False Positive stress test

[missyblue260]

I have had no chest pains and have felt fine.  My GP ordered EKG because I am over 40, that was abnormal, I then had stress test which showed blockage.  On Tuesday I underwent heart catherization and was found to be a false positive.  I don't know what to do now.  Again I feel fine but I am now very sceptical of any test results.  I have diabetes and my father died from a massive heart attack at the age of 54 so I don't want to dismiss test results but am not sure of my next course of action.  Is there a test that is more reliable?


This discussion is related to A false Positive result.

[missyblue260]

Hi all,

I appreciate all of the thoughtful advice and discussion.  To clarify, I did undergo a nuclear stress test prior to my heart cath.  The stress test indicated there was blockage in one of the arteries.  So I was stunned when I was told that I was a false positive and there was no blockage!  I thought that a stress test was more reliable!  I think my physician was being extra cautious because I have diabetes and because my father died of a massive heart attack at the age of 54.  

I guess I am now trying to figure out what do I do now?  How can I take these tests seriously when they can be so wrong?  My sister said to me that your heart may be fine but they've messed with your head.  I totally agree.

missyblue 260

[erijon]

ed,

Your case certainly sounds like the proverbial exception to the rule. When looking at these posts I always look at the norms, what is usually done, protocols followed in the normal course of events with predicted outcomes. If you read the OP, she is having no symptoms, just an abnormal EKG so I don't know that I would make the assumption that your situation is comparable to the OP. Posting experiences like this can lead to unnecessary anxiety.

What I find interesting about this post is that she went directly to a cath from an EKG. It was either a very savvy doctor that read something indicating ischemia or a doctor that was not very savvy in reading an EKG. In any case, no symptoms and a clear cath normally rules out coronary disease, I don't think a worst case scenario should be applied, this is a pretty simple case of an incorrectly read EKG, in my opinion. I'm no doctor but I don't think I would be chasing additional tests and risking further false positive results which could lead to more invasive and expensive procedures not to mention the anxiety. If she was experiencing symptoms I would think otherwise.

Jon

[chrisbobby]

wouldn't a troponin rule out ischemia?

[ed34]

well no an angiogram cannot determine damaged tissue which was proved in my case where the LAD was so severely blocked. The Cardiologist and his colleagues stented my circumflex but left the LAD at the time because they felt there would be tissue damage. This was the general consensus. An echocardiogram was performed which could find no tissue damage and the Cardiologists refused to believe the results stating "An echo doesn't always give accurate enough readings". I was then sent to have a nuclear scan which concured with the echo and shocked the cardiologists. You cannot 'see' tissue damage during an angiogram, all you can do is 'assume/guess'.
On arrival at hospital during MI, an ECG was the first test taken and this somehow told a Cardiologist I needed emergency stenting which was a very accurate diagnosis. Later as I was being transferred to another hospital by ambulance, the blood test results showed my troponin level agreed with the ECG.

[chrisbobby]

I had an abnormal EKG consider inferior ischemia with a 109 pulse and a history of anxiety/panic disorder...the following three troponins were all negative...echo ejection fraction was 65-70..didnt know what to make of it

[erijon]

ed,

My understanding (having never had a cath) is that they can see the termination of blood flow to a given area of the heart. No blood flow equals blocked artery and muscle damage. If they did not see any blockage there would not be any muscle damage by exclusion.

As far as protocol goes here, it is VERY uncommon for someone to have a cath based on the findings of an EKG. That's why I have to think that the doctor reading the EKG was concerned about the nature of the abnormality and thought it severe enough for a cath, very unusual. The next step is typically a nuclear stress test.

Jon

[ed34]

I would also like to just clarify that the GP took an EKG which was abnormal. He then had a stress test which involves being wired up (12 wires) to an EKG machine which also
showed abnormality making them believe there was a blockage. During a Cath you are
also wired up to EKG monitoring so I'm sure a lead defect would have been noticed out of the three occassions.
In the UK you are given a pre assessment before the cath, usually a few days before and this includes an EKG. On the day of the procedure, as soon as you arrive you have another EKG followed by a chest X-ray. What is the normal protocol in your Country for such procedures?

[ed34]

"possibility of some coronary artery disease or a previous MI with muscle damage, both of which would have shown up on a cath"

I was totally unaware of that. I had a Cath and then had to have an echo followed by a nuclear scan to be sure if there was any tissue damage. When I've looked at the monitor during my 5 caths I've never seen anything resembling what could be tissue damage, just Coronary Arteries. What does it look like on the monitor?