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Had Severe Chest Pain. Report Shows TMT-Borderline Positive For Ischemia. What Should I Do?
Hi Dr. Samuel,
Great to introduce myself with you and would like to seek your advice as well. My name is Hrishikesh Baidya a 46 yr old man currently living in Bangladesh as working as an HR professional in a development organization. 3 weeks ago I had sever chest pain at the left side and got admitted in the cardiac hospital. doctors found 2 spots in ECG with a normal Echo result. LDL 105 mg/dl, HDL 34, TC 172, Triglyceride 198, Fasting blood sugar 109 mg/dl. Then I had started getting medicines since April 28. I had also conducted the ETT (Q-Stress) and the report is as follows: TMT- Borderline positive for ischemia, exercise capacity; good, BP response: good, chronotropic response: good, arrhythmia: none. Right now my specialized physician is out of the country. I consulted with another Cardiac physician who asked me to do the Engeogram. What should I do now. Please recommend. Thank you very much in advance for your advice. Have a great day.
Great to introduce myself with you and would like to seek your advice as well. My name is Hrishikesh Baidya a 46 yr old man currently living in Bangladesh as working as an HR professional in a development organization. 3 weeks ago I had sever chest pain at the left side and got admitted in the cardiac hospital. doctors found 2 spots in ECG with a normal Echo result. LDL 105 mg/dl, HDL 34, TC 172, Triglyceride 198, Fasting blood sugar 109 mg/dl. Then I had started getting medicines since April 28. I had also conducted the ETT (Q-Stress) and the report is as follows: TMT- Borderline positive for ischemia, exercise capacity; good, BP response: good, chronotropic response: good, arrhythmia: none. Right now my specialized physician is out of the country. I consulted with another Cardiac physician who asked me to do the Engeogram. What should I do now. Please recommend. Thank you very much in advance for your advice. Have a great day.
Tue, 28 May 2013
Dear Sir
Thanks for writing to us.
If you could perform TMT with good exercise capacity without any chest pain? If there was no chest pain during TMT test, then borderline positive TMT should not lead to angiogram, rather you should get an imaging based stress test (Stress ECHO or Stress Nuclear MPI scan). Because chances of a borderline TMT to be false positive are high if you did not have any chest pain / undue shortness of breath during TMT and you had good exercise capacity.
I also hope that you did not have a repeat chest pain after the first episode and do not suffer from any chest pain on exertion prior to test.
Feel free to discuss further.
Sincerely
Thanks for writing to us.
If you could perform TMT with good exercise capacity without any chest pain? If there was no chest pain during TMT test, then borderline positive TMT should not lead to angiogram, rather you should get an imaging based stress test (Stress ECHO or Stress Nuclear MPI scan). Because chances of a borderline TMT to be false positive are high if you did not have any chest pain / undue shortness of breath during TMT and you had good exercise capacity.
I also hope that you did not have a repeat chest pain after the first episode and do not suffer from any chest pain on exertion prior to test.
Feel free to discuss further.
Sincerely
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