Your Exercise ECG Report: Is My Heart at Risk?

Exercise Electrocardiogram Report

Hello Doctor, my exercise electrocardiogram report from last week is as follows, and it seems to indicate a diagnosis of myocardial ischemia? Should I avoid intense exercise until my follow-up appointment? Do I need to see a doctor immediately for medication or anything similar (my follow-up appointment is still more than ten days away)? Thank you!
1.
Total exercise duration: 4 minutes 8 seconds.

2.
■Normal BP response, □Flat response, □Hypotension.

3.
Maximum HR: 164 BPM, predicted max HR: 173 BPM, % of Predicted: 94%.

4.
□ No significant ST-T change during exercise.
■ Significant ST-T change during exercise: □ I: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
□ II: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
■ III: □ Upslope, ■ Flat, □ Downslope: -■Amplitude.
(-1.05, 0.6) □ aVR: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
□ aVL: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
□ aVF: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
□ V1: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
□ V2: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
□ V3: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
□ V4: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
□ V5: □ Upslope, □ Flat, □ Downslope: -□Amplitude.
□ V6: □ Upslope, □ Flat, □ Downslope: -□Amplitude.

5.
0 APCs, 0 VPCs during exercise.
0 APCs, 0 VPCs after exercise.

6.
Final result: □Positive, □Negative, ■Borderline, □Undetermined.

Niming, 40~49 year old female. Ask Date: 2024/06/14

Dr. He Dongjin reply Cardiology

Hello, it seems that everything is fine.
You can be observed for now.
Changhua Hospital cares about you.

Reply Date: 2024/06/14

More Info

Based on your exercise ECG report, it appears that there are some concerning findings that suggest the possibility of myocardial ischemia. The significant ST-T changes during exercise, particularly the horizontal ST segment depression, indicate that your heart may not be receiving enough blood flow during exertion. This is a classic sign of potential coronary artery disease (CAD), which can lead to serious cardiovascular events if not addressed.

Given that your maximum heart rate reached 164 BPM, which is approximately 94% of your predicted maximum heart rate, it indicates that you were exercising at a high intensity. However, the presence of ST segment changes during this exercise suggests that your heart was under stress and may not have been able to cope adequately with the increased demand for oxygen.

Recommendations for Your Situation
1. Limit Physical Activity: Until you have a follow-up appointment with your healthcare provider, it would be prudent to avoid strenuous physical activities. Engaging in high-intensity exercise could exacerbate any underlying issues and potentially lead to more severe symptoms, such as chest pain or even a heart attack.

2. Monitor Symptoms: Pay close attention to any symptoms you may experience, such as chest pain, shortness of breath, dizziness, or palpitations. If you experience any of these symptoms, it is important to seek medical attention immediately.

3. Follow-Up Appointment: Since you mentioned that your follow-up appointment is still a few weeks away, it is advisable to contact your healthcare provider's office to see if they can expedite your appointment. Given the borderline results of your exercise ECG, timely evaluation and management are crucial.

4. Medication Management: If you have been prescribed medications, such as aspirin or statins, it is important to take them as directed. These medications can help manage your cholesterol levels and reduce the risk of clot formation, which is particularly important if there is any underlying coronary artery disease.

5. Further Testing: Your healthcare provider may recommend additional tests, such as a coronary angiogram or a myocardial perfusion scan, to further evaluate the blood flow to your heart and assess the severity of any blockages. These tests can provide more definitive information about your heart's condition and guide treatment decisions.

Understanding the Risks
The presence of ischemic changes on your exercise ECG indicates that you may be at increased risk for cardiovascular events. Risk factors such as high cholesterol, family history of heart disease, and lifestyle factors (e.g., smoking, diet, exercise) should be carefully evaluated. It is essential to address modifiable risk factors through lifestyle changes, such as adopting a heart-healthy diet, engaging in regular physical activity (as tolerated), and managing stress.

In summary, while your exercise ECG report shows some concerning signs, it is essential to take a cautious approach until you can consult with your healthcare provider. Limiting strenuous activities, monitoring your symptoms, and ensuring timely follow-up will be crucial steps in managing your heart health. Remember, early intervention can significantly improve outcomes in patients with potential coronary artery disease.

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