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Hello! For Many Years Now I’ve Had Sporadic Pressure In
Question: Hello! For many years now I’ve had sporadic pressure in my chest area, and since I never want to presume it’s not heart related, I usually get it checked out. I do have anxiety and fibromyalgia, so the most likely cause is stress and muscle strain. My last episode was about two weeks ago and afterseeing a cardiologist, who suspected it to be muscle related, I had a stress echo two days ago to make sure. I’m attaching a copy of the report as well as a copy of my last stress test from back in 2005. The current cardiologists office told me that the report looks great with a strong heart muscle and no ischemia. Since I tend to over analyze things, I read the report and it mentions a Duke Treadmill score of 2.5 due to ST depression of 1 mm. I’ve been told I’ve had that ST depression forever, and it was present back in 2005 at my last stress test. I did ask the cardiologists office about it via a message on my portal and the response was that it’s nothing to worry about and it is not diagnostic. Would you agree that there is nothing worrisome? Thank you!
Hello! For many years now I’ve had sporadic pressure in my chest area, and since I never want to presume it’s not heart related, I usually get it checked out. I do have anxiety and fibromyalgia, so the most likely cause is stress and muscle strain. My last episode was about two weeks ago and afterseeing a cardiologist, who suspected it to be muscle related, I had a stress echo two days ago to make sure. I’m attaching a copy of the report as well as a copy of my last stress test from back in 2005. The current cardiologists office told me that the report looks great with a strong heart muscle and no ischemia. Since I tend to over analyze things, I read the report and it mentions a Duke Treadmill score of 2.5 due to ST depression of 1 mm. I’ve been told I’ve had that ST depression forever, and it was present back in 2005 at my last stress test. I did ask the cardiologists office about it via a message on my portal and the response was that it’s nothing to worry about and it is not diagnostic. Would you agree that there is nothing worrisome? Thank you!
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
After passing carefully through your uploaded stress Echo reports, I would explain that no evidence of cardiac ischemia is present. So, no cardiac reasons for your chest discomfort has been identified.
It is difficult to consider that 1 mm depression on the ECG, as there exist baseline ST-T abnormalities that make ST evaluation during stress inaccurate.
The most reliable finding from a cardiac stress echo ventricular kinetics, which in your case was normal.
Coming to this point, I would agree with your doctor regarding the conclusions of the test.
In addition, to definitely exclude any underlying cardiomyopathy and to detect any tiny elements of myocardial perfusion defects, a stress cardiac magnetic resonance imagine test would be advisable.
If any minor elements of cardiac ischemia were present (not detectable on stress echo), it would be easily recognized during stress cardiac magnetic resonance imagine test.
You could discuss with your attending cardiologist on the above mentioned issues.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Ilir Sharka
cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
After passing carefully through your uploaded stress Echo reports, I would explain that no evidence of cardiac ischemia is present. So, no cardiac reasons for your chest discomfort has been identified.
It is difficult to consider that 1 mm depression on the ECG, as there exist baseline ST-T abnormalities that make ST evaluation during stress inaccurate.
The most reliable finding from a cardiac stress echo ventricular kinetics, which in your case was normal.
Coming to this point, I would agree with your doctor regarding the conclusions of the test.
In addition, to definitely exclude any underlying cardiomyopathy and to detect any tiny elements of myocardial perfusion defects, a stress cardiac magnetic resonance imagine test would be advisable.
If any minor elements of cardiac ischemia were present (not detectable on stress echo), it would be easily recognized during stress cardiac magnetic resonance imagine test.
You could discuss with your attending cardiologist on the above mentioned issues.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Ilir Sharka
cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
After passing carefully through your uploaded stress Echo reports, I would explain that no evidence of cardiac ischemia is present. So, no cardiac reasons for your chest discomfort has been identified.
It is difficult to consider that 1 mm depression on the ECG, as there exist baseline ST-T abnormalities that make ST evaluation during stress inaccurate.
