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General Medical Questions
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Question : My wife has shortness of breath and sweats when she walks fast or gets anxious. Because she doesn’t get chest pain, she doesn’t think it’s her heart.
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The Trusted Source
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Howard LeWine, M.D.

Thomas H. Lee, M.D., is the chief executive officer for Partners Community HealthCare Inc. He is a professor of medicine at Harvard Medical School. He is an internist and cardiologist at Brigham and Women's Hospital. Dr. Lee is the chairman of the Cardiovascular Measurement Assessment Panel of the National Committee for Quality Assurance.

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March 28, 2012
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A:

Women can have a different set of symptoms that signal coronary heart disease and heart attacks than men.

Your wife’s doctor is partly right. Women are more likely than men to have misleading or incorrect treadmill tests. This is partly because breast tissue distorts the electrocardiogram signals by pushing the sensors further away from the heart.

Positive stress tests in women often turn out to be false alarms. But to be certain, doctors often order an extensive round of other tests that may include an angiogram. That’s why the stress test shouldn’t be used as a screening test for silent heart disease.

This does not mean that exercise testing is useless in all women all of the time. In fact, an exercise test may be useful if your wife has signs of heart disease. It may also be helpful if she has had heart attack warning signs, — such as chest pain, lower back pain, nausea, and excessive fatigue — to determine what’s causing them.

There are different types of exercise stress tests. There’s the standard stress test, which records electrical signals throughout the heart during exercise Other tests use ultrasound to see how the heart contracts or nuclear imaging to watch blood flow through the coronary arteries during exercise. These types of tests make for more accurate results in some people.

I would encourage your wife to see a doctor who is familiar with exercise stress tests and understands how to interpret the results in women. This test may do the same thing for her that it did for you.

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