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What Do My Lab Test Reports Indicate?
Question: Hi Sir,,,
I am 48 year old male and having 74 kg wt... my height is 165 cm.... I recently had a yearly medical checkup.... Reports are is follows....
I had under gone TMT test ... exercise for 6 minutes and 23 seconds of the XXXXXXX Protocol and achieved a workload of 8.10 mets. Attained a peak heat rate of 160 beats/minutes which is 91% of the predicted maximum. The exercise test was stopped due Target heart rate achieved. The blood pressure response was normal (Max BP achieved 150/98 mmHg). Peak double product achieved was 20550mmHg beats/min.
There was no angina. In the pre exercise EKG there was no significant ST Segment change. At peak exercise also there was no significant ST segment change. 1 mm ST segment depression is seen in leads II,III, aVF, V4-V6 during early recovery period which reverted to baseline after 50 seconds. no significant arrhythmias noted.
Impression:
Midly positive for reversible ischemia
Normal BP response
Average exercise tolerance
Other Reports
Triglycerides 171,,,
LDL 116
HDL 45
CHOLESTEROL 195
TSH 6.62
HbA1c 6.3
Suger (Fasting) 100 Sugar (PP) 122
Kindly suggest what to do...
Regards
XXXXXXX Sood
Delhi--- XXXXXXX
I am 48 year old male and having 74 kg wt... my height is 165 cm.... I recently had a yearly medical checkup.... Reports are is follows....
I had under gone TMT test ... exercise for 6 minutes and 23 seconds of the XXXXXXX Protocol and achieved a workload of 8.10 mets. Attained a peak heat rate of 160 beats/minutes which is 91% of the predicted maximum. The exercise test was stopped due Target heart rate achieved. The blood pressure response was normal (Max BP achieved 150/98 mmHg). Peak double product achieved was 20550mmHg beats/min.
There was no angina. In the pre exercise EKG there was no significant ST Segment change. At peak exercise also there was no significant ST segment change. 1 mm ST segment depression is seen in leads II,III, aVF, V4-V6 during early recovery period which reverted to baseline after 50 seconds. no significant arrhythmias noted.
Impression:
Midly positive for reversible ischemia
Normal BP response
Average exercise tolerance
Other Reports
Triglycerides 171,,,
LDL 116
HDL 45
CHOLESTEROL 195
TSH 6.62
HbA1c 6.3
Suger (Fasting) 100 Sugar (PP) 122
Kindly suggest what to do...
Regards
XXXXXXX Sood
Delhi--- XXXXXXX
Brief Answer:
You should go for stress thallium change in lateral leads should not be neg
Detailed Answer:
Hi XXXXXXX
Thanks for asking the query dear.
I am a Cardiologist and would be answering your query.
Frankly speaking there can be to approaches for you.
Firstly XXXXXXX approach(Cost effective) as you can also see TMT is mildly positive for ischemia so we can assume that coronaries are normal and no further investigations are required.However to mention tread mil test is one of the basic tests of cardiology and is about 70% sensitive to rule out coronary artery disease.In lay mans language this means that in 30 out of 100 cases TMT misses a coronary problem.
Approach 2-(Standard protocol)
As per the latest XXXXXXX guidelines changes in lead 2,3 and avf have no significance in a stress test however even changes less then 0.5mm in lateral leads V5 and V6 are highly significant and further testings should be done to rule out the involvement of Coronaries.
As in your case there is a clear cut 1mm depression in all lateral leads V4,V5 and V6 i would strongly recommend you to go for a test called stress thallium.
Stress thallium is a nuclear based test and will take about 2 hours.Its a painless non invasive test and is almost 99% sensitive to rule out coronary artery disease(almost equivalent to angiogram).It has no major complications and is very safe.
So if i were your primary i would have asked you to go for Stress thallium.
Regards
You should go for stress thallium change in lateral leads should not be neg
Detailed Answer:
Hi XXXXXXX
Thanks for asking the query dear.
I am a Cardiologist and would be answering your query.
Frankly speaking there can be to approaches for you.
Firstly XXXXXXX approach(Cost effective) as you can also see TMT is mildly positive for ischemia so we can assume that coronaries are normal and no further investigations are required.However to mention tread mil test is one of the basic tests of cardiology and is about 70% sensitive to rule out coronary artery disease.In lay mans language this means that in 30 out of 100 cases TMT misses a coronary problem.
Approach 2-(Standard protocol)
As per the latest XXXXXXX guidelines changes in lead 2,3 and avf have no significance in a stress test however even changes less then 0.5mm in lateral leads V5 and V6 are highly significant and further testings should be done to rule out the involvement of Coronaries.
As in your case there is a clear cut 1mm depression in all lateral leads V4,V5 and V6 i would strongly recommend you to go for a test called stress thallium.
Stress thallium is a nuclear based test and will take about 2 hours.Its a painless non invasive test and is almost 99% sensitive to rule out coronary artery disease(almost equivalent to angiogram).It has no major complications and is very safe.
So if i were your primary i would have asked you to go for Stress thallium.
Regards
Above answer was peer-reviewed by :
Dr. Remy Koshy
thanks Sir,,
I will follow your advice... Please elaborate what is this Stress thallium and how this test diagnose my problem...
Kindly look my entire medical report at www.focusimaging.co.in
Net ID - 0000
Password - 14D88E00
Regards
XXXXXXX Sood
0000
I will follow your advice... Please elaborate what is this Stress thallium and how this test diagnose my problem...
Kindly look my entire medical report at www.focusimaging.co.in
Net ID - 0000
Password - 14D88E00
Regards
XXXXXXX Sood
0000
Brief Answer:
Follow up answer.
Detailed Answer:
Hi again,
A thallium stress test is a nuclear imaging test that shows how well blood flows into the heart while you're exercising or at rest. During the procedure, a radioisotope (nuclear liquid) is administered through an IV.A myocardial perfusion (MIBI) scan is carried out to investigate the blood supply to the heart. These tests will be carried out before you have your scan. There are two parts to the investigation, a rest test and a stress test.how well blood flows through (perfuses) your heart muscle is studied on films on computer It can show areas of the heart muscle that aren't getting enough blood flow.
I cant access your reports.
Please attach screenshots or pdf copy or mail it to me on YYYY@YYYY
Waiting.
Follow up answer.
Detailed Answer:
Hi again,
A thallium stress test is a nuclear imaging test that shows how well blood flows into the heart while you're exercising or at rest. During the procedure, a radioisotope (nuclear liquid) is administered through an IV.A myocardial perfusion (MIBI) scan is carried out to investigate the blood supply to the heart. These tests will be carried out before you have your scan. There are two parts to the investigation, a rest test and a stress test.how well blood flows through (perfuses) your heart muscle is studied on films on computer It can show areas of the heart muscle that aren't getting enough blood flow.
I cant access your reports.
Please attach screenshots or pdf copy or mail it to me on YYYY@YYYY
Waiting.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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