<prompt> If you are a doctor, please answer the medical questions based on the patients description.First, I failed the stress test. The Doctor seemed very concerned that my heart rate was so high after 2 minuets on the tredmill. My question is that after doing a cardio exercise for about 1 minuet, my heart rate went to 150 and there was no immediate ache but at some point durning the night, I had a dull ache in the heart. Could there be any other concern? I had the procedure where they went in to check for blockage. There was none. My age is 46 and I am approx 275lbs  <response>: Hi, welcome to Chat Doctor. Thanks for writing to us.First, you failed in the stress test, that means the TMT test was positive for inducible ischemia. So there is some concern. There are certain risk factors for the development of coronary artery diseaseheart attack, these are:1.waist circumference 40 inchesmen2.triglyceride150 mg dl3.HDL cholesterol4.BP13085 mm of hg5.fasting blood sugar110 mgDL If 3 or more risk factors are present in your case. Chance of developing CAD is much higher. So, you should first go for the following tests:1.lipid profile2.fasting blood sugar3.complete blood count4.EKG5. Repeat ANGIOGRAPHYprocedure to check for blockage if necessary. Hope I have answered your query. Stay fit, good luck. 