Im 21,active, and 10 pounds overweight. i recently had an ekg, heart enzymes, chest xray, and stress test. all good. safe to rule out a heart problem?

At your age: Yes. ECHO is the final test to be absolutely certain a structural abnormality does not exist.

Partly...: You can rule out significant coronary artery disease; however, if you still have symptoms (for which you had all these tests), ask your doctor to send you to a cardiologist who will carefully take your H&P and possibly order other tests, such as Holter monitoring, electrophysiology studies, echocardiogram, and others as clinically indicated by his examination.