Is the ECG stress test able to detect symptoms before sudden death happened ?

http://www.malaysia-chronicle.com/index.php?option=com_k2&view=item&id=183571:25-year-old-woman-dies-after-running-10km-marathon&Itemid=4#axzz2jmTSqt87

A 10 km run which killed a 25 year old young lady make you wonder whether you should participate in the upcoming Penang bridge run which range from 10 km to 42 km. Is the stress test a must prior to participation ? Is the stress test can avoid such issue happening to you and your loved one.

The answer is yes and no !

Yes, For people with chest pain, a positive result can determine whether the problem is heart-related. Stress tests can also evaluate heart risk before a surgery or after a heart attack. Stress tests can effectively show whether the heart's arteries are 70% narrowed or more. Most of the patients got heart attack when artery to the heart is 70-75% blocked
But heart attacks can arise from arteries that are less than 50% blocked ! The answer is no as it wont detect 50% blockage.

Stress test is only 60% accurate meaning they miss 40% of the diagnosis ! Women got less accuracy compared to man as smaller branch of artery are affected when woman got heart disease. Breast tissue can trigger false negative.

The false positive and false negative bring potential problem as it give extra security or more invasive procedures and the unnecessary use of medications.

U.S. Preventive Service Task Force does not recommend treadmill testing for those with a low risk.

2nd question will arise after reading this is why 50% or lower plaque will cause heart attack ?
The heart attack occurred when vulnerable plaque rupture. Vulnerable plaque rupture causing thrombosis of artery . A small plaque with thin core is easily rupture then the big plaque with thick core. Small vulnerable plaque is higher risk compared to big plaque.


What is the definite strategy of  detecting ischemic heart disease?
The gold standard is angiogram ( invasive procedure where a thin tube is inserted into the artery of the heart) . The procedure is needed when symptom suggestive of heart disease and risk of heart disease is present . The risk of heart disease are high blood pressure, fa,mily history of sudden death , diabetes, obesity and high cholesterol.

Back to the above news, is the patient died of heart disease?
The answer is yes but not heart attack (coronary artery blockage). The cause of death for young athletes is mainly hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is a congenital condition in which a portion of heart muscle is thickened . It can be detected by ECG but definite test would be echocardiogram and cardiac MRI.

Disclaimer
All advice and information on this news is given in good faith and is based on sources believed to be reliable and accurate at the time of release on the article. I do not accept legal liability or responsibility for the content of the advice or information or any consequences arising from its use.
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