I just passed a phyical for a fire fighter test, at 45 the doctor said my ekg was ok, i still need aprroval from my primary doctor to get the ok. why?

Formality?: Check with your work place, must be a formality that primary md needs to be involved.

EKG isn't everything: Congratulations on having a normal ekg but how's your vision? Hearing? Reflexes? Gait? Coordination? Weight? General health? There's a lot more to passing the test and your primary care doctor hopefully knows you best. Think of him/her as the "captain of the team" who coordinates all your care.