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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suffering From Diabetes And BP. Pain In Heart. TMT Tested Positive For Inducible Ischemia. What's Wrong?

Few days back My Dad has got pain in his heart ,, he consulted 2 d doctor,, He went through few test & TMT result was positive for inducible ischemia . He is a Diabetic Person & he has BP also. Now Doctor is saying to do ECG test. Actuly, I wanna knw wts d matter???? What exactly has happen to him.. Plz Ans my question Doctor.
Wed, 28 Aug 2013
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Ayurveda Specialist 's  Response
Hello Nihangel and thanks for writing in at HCM
I am a jr. to cardiologist in India. You have given a short history but enough to get to a diagnosis of CAD (Coronary heart disease) or IHD (Ischemic Heart Disease). As your father got chest pain(you have mentioned heart pain), Treadmill Test (TMT) positive for inducible Ischemia and he is hypertensive and diabetic, male, age likely to be above 40, we don't know about his lipid profile and family history of heart disease, there are many risk factors which ensure us to get investigated for CAD or IHD.
My advice to you is to consult your cardiologist ASAP and get your ECG and Coronary Angiography done. CART (Coronary Angiography) is 100% surety test for Coronary heart disease.
There is 33% chance that your coronaries are normal and needs treatment for Hypertension and Diabetes and Dyslipidemia (if present)
33% chance the there is lesions in the artery which are treated by medication only and some life style changes.
33% chance are that the lesions are such type that they requires Coronary Angioplasty (PTCA + stent implantation) or CABG (Coronary Artery Byepass Graft Surgery)
So All the further treatment is depends on Coronary angiography, get it done by a qualified DM Cardiology doctor as soon as possible. So that you may not reach to a extent of Heart attack or Myocardial Infraction.
After TMT, ECG is only the formality, if your stress test is positive than go for CART.
Step by step diagnosis procedure for CAD is First ECG, than Echocardiography or TMT and than CART.
By the time you get consultation with your cardiologist, Keep tablet Sorbitrate 5mg and Tab. Ecosprin 150 mg in your pocket. If you get chest pain, breathlessness or Ghabrahat, chest discomfort than take the tablets and rush to ER ASAP. Please note that Cheat pain in heart attack may be absent in diabetic patient.
Best Wishes
Dr. Dinesh Kumar Bhatia
Health Care Magic
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Diabetologist Dr. Pratap VGM's  Response
Dear sir/madam

Actually if TMT is positive for inducible ischemia, then it indicates there may be some stenosis in the coronary arteries. Usually resting ECG will be normal.
If the patient has incomplete stenosis in the coronary arteries better you proceed with the angiogram and start antiplatelet and statins

Thanks
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Suffering From Diabetes And BP. Pain In Heart. TMT Tested Positive For Inducible Ischemia. What's Wrong?

Hello Nihangel and thanks for writing in at HCM I am a jr. to cardiologist in India. You have given a short history but enough to get to a diagnosis of CAD (Coronary heart disease) or IHD (Ischemic Heart Disease). As your father got chest pain(you have mentioned heart pain), Treadmill Test (TMT) positive for inducible Ischemia and he is hypertensive and diabetic, male, age likely to be above 40, we don t know about his lipid profile and family history of heart disease, there are many risk factors which ensure us to get investigated for CAD or IHD. My advice to you is to consult your cardiologist ASAP and get your ECG and Coronary Angiography done. CART (Coronary Angiography) is 100% surety test for Coronary heart disease. There is 33% chance that your coronaries are normal and needs treatment for Hypertension and Diabetes and Dyslipidemia (if present) 33% chance the there is lesions in the artery which are treated by medication only and some life style changes. 33% chance are that the lesions are such type that they requires Coronary Angioplasty (PTCA + stent implantation) or CABG (Coronary Artery Byepass Graft Surgery) So All the further treatment is depends on Coronary angiography, get it done by a qualified DM Cardiology doctor as soon as possible. So that you may not reach to a extent of Heart attack or Myocardial Infraction. After TMT, ECG is only the formality, if your stress test is positive than go for CART. Step by step diagnosis procedure for CAD is First ECG, than Echocardiography or TMT and than CART. By the time you get consultation with your cardiologist, Keep tablet Sorbitrate 5mg and Tab. Ecosprin 150 mg in your pocket. If you get chest pain, breathlessness or Ghabrahat, chest discomfort than take the tablets and rush to ER ASAP. Please note that Cheat pain in heart attack may be absent in diabetic patient. Best Wishes Dr. Dinesh Kumar Bhatia Health Care Magic