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What Causes Myocardial Ischemia?
Question: hello
I have recently gone through the process of ECG, ECO and Stress TMT
ECG : Normal
ECO: Normal
TMT : Mildly Positive for Provocable myocardial ischemia.
Report as below
: 00:00 BPM 75 BP (mmHG) 120/80 Symtoms nil
Stage 1: 03:00 BPM 118 BP (mmHG) 140/80 Symtoms nil
Stage 2: 03:00 BPM 139 BP (mmHG) 140/80 Symtoms nil
Stage 3: 03:00 BPM 160 BP (mmHG) 150/80 Symtoms nil
Stage 4: 00:30 BPM 164 BP (mmHG) 150/80 Symtoms nil
Final Impression: The exercise stress test is mildly positive for Provocable myocardial ischemia.
Good effort tolerance.
Treadmill score = +5
So my qus. is : Should I go for Angiography.
what exactly the position of my heart. I mean the expected blockage. intact I am under weight.
Can I avoid this test.
Should I start the medicine as prescribed.
Please advise I am little nervous.
Regards
S XXXXXXX
0000
Should I go for Angiography.
what exactly the position of my heart. I mean the expected blockage. infact I am under weight.
Can I avoid this test or there is any other better test to identify this.
Should I start the medicine as prescribed.
I have recently gone through the process of ECG, ECO and Stress TMT
ECG : Normal
ECO: Normal
TMT : Mildly Positive for Provocable myocardial ischemia.
Report as below
: 00:00 BPM 75 BP (mmHG) 120/80 Symtoms nil
Stage 1: 03:00 BPM 118 BP (mmHG) 140/80 Symtoms nil
Stage 2: 03:00 BPM 139 BP (mmHG) 140/80 Symtoms nil
Stage 3: 03:00 BPM 160 BP (mmHG) 150/80 Symtoms nil
Stage 4: 00:30 BPM 164 BP (mmHG) 150/80 Symtoms nil
Final Impression: The exercise stress test is mildly positive for Provocable myocardial ischemia.
Good effort tolerance.
Treadmill score = +5
So my qus. is : Should I go for Angiography.
what exactly the position of my heart. I mean the expected blockage. intact I am under weight.
Can I avoid this test.
Should I start the medicine as prescribed.
Please advise I am little nervous.
Regards
S XXXXXXX
0000
Should I go for Angiography.
what exactly the position of my heart. I mean the expected blockage. infact I am under weight.
Can I avoid this test or there is any other better test to identify this.
Should I start the medicine as prescribed.
Brief Answer:
please upload ecg graphs of tmt test
Detailed Answer:
Dear sir,
1. Since TMT is better interpreted by looking at actual ECG graphs, please upload those graphs on this page.
2. In cases of borderline positive test and no symptoms & good exercise capacity, next logical step as per literature is imaging based stress test like Stress ECHO or stress thallium.
I am waiting for your graphs to be uploaded.
Sincerely
Sukhvinder
please upload ecg graphs of tmt test
Detailed Answer:
Dear sir,
1. Since TMT is better interpreted by looking at actual ECG graphs, please upload those graphs on this page.
2. In cases of borderline positive test and no symptoms & good exercise capacity, next logical step as per literature is imaging based stress test like Stress ECHO or stress thallium.
I am waiting for your graphs to be uploaded.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doc
Good Morning !
Thanks for your revert.
Please find attached TMT graph report and Doc. prescription.
My cholesterol level is also controlled.
Questions:
Should I go for Angiography ?
what exactly the position of my heart. I mean the expected blockage. infact physically I am under weight ?
Can I avoid this test ?
I normally do jogging at weekend should I stop it or advice what kinds of exercises I can do to recover it ?
Can I do cycling ?
What type of food I must take.
Thanks
S XXXXXXX
Good Morning !
Thanks for your revert.
Please find attached TMT graph report and Doc. prescription.
My cholesterol level is also controlled.
Questions:
Should I go for Angiography ?
what exactly the position of my heart. I mean the expected blockage. infact physically I am under weight ?
