PLEASE help me understand my heart tests (I am confused!!!)?

I am a 36 year old male (non-smoker) that had an abnormal Echocardiogram and stress test 2 months ago. Here were the results:

1) Echocardiogram: Mild Hypokinesis of base and mid septum. Ejection Fraction of 55%.

2) Exercise Stress Test: Anterior and inferior ischemia. Normal Electrocardiogram response. Ejection Fraction of 45%.

At that point the Cardiologist was sure that I had blockages so I underwent a Cardiac Catheterization the following day. The results were normal coronary arteries. Normal left ventricular function with no wall motion abnormalities. Ejection Fraction of 50%. No blockages. No underlying disease. The cardiologist actually told me that my arteries were so clear that he could "ski" through them.

The only explanation that he could give me for the abnormal Echo and stress test were that they were "FALSE POSITIVES". I am a bodybuilder and he stated that my larger chest size could have possibly given inaccurate readings on these types of tests. The only medications that he has me on are Lisinopril for slightly elevated blood pressure and Lipitor for slightly elevated cholesterol. Otherwise, he sent me home with no restrictions. He stated that my heart is just "slightly" weaker than normal but that I can improve it with aerobic exercise and good blood pressure/cholesterol control. He did not seem concerned in the least.

Have you guys ever heard of having "false positives" on the above tests and then being cleared with the heart cath? I have been stressing over this for the past 2 months.

False positives happen ALL THE TIME and it's why I'm continually telling patients that ordering all sorts of tests is not necessarily a good thing- they can often mislead as they have done here.
The coronary cath is the "gold standard test" and if it was "normal" you are most likely fine. Stop worring.
As for "false positives" if you are so inclined, do some reading about "Bayes Theorems" but simply put: positive test result will make it "more likely" that you have disease- in this case heart disease- based on your "pretest probability" or odds of having the disease before the test. To apply this to you, if you are 36 and active, have no family members that have had heart attacks at an early age, your chance of having heart disease is very small to begin with, say 1%. If you have high blood pressure you chance of having heart disease goes up to 1.5% now, if you have high cholesterol or diabetes on top of this your chance of having heart disease goes up some more to now say 4% still somewhat low. If you now have a test done, in your case an echo cardiogram and stress test, even if they were positive, given your low probablility of having heart disease to begin with, they boost the odds of you truely having heart disease to now say 40%. However, given that they were positive, the doctor now would have to explain them with more testing, hence the cardiac cath, which was done, which was "normal", and now your odds of heart disease are back to being very low, say 2%. Note this is not zero, as no test can say with certainty that you do or do not have disease (the false negative), but suffice to say, I wouldn't be worried if I were you- keep exercising, eating right and be happy.

False positives are not uncommon and can occur for a number of reasons. Too bad you've been stressing over this, because the stress is worst for you than the original condition might have been.
Listen to your cardiologist, get back to the gym and enjoy working out.You might want to add a little yoga to your routine, for two reasons. The stretching, as you know, is great after workouts, and the relaxation is even better. Yoga itself can help lower your blood pressure. And of course, you know that diet can help lower your cholesterol levels.

Yes, it happens. Medicine isn't an exact science, which is why the doctor ordered the cath, perhaps the only way to rule out serious problems. Have regular check ups and always get a second opinion if you're concerned. A cardiac catheterization is a serious procedure.

Eat less animal fat like cheese, eggs and meat.