Which waves in my treadmill stress test indicate problems?

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I have gone through your report (attachment removed to protect patient identity). It is unlikely to be a machine error. Errors do not have such patterns and it is suggestive of old infarction only. Its present in inferior leads, which suggests inferior part of the heart is damaged and these are relatively less severe kind of infarction. However, an echocardiogram will give a better idea regarding the severity and extent of damage done. So it is better to get an echocardiogram done, if not done yet. Now, you can see in lead 1, P wave followed by a sharp spike called as QRS complex followed by an upright wave called as T-wave. So now, you can see in lead 2, 3, and AVF which are inferior leads, showing downward QRS spike instead of upward and T-wave is also inverted suggestive of heart damage. So, the next step is an echo to look for the extent of damage and followed by angiography to see the blockages and if needed then revascularization. Hope this helps you and get back if you have any doubts.

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The significant changes are only in lead 2,3 and AVF, not in other leads. So, if echocardiogram is normal then the severity is not great. Here, our main priority is to rule out ischemic changes. Infarction will lead to some damage to the heart and can be very well seen on echo. So, considering your ECG changes, we were expecting some changes on echo. Also, normal echo raises the possibility of false positive ECG (electrocardiogram) changes. Here, CAT (computerized tomography) scan will give an idea regarding whether any blockages are there or not. Rheumatic is an entirely different thing, and it causes damage to the heart valves, and a normal echo rules out any damage. Also, sometimes it can cause ECG changes.