Ask the doctors: Do I have heart disease?

Q. I am a 67-year-old woman with high blood pressure. Two weeks ago, I felt some chest pressure and went to the emergency department. The pain cleared up when they gave me an antacid. My EKG and blood tests were normal. The doctor thought my pain might be due to acid in my esophagus. But when my own doctor sent me for an exercise test, I got chest pain after about five minutes, and the cardiologist said my EKG showed abnormalities that are strongly suggestive of coronary disease. She prescribed a beta blocker and suggested a cardiac catheterization. Do you agree with this?

A. It does, indeed, sound like you have coronary disease. Chest pain after just five minutes of exertion on a standard stress test might mean fairly severe coronary disease. It is very good that you started the beta blocker right away. One approach now would be to do a different type of stress test to see if the presence of coronary disease can be confirmed. But even if that test is normal, I'm not sure I would be comfortable assuming that your first test had no meaning. I think that going forward with a cardiac catheterization is a reasonable strategy.

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