Stress Test Showed Coronary Artery Disease And EKG Normal. Worrisome

Posted on Wed, 20 Mar 2013

Question: I have had an EKG which showed two extra heart beats. Would that make a diagnosis o0f CAD which the doctor wrote that I had for a stress test.? I am worried

Answered by Dr. Mayank Bhargava (1 hour later)

Hi XXXXXXX,
Welcome to XXXXXXX forum.

Let me know the associated symptoms along with extra beats.
Do you have chest pain/ sweating/ respiratory distress?
Are you feeling pounding sensation in chest?

Considering your age with presence of extra beats, possibility of CAD must be ruled out.
Heart not only contains muscles but also conduction system which carry on impulses generated in SA node to other part of heart.
There are 3 major arteries in heart and supply blood to muscles as well as conduction system.

Extra beats may be physiological or pathological.
Physiological could be due to fever, use of tea, coffee, chocolates and after exercise.
Pathological extra beats definitely indicates some sort of impaired blood supply with effect on conduction system.

Stress test is a maneuver in which speed of machine is progressively increased and work load on heart is also increased.
If blood supply is hampered, EKG tracing start showing downward sloping in affected leads.
So with use of stress test, differentiation between physiological and pathological could be made.

So stress test is mandatory with considering your age.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar