Question: Dear doctor, my father 65 years age undergone executive health check up in a corporate hospital, BIOCHEMISTRY REPORT : CHOLESTEROL-SERUM/PLASMA -211, HDL CHOLESTEROL - SERUM / PLASMA - 50, TOTAL CHOLESTEROL / HDL CHOLESTEROL RATIO - 4.2, TRIGLYCERIDES - SERUM - 146, LDL CHOLESTEROL - SERUM / PLASMA - 132, and TMT Test Report - The patient exercised according to the XXXXXXX for 5.04 mins, achieving a work level of XXXXXXX METS: 7.00 resting heart rate of 61 bpm XXXXXXX to a maximal heart rate of 142 bpm. The value represented 91% of the maximal, age-predicted heart rate. The resting blood pressure of 120/80 mm Hg, XXXXXXX to a maximum blood pressure of 200/90 mmHg. The exercise test was stopped due to Fatigue / SOB. TMT CONCLUSIONS: 1) SYSTOLIC HIGH BP RESPONSE 2) NO CHEST PAIN / ARRHYTHMIA 3) AVERAGE EFFORT TOLERANCE 4)TEST IS POSITIVE FOR INDUCIBLE ISCHAEMIA. Based on the above reports 1) What do it mean, test is positive for inducible ischaemia 2) What should be my next step ?

Thanks doctor for your reply, sending complete TMT reports as attachment. In past my father is a smoker and stopped ten years back and not diabetic. 1) Based on the reports do they have clearly indicate the problem in heart , where and in which page they are indicating. Doctor can you be detailed. 2) As a doctor , what would be your final impression on report , suggestions and advise to patient. Regards, XXXXXXX

Thanks Doctor for your reply and valuable suggestions, now i am coming to final point. My father took health checkup in Apollo , Hyderabad on 18/07/2011 and Consultant doctor said everything is fine based on reports and on 19th ,he moved to his native place and 19th evening 6pm , he felt pain and uneasy , my father thought reports are fine and took gastric medicines, as he well educated and Retd Professor , went to local doctor and they took ECG , next minute they put a tablet under tongue , they asked us to move Vijayawada to visit cardiologist,its on 20th.This all happened within 30 hours after health checkup. I purely think this as medical negligence . Please see final impression given by Apollo doctor - Consultant Internal Medicine. So we filed a case in Andhra Pradesh State Consumer Forum. We need Doctors advise. Report by Vijayawada Emergency Doctor:This is to certify that Dr.D XXXXXXX XXXXXXX aged 65 years , was admitted in our hospital on 20/07/2011 with a diagnosis of Acute inferoposterior wall M1, Killips C1.11, Mild to Moderate LV Systolic Dysfunction, HTN. He underwent coronary angiogram on 20/07/2011 which revealed double vessel disease with RCA 100% blocked in the mid segment and Primary PCI with stent to Mid RCA on 20/07/2011. He was discharged on 24/07/2011. We delayed nearly 6-8 hours, after pain. By god Grace he is well, if anything would have happen, we are the suffers. Reports shows TMT Positive and final impression shows TMT Negative given by Apollo doctor. 1) That's why doctor every time , i been insisting you , what would you do based on reports , if you were in that place. 2) Do you think its purely medical Negligence or not. Do i have sufficient evidence, to fight. 3)Needed valuable suggestions and advise, it will be great helpful to us, to fight. Regards, XXXXXXX

Thanks doctor for your valuable suggestions, whether they are convincing or not, its a different matter. I felt , i will get a supportive answer and some hopeful evidence. As a doctor you have given , your expertise and advise. So Thankful to you ,and for spending your valuable time. Closing my discussion. Regards, XXXXXXX