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What Should Be Done After Positive Stress Test Results?

Posted on Thu, 5 Jun 2014

Question: I just went through an eco stress test. I am 59 years old with 3 heart stents, all 3 are in the LAD and the last two were placed 2 years ago. One was placed inside the first one that was place 10 years ago at the top of the LAD and the other was place towards the bottom of the LAD caging off one of the small artrites. I was told by my doctor that my test had two false negatives and two false positives. I don't understand what he is telling me other than it appears as tho I had an incress in my ST V1 and V2 my 12 to 1 mil. He is now recommending another hearth XXXXXXX and I am simply not into that. What other options do I have in lue of having that done?

Answered by Dr. Benard Shehu (6 hours later)

Brief Answer:
Further tests are needed...

Detailed Answer:
Hi there,

I have gone through your medical history carefully and understood your concerns.

Before running into conclusions, can you please provide the tests reports? So, I can have a look at them myself?

Next, if stress test resulted positive, if I was your caring doctor would recommend to do:
- coronary angiography
- or Ct-coronary angiogram

to determine any heart problem.

I understand your worries, but these tests are necessary to run.

Looking forward to have your tests reports in!
Dr.Benard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (2 hours later)

My target rate was 138 which I reached around the 8 minute mark but I felt the need to run further which I did. I stopped at the 12 minute mark with a heart over 160 BPM and Blood pressure of 200/80. Please let me know if you can open the document.

Thanks

Answered by Dr. Benard Shehu (2 hours later)

Brief Answer:
Kindly attach the reports at the following address

Detailed Answer:
Hi there,

Unfortunately, I was not able to receive any report. Can you please re-upload it or attach at:

YYYY@YYYY

with the subject line: "Attention to Dr.Benard Shehu"

Thank you!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (20 hours later)

Ok I sent it here again and in an email to the address you provided above.

Thanks
XXXXXXX

Answered by Dr. Benard Shehu (31 hours later)

Brief Answer:
Coronarygraphy suggested...

Detailed Answer:
Hi back XXXXXXX

I have gone through the reports you sent to me.

The change found in exercise ECG are characteristic for a positive test for exercise induced myocardial ischemia. As the exercise echo has a lot of artifacts due to technical difficulties, I suggest to run coronary angiography for further evaluation.

Hope it helped!
Dr.Benard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (38 hours later)

Ok they ran the coronary angiography for further evaluation. The finding were that I once again had some EKG changes similar to the stress ECO and that they could not see any occlusions/blockages and or restrictions. My ejection fraction was 68%. This test was done using chemical call electsascan or something like that. I didn't not speak to my doctor because he was out of town but his nurse said that I am ok to go on my vacation for the next 15 days. With this information, do you think it's a good idea and what would you recommend as follow-up treatment or procedure if any?

Answered by Dr. Benard Shehu (10 hours later)

Brief Answer:
Enjoy your vacations!

Detailed Answer:
Thank you for following up.

I am happy that no negative changes (occlusions) have been found during angiography. At this point, you can go on vacation. You should be careful with your diet and lifestyle regimen and should continue taking aspirin, statin, and betablockers as prescribed by your doctor. Please do not skip taking any of them.

I also advise to run :
- EKG
- Stress test
- cardiac echo

at least once yearly as per regular follow ups.

Enjoy your vacations!
Dr.Benard
If my answer was at your satisfaction, kindly rate it while closing this thread. If you have further queries, do not hesitate to contact me again.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar