<s>[INST] Dr. Gopi, I recently had an EKG for surgery clearance that showed I had a heart attack.  The EKG was repeated four times to be sure.  Same result.  I was sent for a stress test that showed no blockage, no damage and OKd for surgery.  Should I have an angioplasty to be sure????  I am terrified.  Could I have a heart attack that left no sign of damage and no blockage??? [/INST] Hello Welcome to Chat Doctor. As per your description, your ECG suggests that you have already sustained a heart attack. But only ECG cannot be relied upon since your stress test is normal, and you have had no symptoms. Stress test is normal, but it has only 70% sensitivity that means it will catch only 70% of cases with blocks. Some people do have ECG's that suggest heart attack but end up having normal results. I recommended, and you undergo a 2D echo which will show if there has been any damage caused to the heart by the attack. The damage if present should correspond to the area in which ECG suggests a heart attack. If the echo shows abnormalities, then you must undergo a coronary angiogram. If 2d echo is normal then you need not worry about the ECG findings. Also, important here is to do a 2d echo from a reputed center, because it is an observer dependent test and details may be missed if done at non-experienced hands. I hope I have answered your query satisfactorily. Wishing you good health.regards. </s>