The most reliable finding from a cardiac stress echo ventricular kinetics, which in your case was normal.
Coming to this point, I would agree with your doctor regarding the conclusions of the test.
In addition, to definitely exclude any underlying cardiomyopathy and to detect any tiny elements of myocardial perfusion defects, a stress cardiac magnetic resonance imagine test would be advisable.
If any minor elements of cardiac ischemia were present (not detectable on stress echo), it would be easily recognized during stress cardiac magnetic resonance imagine test.
You could discuss with your attending cardiologist on the above mentioned issues.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Ilir Sharka
cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
After passing carefully through your uploaded stress Echo reports, I would explain that no evidence of cardiac ischemia is present. So, no cardiac reasons for your chest discomfort has been identified.
It is difficult to consider that 1 mm depression on the ECG, as there exist baseline ST-T abnormalities that make ST evaluation during stress inaccurate.
The most reliable finding from a cardiac stress echo ventricular kinetics, which in your case was normal.
Coming to this point, I would agree with your doctor regarding the conclusions of the test.
In addition, to definitely exclude any underlying cardiomyopathy and to detect any tiny elements of myocardial perfusion defects, a stress cardiac magnetic resonance imagine test would be advisable.
If any minor elements of cardiac ischemia were present (not detectable on stress echo), it would be easily recognized during stress cardiac magnetic resonance imagine test.
You could discuss with your attending cardiologist on the above mentioned issues.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Ilir Sharka
cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Sharka! Thank you so much for your informative reply...I truly appreciate it!!
My chest pressure has subsided, as it always has in the past. So I would think most likely the cause is muscular (I have fibromyalgia). In any event, I have just a few follow up questions:
1) would you say that essentially my stress results are the same as what they were fifteen years ago for my last teat back in 2005?
2) given that I have a baseline ST depression (which has bee there for years), would you say that the Duke score on the stress test isn’t necessarily worrisome or of prognostic value?
3) can I rest relatively easy and not worry given the results of the stress test (unfortunately I have some health anxiety)?
4) I will certainly ask my cardiologist about the additional cardiac imaging you suggested. Since they seemed to indicate that no further testing is necessary, if they do not order that additional imaging, do I need to be worried? Again, the chest pressure has completely subsided and it seems to have the same pattern every time it appears; in fact the prior time when I had it I went to urgent care where they did an EKG and cardiac enzyme bloodwork and all was fine.
Thank you again for your kindness...I so very much appreciate it!!
My chest pressure has subsided, as it always has in the past. So I would think most likely the cause is muscular (I have fibromyalgia). In any event, I have just a few follow up questions:
1) would you say that essentially my stress results are the same as what they were fifteen years ago for my last teat back in 2005?
2) given that I have a baseline ST depression (which has bee there for years), would you say that the Duke score on the stress test isn’t necessarily worrisome or of prognostic value?
3) can I rest relatively easy and not worry given the results of the stress test (unfortunately I have some health anxiety)?
4) I will certainly ask my cardiologist about the additional cardiac imaging you suggested. Since they seemed to indicate that no further testing is necessary, if they do not order that additional imaging, do I need to be worried? Again, the chest pressure has completely subsided and it seems to have the same pattern every time it appears; in fact the prior time when I had it I went to urgent care where they did an EKG and cardiac enzyme bloodwork and all was fine.
Thank you again for your kindness...I so very much appreciate it!!
Hi Dr. Sharka! Thank you so much for your informative reply...I truly appreciate it!!
My chest pressure has subsided, as it always has in the past. So I would think most likely the cause is muscular (I have fibromyalgia). In any event, I have just a few follow up questions:
1) would you say that essentially my stress results are the same as what they were fifteen years ago for my last teat back in 2005?
2) given that I have a baseline ST depression (which has bee there for years), would you say that the Duke score on the stress test isn’t necessarily worrisome or of prognostic value?
