Hi Birdi,

Although mild hypertension is not necessarily a pre-requisite, 15% of patients with mild-to-moderate hypertension, who are free of clinical signs of coronary artery disease, experience episodes of ST-segment depression during Holter monitoring or exercise stress testing. Most of these episodes are asymptomatic and are not associated with the severity of hypertension, the presence of left ventricular hypertrophy, and other risk factors for coronary artery disease. Episodes of ST-segment depression are more common for women than they are for men, particularly during Holter monitoring. In the absence of other findings, I'm going to give this one my yaaaaaawwwwn response. Nothing remarkable here, so take a deep breath and relax. There are thousands of variants for what is deemed a normal ECG and I while I don't particularly think a 3-lead is the best for making the most specific analysis, it is sufficient.

As for the chest pain, you are highly likely to be experiencing a phenomenon known as Da Costa's syndrome. The name was coined after the Civil War officer who identified it in a mass number of his foot soldiers, all complaining of chest pain and symptoms loosely associated with a heart attack. To the surprise of researchers studying the phenomenon to some length, it was discovered that the soldiers were actually suffering symptoms of elevated anxiety and stress associated with exposure to highly emotional environmental circumstances. It need not be wartime for you to suffer this syndrome and I have a good number of patients who present themselves with the identical complaint.

If you still worry, then my recommendation is to see a cardiologist and undergo a 12-lead ECG, a treadmill stress test, and echocardiogram. This combination of tests will undeniably inform you whether trouble truly exists, which I doubt at this point is likely the case. However, many people "must know" so if you decide to have these tests run, then you must also resolve yourself to the fact that if the tests are all negative, it clearly means you have no disease and that you must press on with your life and leave your worries in this regard behind you. Otherwise, you may find your anxiety causing you to chase endlessly to find something that in fact, does not exist except in the corridor of fears about your health status. You'll be just fine.

Best regards and Good Health