Can I avoid this test ?
I normally do jogging at weekend should I stop it or advice what kinds of exercises I can do to recover it ?
Can I do cycling ?
What type of food I must take.
Thanks
S XXXXXXX
Brief Answer:
please provide some details.
Detailed Answer:
Dear Sir
1. As per the prescription of your doctor, you have breathlessness on exertion which comes om moderate exertion. is it true? If you developed any breathlessness while doing TMT?
2. If you developed any chest pain while doing TMT? Why did you undergo all these tests?
I will reply to all your queries in details after these clarifications and will also explain your TMT graphs.
Sincerely
Sukhvinder
please provide some details.
Detailed Answer:
Dear Sir
1. As per the prescription of your doctor, you have breathlessness on exertion which comes om moderate exertion. is it true? If you developed any breathlessness while doing TMT?
2. If you developed any chest pain while doing TMT? Why did you undergo all these tests?
I will reply to all your queries in details after these clarifications and will also explain your TMT graphs.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir
Thanks for your revert.
No, I was not breathless while TMT test. In fact no chest pain during TMT. But yes I have told him sometimes I feel pain in chest but not at a certain position. I don't know the difference between gastric pain / muscle pain or pain because of heart.
It was my personal interest of having these test because I saw many cases where the people of age 40 having more heart problems.
Thanks
S XXXXXXX
Thanks for your revert.
No, I was not breathless while TMT test. In fact no chest pain during TMT. But yes I have told him sometimes I feel pain in chest but not at a certain position. I don't know the difference between gastric pain / muscle pain or pain because of heart.
It was my personal interest of having these test because I saw many cases where the people of age 40 having more heart problems.
Thanks
S XXXXXXX
Brief Answer:
please see details.
Detailed Answer:
Dear Sir
1. Only one lead of the TMT graphs show borderline changes, that too at peak exercise only. In the given scenario, the likelihood of them to be a normal variant is high. Moreover you did not have any breathlessness/ chest pain and your exercise capacity was good. In view of all these facts, the next logical step should be an imaging based stress test rather than angiography, as I detailed in previous answer.
2. You need not to worry and get this test done at earliest to remove the doubt which has creeped up. Once your stress ECHO or thallium comes out to be normal, you can do all exercises.
3. You should avoid fried food items and excess of sweets. Maintain ideal body weight and never smoke. Try to remain stress free. Once the stress test is normal, continue your daily jogging/ cycling and exercise.
4. There is no test available which can surely tell us that if a given person will have heart attack in future or not. Only prevention is best cure. Even if all stress tests are normal, still person can have heart attack in near future. These test only tell us current state of affairs and do not guarantee about future.
Sincerely
Sukhvinder
please see details.
Detailed Answer:
Dear Sir
1. Only one lead of the TMT graphs show borderline changes, that too at peak exercise only. In the given scenario, the likelihood of them to be a normal variant is high. Moreover you did not have any breathlessness/ chest pain and your exercise capacity was good. In view of all these facts, the next logical step should be an imaging based stress test rather than angiography, as I detailed in previous answer.
2. You need not to worry and get this test done at earliest to remove the doubt which has creeped up. Once your stress ECHO or thallium comes out to be normal, you can do all exercises.
3. You should avoid fried food items and excess of sweets. Maintain ideal body weight and never smoke. Try to remain stress free. Once the stress test is normal, continue your daily jogging/ cycling and exercise.
4. There is no test available which can surely tell us that if a given person will have heart attack in future or not. Only prevention is best cure. Even if all stress tests are normal, still person can have heart attack in near future. These test only tell us current state of affairs and do not guarantee about future.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir
Thanks for your revert.
I will surely go for stress ECHO or thallium test.
Thanks for your suggestions again.
Regards
S XXXXXXX
Thanks for your revert.
I will surely go for stress ECHO or thallium test.
Thanks for your suggestions again.
Regards
S XXXXXXX
Brief Answer:
welcome sir
Detailed Answer:
Welcome sir
Sincerely
welcome sir
Detailed Answer:
Welcome sir
Sincerely
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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