3) can I rest relatively easy and not worry given the results of the stress test (unfortunately I have some health anxiety)?
4) I will certainly ask my cardiologist about the additional cardiac imaging you suggested. Since they seemed to indicate that no further testing is necessary, if they do not order that additional imaging, do I need to be worried? Again, the chest pressure has completely subsided and it seems to have the same pattern every time it appears; in fact the prior time when I had it I went to urgent care where they did an EKG and cardiac enzyme bloodwork and all was fine.
Thank you again for your kindness...I so very much appreciate it!!
My chest pressure has subsided, as it always has in the past. So I would think most likely the cause is muscular (I have fibromyalgia). In any event, I have just a few follow up questions:
1) would you say that essentially my stress results are the same as what they were fifteen years ago for my last teat back in 2005?
2) given that I have a baseline ST depression (which has bee there for years), would you say that the Duke score on the stress test isn’t necessarily worrisome or of prognostic value?
3) can I rest relatively easy and not worry given the results of the stress test (unfortunately I have some health anxiety)?
4) I will certainly ask my cardiologist about the additional cardiac imaging you suggested. Since they seemed to indicate that no further testing is necessary, if they do not order that additional imaging, do I need to be worried? Again, the chest pressure has completely subsided and it seems to have the same pattern every time it appears; in fact the prior time when I had it I went to urgent care where they did an EKG and cardiac enzyme bloodwork and all was fine.
Thank you again for your kindness...I so very much appreciate it!!
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello again!
Here are my answers to your questions:
1- I think that it is the same pattern of stress results as that of 2005. There is no presence of ineducable cardiac ischemia in all of them.
2- The Duke score may help to stadify the risk. Anyway, in your case, I would agree that those baseline ECG findings would mislead the score conclusions. As I explained to you above, I would rely more on any potential myocardial wall motion abnormalities (kinetics), than on those ECG findings.
3- There is no reason to worry about. So, try to relax as anxiety is not going to help.
4- In my opinion, you should not worry, even if you do not perform the cardiac MRI. It would certainly give more information. Anyway, the stress echo helps to exclude a possible cardiac ischemia.
Fibromyalgia could trigger all this clinical situation. I agree with you that this could be the main cause underlying your complaints.
So, just relax and don't worry about it!
Hope to have been helpful!
Wishing all the best,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello again!
Here are my answers to your questions:
1- I think that it is the same pattern of stress results as that of 2005. There is no presence of ineducable cardiac ischemia in all of them.
2- The Duke score may help to stadify the risk. Anyway, in your case, I would agree that those baseline ECG findings would mislead the score conclusions. As I explained to you above, I would rely more on any potential myocardial wall motion abnormalities (kinetics), than on those ECG findings.
3- There is no reason to worry about. So, try to relax as anxiety is not going to help.
4- In my opinion, you should not worry, even if you do not perform the cardiac MRI. It would certainly give more information. Anyway, the stress echo helps to exclude a possible cardiac ischemia.
Fibromyalgia could trigger all this clinical situation. I agree with you that this could be the main cause underlying your complaints.
So, just relax and don't worry about it!
Hope to have been helpful!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello again!
Here are my answers to your questions:
1- I think that it is the same pattern of stress results as that of 2005. There is no presence of ineducable cardiac ischemia in all of them.
2- The Duke score may help to stadify the risk. Anyway, in your case, I would agree that those baseline ECG findings would mislead the score conclusions. As I explained to you above, I would rely more on any potential myocardial wall motion abnormalities (kinetics), than on those ECG findings.
3- There is no reason to worry about. So, try to relax as anxiety is not going to help.
4- In my opinion, you should not worry, even if you do not perform the cardiac MRI. It would certainly give more information. Anyway, the stress echo helps to exclude a possible cardiac ischemia.
Fibromyalgia could trigger all this clinical situation. I agree with you that this could be the main cause underlying your complaints.
