echocardiogram or Nuclear Imaging? These imaging tests are more sensitive or reliable than simple EKG stress test when determining if ischemia is present. It is difficult to provide recommendations without knowing how long you lasted during the stress test, exactly what the EKG abnormalities were and the location on the EKG of these abnormalities. I also do not know if you have any risk factors for heart disease, such as high blood pressure, diabetes, smoking, obesity, etc. Sometimes EKG changes on an EKG stress test can be false positives, meaning that they aren't truly secondary to an underlying heart condition. This is certainly possible in your case. It is also possible that these EKG changes are secondary to blockages in the arteries that supply the heart. Angiogram (cardiac catheterization) is the definitive test to determine if someone has blockages in the arteries supplying the heart. Personally I would recommend a stress test with EKG and some type of imaging (Echocardiogram or Nuclear imaging) to help determine if ischemia is really present or if these are false positive EKG changes. The decision to perform angiogram could be determined after that. You should discuss this with the doctors who ordered and reviewed your stress test.

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