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Dr. Andrew Rynne

Family Physician

Exp 18 years

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34-year-old female with positive Holter and stress test

I am a 34-year-old female smoker with chest pains (exertion and at rest), palpitations, and a fast heart rate. I have no other cardiac risk factors (other than smoking), and I had a 24-hour Holter and a dual-isotope exercise stress test. The Holter monitor showed my resting heartbeat at a maximum of 168 bpm, with symptoms of chest pain and a fluttery feeling in my chest during the increased heart rate. The stress test came back positive, showing decreased blood flow into parts of my heart after exercise. Does anyone else have a similar experience? Should I still be worried? Why is the chest pain persisting if the stress test was a false positive? How reliable are they? I am having a CT angiogram, but my cardiologist is not taking this as seriously as I would like because of my age. What do you think?? The chest pains and symptoms I am having are getting increasingly worse and more frequent. I saw my cardiologist today, and he said that while my stress test came back positive and my Holter showed the abnormal heart rate, he does not think there is anything seriously wrong. He thinks the stress test might be a false positive . I am extremely worried about these chest pains and other symptoms, and I am worried that both of these test came back positive. I just wanted to add a thank you to your answers. I was so frustrated when I left the doctor s office, I can t even tell you. I am seriously concerned about these symptoms, even if they turn out to be nothing. I realize that a fast heartbeat may be controlled with medication, and if there would actually be any blockages, those could probably be controlled wiht medication, also. I just didn t feel like he was taking me seriously at all and dismissing my symptoms. I actually started to wonder tonight if it was in my head. The cardiologist was not going to leave it unchecked, but he didn t address my chest pain, and he didn t seem to take my symptoms as seriously as I thought he should have. Thank you so much for the answers. I am looking for another cardiologist tomorrow. Did I mention that he lost my echocardiogram (and never read it), and didn t give me the prescription for the Cardizem for my fast heart rate (not to mention, didn t even really address it or its cause).
Thu, 17 Dec 2009
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  User's Response
I read your question last night in complete disbelief. I've written this remark several times and that is that women's cardiac health issues are frequently ignored, your situation is the worst I've ever read. You have a positive stress test nuclear study and abnormal holter. He should of immediately booked you for a coronary angiogram incase there are blockages in your arteries. You now have unstable angina if chest pain in occuring at rest, another indication for a coronary angiogram.He loses your echocardiogram but doesn't order it to be repeated is sheer negligence.Did he prescribe any medications for you at all to deal with your cardiac problems? With women a false positive can be cause by the density of breasts tissue interferring with the instruments being the test, the bigger the boobs, the bigger the problem. How many episodes of chest pain are you having a day? What do you do for them? If you ever have chest pain lasting more than 15 minutes you have to call 911 and go to the hospital. Does this quack think you have coronary artery spasm? Was that the reason for the Cardizem? Whats your blood pressure like. Why did he not want to treat your tachycardia? This should all be reported to his professional orginization because of his complete negligence in managing your serious cardiac issues.You must,must, must quit smoking. While you are waiting to see your new cardiologist you also must not do any strenuous activities because your chest pain is occurring at rest. Document all this and send him a strongly worded letter as to why you changed Drs. All the best, Donna, you can email me if you have any more questions Make a list of questions to bring with you to your new cardiologist, arm your self with knowledge before hand.
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