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Have acid reflux, HBP, good echo, ekg, and enzyme test. Should I go for stress test?

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Practicing since : 1981
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If I have a good echo, ekg, and enzyme test, do I really need a stress test, If I have no other symptoms relating to my high blood pressure? I have acid reflux, and I think procardia is adding to it. Never had chest pain before. 35 yrs old 300lbs, no history of heart issues in family.
Posted Mon, 6 Aug 2012 in X-ray, Lab tests and Scans
Answered by Dr. Anil Grover 16 minutes later
Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist.
The fact remains that you have hypertension which is a risk factor for coronary artery disease.
I assume you had some sort of pain in chest for which enzymes were done. These must be negative that is why it is being suggested that Stress Test is done. Conventional stress test is done by making you walk on treadmill and monitoring each and every beat of heart and trends of response of your blood pressure and heart rate with exercise. Should you feel discomfort or otherwise wish to discontinue you can. Nevvertheless, it gives very pertinent and useful information apart from how your heart behaves when put under physical stressful condition. A person with heart disease may harbouring it without manifestation on resting EKG is unmasked. This way he can be treated for the same. Reverse le riskcan also be true a borderline EKG can be normal for that person for no change occurs with exercise test. Furthermore, it is a reference point that you did so much (quantified) exercise without changes at age 35, for future. And all this with negligible risk to you or your heart. It is useful test which has both diagnostic and prognostic value.

If your doctor feels that he needs it means he has something in his mind which he wants to clear so that he can give you some useful advice. Good Luck.

With Best Wishes
Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
Follow-up: Have acid reflux, HBP, good echo, ekg, and enzyme test. Should I go for stress test? 33 minutes later
Thanks. I never had any chest pain or discomfort. My doctor sent me to the ER because my resting EKG changed. Cardiologist said at hospital, that a changing ekg among HBP patients is not out of the ordinary. He scheduled the stress test, not my doctor, but told me everything looked fine. EKG has not changed since them. Should I have an angiogram instead of a stress test? I have acid reflux. Does procardia aggravate that condition? My blood pressure has been running high at about 160/100. I have been on accupril for over 10yrs. Is it time for a change?
Answered by Dr. Anil Grover 56 minutes later
Hi there,
Well, to diagnose a heart attack we follow World Health Organization Criteria (two out of three have to be positive)
1. Pain or angina equivalent symptoms rapid breathing rapid heart rate
2. Abnormal EKG especially EKG changes are dynamic that is change with time
3. Blood tests for heart enzymes that is Creatine Phospho Kinase Myocardial isoform
(CPK MB) or Serum Myoglobin or Tropinin T or Troponin I.

As during your visit, you met the above criteria, it is highly unlikely that you had heart attack. You have history of hypertension so as to complete risk profile to that preventive measures can be taken, TMT has been advised. You can calculate your own risk profile. * means present, +/- I do not know at present.

Diabetes +/-
Stress* (Hypertension is stress in action)
Obesity and Sedentary Life Style+/-
High Bad Cholesterol and Lipid Component +/-
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: +/-
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
Family History 0f Coronary Heart Disease +/-
Increasing age*
Being a Man (as opposed to women) till the age 45*

Even with one modifiable risk factor, suspicious EKG needed to be evaluated. That is all I have to say. If you have further query please ask, I will be most happy to answer as soon as possible. Regards.
With Best Wishes

Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by
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