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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had TMT Test That Said Mildly Positive For Reversible Ischaemia, No Classical Angina. Meaning?

Name Result Units Normal Range FINDINGS: Patient could exercise for 06 minutes and 56 seconds of the Bruce Protocol and achieved a workload of 7.40 mets. She attained a peak heart rate of 150beats/minute which is 93% of the predicted maximum. The exercise was terminated owing to attainment of THR. There was no classical angina. Clinically the blood pressure response was normal ( BP 140/80 mmHg.) and there was no S3 and S4 gallop in the recovery period. In the pre exercise there was no significant ST segment change. At peak exercise there was 1.4 � 1.5mm ST segment depression in leads 2,3aVF and 1.1mm in leads V5-V6. However at 2minutes there was 1.2-1.5mm ST segment depression in leads 2,3aVF. Changes reverse within 4minutes post exercise. IMPRESSION: Mildly positive for reversible ischaemia. Fair exercise tolerance. Please let me know meaning of above mentioned result and impression of TMT test?
Sun, 31 Mar 2013
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Cardiologist,  's  Response
Hello Ma'm
welcome to healthcaremagic.
your TMT shows you have good exercise capacity for your age (calculated to be ~59 years, from the data given above) and you were asymptomatic during the test. this itself portends that likelihood of a significant obstruction in your coronary arteries (blood vessels supplying heart) is low. however in view of ST depression more than 1mm in during stress test it has been given mildly positive. the possibilities could be
a. it is a false positive response especially if the shape of ST depression was upslopping and you are otherwise asymptomatic.
b. it may indicate silent ischemia if you are a diabetic, had undue shortness of breath during TMT and ST response was downslopping.
i advise you to consult your cardiologist for further clarifications. he may advise you to undergo stress-imaging study (stress ECHO) or may choose to stop work-up depending upon the scenario.
warm regards
sincerely
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Had TMT Test That Said Mildly Positive For Reversible Ischaemia, No Classical Angina. Meaning?

Hello Ma m welcome to healthcaremagic. your TMT shows you have good exercise capacity for your age (calculated to be ~59 years, from the data given above) and you were asymptomatic during the test. this itself portends that likelihood of a significant obstruction in your coronary arteries (blood vessels supplying heart) is low. however in view of ST depression more than 1mm in during stress test it has been given mildly positive. the possibilities could be a. it is a false positive response especially if the shape of ST depression was upslopping and you are otherwise asymptomatic. b. it may indicate silent ischemia if you are a diabetic, had undue shortness of breath during TMT and ST response was downslopping. i advise you to consult your cardiologist for further clarifications. he may advise you to undergo stress-imaging study (stress ECHO) or may choose to stop work-up depending upon the scenario. warm regards sincerely