If my heart enzymes, ekg, and chest x-ray are all good, can i rule out any major heart issue? 21, active. slightly overweight, but only by a few lbs.

Typically: While these tests can be helpful in an acute setting, they are not good for telling you about your risk of cardiac disease. Typically we are looking at lipid/cholesterol ratios, HS-CRP and what happens when stressed (like the above tests DURING exercise). Heart disease is less common in younger people without significant risk factors including SMOKING and family history.

Yes and no: If the question is about trying to understand if you are having palpitations, a Holter monitor might help. Alternatively, if the question is about chest pain, even though coronary artery disease is less likely given your age, a stress test might be considered. The best test to look for valvular abnormalities will be a 2D-echo heart. Talk to your doc about a possible Cardiology consult.

Pretty much: Italy successfully lowered the incidence of sudden cardiac death in children by an EKG screen. The rate dropped BELOW 1 in a million. THere are some rare congenital abnormalities (that would be found with ekg all by itself). Downside... 1% of children had some abnormality that had to be looked at and nearly zero of the kids actually had anything actually wrong.