<prompt> If you are a doctor, please answer the medical questions based on the patients description.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???  <response>: 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 ECGs 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. 