Your Exercise ECG Report: Do You Need a Heart Catheterization?

Exercise Electrocardiogram Report

Could you please help me review the report regarding the level of hypoxia and whether a cardiac catheterization is necessary? Thank you.
Pretest ECG: sinus rhythm, rate: 85 bpm
2.
Exercise time: 12'59"
3.
The test was terminated due to shortness of breath (SOB)
4.
There was ST depression > 1mm in leads V4-6, II/III/aVF
5.
Reached 103% of maximum age-predicted heart rate
6.
Conclusion: positive

Ning Meng, 30~39 year old female. Ask Date: 2021/11/22

Dr. He Dongjin reply Cardiology

Hello, based on the Duke Treadmill Score, a score of +8 falls into the low-risk category, indicating a 99% survival rate at 5 years.
If there are no significant symptoms, you can be monitored for now.
Changhua Hospital cares about your well-being.

Reply Date: 2021/11/22

More Info

Based on the details provided in your exercise ECG report, it appears that there are significant findings that warrant further investigation. The report indicates that you experienced shortness of breath (SOB) during the test, which is a concerning symptom. Additionally, the presence of ST segment depression greater than 1 mm in multiple leads (V4-6, II, III, aVF) during exercise is indicative of potential myocardial ischemia. This means that your heart may not be receiving enough oxygen during physical exertion, which can be a sign of underlying coronary artery disease (CAD).

Given these findings, the recommendation for further evaluation through heart catheterization (also known as coronary angiography) is reasonable. Heart catheterization is a procedure that allows doctors to visualize the coronary arteries and assess for blockages or significant narrowing that could be contributing to your symptoms and the observed ECG changes. This procedure can provide critical information about the state of your coronary arteries and help guide treatment decisions.

In your case, the exercise ECG conclusion being labeled as "positive" suggests that there is a likelihood of ischemic heart disease. This is particularly relevant considering your age and the presence of ST segment changes during the test. While you may not have a history of chest pain or other risk factors typically associated with heart disease, the findings from this test indicate that further investigation is warranted.

It is important to discuss these results with your healthcare provider, who can assess your overall clinical picture, including any symptoms you may be experiencing, your medical history, and any other risk factors for heart disease. They can help determine the urgency of the situation and whether immediate catheterization is necessary or if other non-invasive tests should be conducted first.

In summary, the presence of ST segment depression during exercise, combined with your symptoms of shortness of breath, suggests that you may have underlying coronary artery disease. Heart catheterization is a valuable tool for diagnosing and assessing the severity of any blockages in the coronary arteries. It is crucial to follow up with your healthcare provider to discuss these findings and the next steps in your evaluation and management.

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