Brief Answer: Angiogram protocol explained Detailed Answer: Hi XXXXXXX welcome to our site. I am Dr Saumya Mittal. Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your query as simply as possible. A positive TMT signifies that the status of your coronary arteries has moved towards some blockage. Now what happens is that there is a blockage in the lumen of the vessel. Therefore the lumen of the vessel is less, and so only a limited amount of blood flows through it Now this amount of blood is ok and sufficient for the normal relaxed state. But when you exercise, as in TMT, the blood flow becomes insufficient. So the TMT becomes positive. An ecg and echo will not show too many changes because so far the baseline values of blood supply are sufficient I would suggest you go for an angiography. Only an angiography can truly show the degree of blockage in the blood vessels. There are two types of angiographies- 1. CT guided angiography- in this the angiography is done like an x ray. The test is cheaper and relatively easier to perform and less invasive and you need not be hospitalized. But the test is relatively inaccurate. If doubt remains, Angiogram will have to be done. And therapeutics is not possible. 2. Angiogram- A cardiologist performs this test, and is the best test possible. The advantages are that it shows the blockage directly to the doctor. The doctor can do the remedy like stenting immediately. And is a short procedure. Its however more expensive, and needs hospitalization. I hope this helps you. Best of luck. I have given you the answer to the maximum considering the information provided. Please do understand that some details could be extracted from a detailed history and examination. Looking forward to your return query with more details you may want to ask so that I can help you further. (If the answer has helped you, please indicate this) Dr Saumya Mittal, MD

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