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Dear Sir ,please Provide Your Valuable Opinion On Attached TMT
Question: Dear Sir ,please provide your valuable opinion on attached TMT 0000 report of 49 y/m , K/C/O DM SINCE 1 YR. ON ORAL MEDICATIONS , there was T wave inversion in aVL and slight ST elevation in lateral Leads ,so TMT was suggested.
Brief Answer:
TMT INTERPRETATION
Detailed Answer:
Hi....
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX
I have gone through your query/reports and here is my opinion.
The clinical value of T wave inversion in lead aVL in diagnosing coronary artery disease (CAD) is still unclear though some relate it strongly with coronary artery disease(CAD)- left anterior descending artery(LAD) lesions.
ST -T changes are non specific findings which originate due to multiple reasons like electrolyte imbalance(Specially Potassium),thyroid anomaly,hypertension etc and hardly signify a particular diagnosis.
As the reference patient is middle aged (49 yrs) and has diabetes(must be having diabetic dyslipidaemia too),so automatically he becomes a high risk candidate for CAD.
Other risk factors which should be inquired are history of hypertension,associated obesity,increased blood lipids,history of heart disease in family,stress levels,history of smoking and degree of physical activity(sedentary life)
Kindly share the symptomatology of the patient.
Is the patient having angina?
As far as this TMT report is concerned,it is negative(As no significant ST Depression was encountered during the exercise) but TMT has multiple variables measured that predict the clinical outcome and indicates the cardiac status.
They include....Exercise duration,hypotension during exercise,abnormal hypertension encountered during exercise,failure of heart rate to increase adequately in response to exercise or if it does not recover rapidly after exercise etc.
Of all the prognostic factors, exercise duration is most important and is the one most strongly associated with risk of coronary artery disease and sudden death.
In this way,a negative stress test alone is not of sufficient diagnostic value.
We should always read the investigation reports in context of the patient and not in isolation.
Hope that I have answered your query.
If you have any queries,please let me know.
Stay healthy and stay blessed.
Regards.
TMT INTERPRETATION
Detailed Answer:
Hi....
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX
I have gone through your query/reports and here is my opinion.
The clinical value of T wave inversion in lead aVL in diagnosing coronary artery disease (CAD) is still unclear though some relate it strongly with coronary artery disease(CAD)- left anterior descending artery(LAD) lesions.
ST -T changes are non specific findings which originate due to multiple reasons like electrolyte imbalance(Specially Potassium),thyroid anomaly,hypertension etc and hardly signify a particular diagnosis.
As the reference patient is middle aged (49 yrs) and has diabetes(must be having diabetic dyslipidaemia too),so automatically he becomes a high risk candidate for CAD.
Other risk factors which should be inquired are history of hypertension,associated obesity,increased blood lipids,history of heart disease in family,stress levels,history of smoking and degree of physical activity(sedentary life)
Kindly share the symptomatology of the patient.
Is the patient having angina?
As far as this TMT report is concerned,it is negative(As no significant ST Depression was encountered during the exercise) but TMT has multiple variables measured that predict the clinical outcome and indicates the cardiac status.
They include....Exercise duration,hypotension during exercise,abnormal hypertension encountered during exercise,failure of heart rate to increase adequately in response to exercise or if it does not recover rapidly after exercise etc.
Of all the prognostic factors, exercise duration is most important and is the one most strongly associated with risk of coronary artery disease and sudden death.
In this way,a negative stress test alone is not of sufficient diagnostic value.
We should always read the investigation reports in context of the patient and not in isolation.
Hope that I have answered your query.
If you have any queries,please let me know.
Stay healthy and stay blessed.
Regards.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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