What Causes Chest Discomfort While Jogging?
Early evaluation is indicated.
Detailed Answer:
Dear Sir
1. A history of chest discomfort while jogging and taking steps with a positive for ischemia TMT test with suboptimal exercise duration indicates towards anginal heart disease.
2. The next step is to meet your cardiologist on priority and get your self evaluated. We normally do ECHO in all such cases on priority. The Echo will rule out any structural heart disease responsible for such symptoms. We also do coronary angiogram in most such cases, unless we are convinced that it is only secondary angina. As per standard literature, the history of angina on exertion and positive stress test with poor exercise capacity form an indication for coronary angiogram.
Sincerely
Sukhvinder
I would greatly appreciate your feedback.
Thanks & regards,
XXXX
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Detailed Answer:
Dear Sir
No, it is not possible to confirm secondary angina from the TMT.
The Echo, clinical evaluation and some laboratory tests like hemoglobin, points towards secondary angina.
Sincerely
Sukhvinder
As next step to your suggestion. I have done Echo and Blood work such as creatinine-serum/pasma, potassium-serum/plasma, Anti HCV ELISA, HBsAg, HIV- 1+2 Screening (Ag+Ab), Hemoglobin and etc. All my reports are normal. Please see the reports as attachments.
Please see suggest if still I need to go for Coronary Angiogram.
Regards
XXXX
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Detailed Answer:
Dear Sir
1. There is no structural heart disease as per your ECHO report. The hemoglobin is also normal. These are two major determinants of secondary angina which are normal.
2. As I have already explained, that in cases of typical chest pain with positive TMT test, the next logical step is coronary angiogram in most cases.
Therefore, you must consult an interventional cardiologist and discuss all the details. A decision to undergo coronary angiogram will be best taken up after discussing with your treating cardiologist and your family. An angiogram is always performed with the intent of fixing a prospective lesion in coronary artery by stenting or bypass surgery. Sometime, patient can be managed by medicines alone.
We normally perform angiogram in all such cases if the patient and family agrees for same.
Sincerely
Sukhvinder