So, just relax and don't worry about it!
Hope to have been helpful!
Wishing all the best,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello again!
Here are my answers to your questions:
1- I think that it is the same pattern of stress results as that of 2005. There is no presence of ineducable cardiac ischemia in all of them.
2- The Duke score may help to stadify the risk. Anyway, in your case, I would agree that those baseline ECG findings would mislead the score conclusions. As I explained to you above, I would rely more on any potential myocardial wall motion abnormalities (kinetics), than on those ECG findings.
3- There is no reason to worry about. So, try to relax as anxiety is not going to help.
4- In my opinion, you should not worry, even if you do not perform the cardiac MRI. It would certainly give more information. Anyway, the stress echo helps to exclude a possible cardiac ischemia.
Fibromyalgia could trigger all this clinical situation. I agree with you that this could be the main cause underlying your complaints.
So, just relax and don't worry about it!
Hope to have been helpful!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Oh Dr. Sharka...thank you again for your informative and reassuring responses! It truly means the world to me!
I’m a lawyer by trade which causes me to question and read into things such as these way too much...couple that with the ability to google all things medical and it can be an recipe for disaster!
I result appreciate your wonderful explanations and putting it all into perspective! I put a message into the cardiologists office and simply indicated that I googled some of the findings and inquired as to whether they feel the nuclear cardiac MRI is warranted...so I’ll just follow their recommendations.
You are truly an incredible and kind doctor, and I can’t thank you enough for your help!!
I’m a lawyer by trade which causes me to question and read into things such as these way too much...couple that with the ability to google all things medical and it can be an recipe for disaster!
I result appreciate your wonderful explanations and putting it all into perspective! I put a message into the cardiologists office and simply indicated that I googled some of the findings and inquired as to whether they feel the nuclear cardiac MRI is warranted...so I’ll just follow their recommendations.
You are truly an incredible and kind doctor, and I can’t thank you enough for your help!!
Oh Dr. Sharka...thank you again for your informative and reassuring responses! It truly means the world to me!
I’m a lawyer by trade which causes me to question and read into things such as these way too much...couple that with the ability to google all things medical and it can be an recipe for disaster!
I result appreciate your wonderful explanations and putting it all into perspective! I put a message into the cardiologists office and simply indicated that I googled some of the findings and inquired as to whether they feel the nuclear cardiac MRI is warranted...so I’ll just follow their recommendations.
You are truly an incredible and kind doctor, and I can’t thank you enough for your help!!
I’m a lawyer by trade which causes me to question and read into things such as these way too much...couple that with the ability to google all things medical and it can be an recipe for disaster!
I result appreciate your wonderful explanations and putting it all into perspective! I put a message into the cardiologists office and simply indicated that I googled some of the findings and inquired as to whether they feel the nuclear cardiac MRI is warranted...so I’ll just follow their recommendations.
You are truly an incredible and kind doctor, and I can’t thank you enough for your help!!
Brief Answer:
You are welcome!
Detailed Answer:
I am glad to have been helpful to you!
If you have any other questions, in the future, please feel free to ask me again directly at any time.
I would be glad to review all your future tests for a second professional opinion!
Wishing good health,
Dr. Iliri
You are welcome!
Detailed Answer:
I am glad to have been helpful to you!
If you have any other questions, in the future, please feel free to ask me again directly at any time.
I would be glad to review all your future tests for a second professional opinion!
Wishing good health,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
You are welcome!
Detailed Answer:
I am glad to have been helpful to you!
If you have any other questions, in the future, please feel free to ask me again directly at any time.
I would be glad to review all your future tests for a second professional opinion!
Wishing good health,
Dr. Iliri
You are welcome!
Detailed Answer:
I am glad to have been helpful to you!
If you have any other questions, in the future, please feel free to ask me again directly at any time.
I would be glad to review all your future tests for a second professional opinion!
Wishing good health,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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