I am a 36 year old male - 1 risk factor (smoking). Cholesterol is excellent, no family history.
2 years ago I started getting chest and back pains. Stress test came out positive with 1.5mm S-T depression, (onset @120BPM) - this was a submaximal test; Modified Bruce, max HR of 165 BPM, max exercise T=7min. Given the protocol, I think this is about 5 METS (?)
Since, I have exercise-phobia…
A follow-on nuclear perfusion stress test was done - S-T depression of 1.5mm, T=8min, 165 BPM, sub-maximal modified Bruce. Resting Echo OK.
The cardiologist deemed this a "false-positive", as imaging showed no abnormalities, and the ejection fraction was ok. Symptoms disappeared for over a year.
When symptoms re-appeared, a new FP sent me over for another round of tests.
1: Ex. Test, normal Bruce, maximal test: 9.5 min, 184 BPM, and the following note "there was an S-T depression, but it did not exceed >0.9mm. No evidence of myocardial ischemia". The nurse performing the test, said S-T changes appeared early, at 140 BPM, and disappeared within seconds of stopping.
2: resting echocardiogram: normal, EF 63%
3. Ex. echo, Bruce pr., maximal: 10+ min (11METS), 188BPM, again the note "there was an S-T depression, but it did not exceed >0.9mm. No evidence of myocardial ischemia". The echo part came out ok (no abnormal wall movement); EF was not specified.
It bothers me that S-T depression is showing up, time after time. So:
- Can S-T depression decrease over 2 years from 1.5mm @ 5 METS/165BPM to "less than 0.9mm" @11 METS/188BPM?
- if the results say "less than 0.9mm" does it typically mean between 0.8mm to 0.9mm, or could it mean 0.5mm (I saw two numbers on the test display - one was showing "max 0.5" the other "max 1.1")
- what about "early onset" of S-T depression even if the max is less than 1mm?
- could the S-T be caused by something else? (I do not have MVP, but my K+ is 3.6 mmol/L)