does an abnormal exercise stress test mean that it can only be blocked artieries or could it be other problems? if so what else could be wrong
There are many variables in exercise stress testing. The unfavorable variables include angina and ischemic ECG changes during exercise, complex ventricular arrhythmias at low exercise workloads, fall in blood pressure during exercise, abnormal heart rate recovery and inability to increase the heart rate or systolic blood pressure with increased workloads. Functional capacity is probably the most important variable.
Normal, healthy people show ECG changes during exercise. Factors associated with changes that might be seen on an exercise ECG in people with potential problems are listed above. Myocardial ischemia manifests itself as angina at low exercise workloads and could represent an increased risk of a multivessel coronary disease or vasospasm. Wall motion abnormalities from a prior MI can be seen, as can ventricular arrhythmias.
One thing to remember is that the sensitivity and specificity of this test can be as low as 68-77% for obstructive CAD of more than 70%. So, false positives or negatives are possible. Sensitivity to detect CAD increases with the severity of narrowing of blood vessel, or when multiple vessels are involved.
Abnormalities in baseline (rest) ECG from conditions such as left bundle branch block, Wolff-Parkinson-White syndrome, left ventricular hypertrophy and digitalis therapy reduce the specificity of exercise test to exclude CAD. In these circumstances, it is best to use exercise stress tests with imaging. Other factors that can give a false positive result are severe anemia, low potassium, oxygen deficiency and MVP. So, the abnormalities on your ECG might not mean anything more than a low potassium level, which is easily corrected. Or, a false positive result, given the limitations of these tests. You'll just have to wait and see. Try not to worry too much! Meanwhile, read about the specificity and sensitivity of stress exercise ECG testing and you'll feel beter.