thank you for your query. your stress test results show that there is Ischemic Heart Disease (IHD) as evident by ST depression in INF-Lateral leads and presence of VPC (Ventricular Premature Complexes), which are basically skipped beats originating from the ventricle. IHD means there is probable narrowing of one or more arteries supplying the heart, which result in decreased blood flow to the heart under stress, causing the ECG changes. It also paves the way for a heart attack (Acute Myocardial Infarction). An ideal next step would be to do an Angiography, in which a dye is injected and its passage through the coronary arteries (artery to the heart) monitored. this gives an idea about the site and size of blockade of the coronary arteries. depending upon which, further intervention may or may not be needed. If needed, it may be an angioplasty, an out patient procedure, or a bypass grafting operation, a major operation where arteries from other part of your body is transplanted to the heart and a bypass is created to the blocked vessels. Other investigations like lipid profile, fasting blood sugar, echocardiography can be done to find out the cause of the arterial narrowing. hope i ve been able to satisfy your query. for any further clarifications, please don t hesitate to contact me.