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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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TMT Report Showed Mildly Positive For Reversible Ischaemia, Good Exercise Tolerance. Explain

Please explain my TMT report:

Patient could exercise for 08 minutes and 20 seconds of the Bruce Protocol and achieved a workload of 10.10 mets. He attained a peak heart rate of 162 beats/minute which is 88% 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 130/80 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 1.9-2.3 mm upsloping significant ST segment changes in leads 2,3aVF and 1.0-1.2 mm upsloping depression in leads V4-V6. Changes reverse within one minute into the recovery period.          
IMPRESSION:     Mildly positive for reversible ischaemia. Good exercise tolerance.
Sat, 1 Jun 2013
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General & Family Physician,  's  Response
Hello,
Thanks for the query to H.C.M. Forum.
As mentioned in TREAD MILL TEST ( TMT) reports you achieved a target normally very well.
Heart beat normal ( 88%)
There was no angina, very good thing.
Cause of concern is blood pressure as it was 130/80 ( only systolic blood pressure increased that too very mild degree).
Failure of the blood pressure to increase with signs of ischemia ( not in your case as there was no angina) during T M T is an important sign, SINCE THIS REFLECT ischemia induced left ventricular dysfunction.
Here I want to tell you that blood pressure not increased up to a peak level ,so thing was not good.
S T depression was there but recovery was within less than one minute, so this was normal, but also an indication of simple ischemia as clearly shows in report of T M T.
Now consult a physician and get in an examination of left ventricle.
Hope I have answered your query.
If further any question I will reply happily.
Good luck.
Dr. HET.
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TMT Report Showed Mildly Positive For Reversible Ischaemia, Good Exercise Tolerance. Explain

Hello, Thanks for the query to H.C.M. Forum. As mentioned in TREAD MILL TEST ( TMT) reports you achieved a target normally very well. Heart beat normal ( 88%) There was no angina, very good thing. Cause of concern is blood pressure as it was 130/80 ( only systolic blood pressure increased that too very mild degree). Failure of the blood pressure to increase with signs of ischemia ( not in your case as there was no angina) during T M T is an important sign, SINCE THIS REFLECT ischemia induced left ventricular dysfunction. Here I want to tell you that blood pressure not increased up to a peak level ,so thing was not good. S T depression was there but recovery was within less than one minute, so this was normal, but also an indication of simple ischemia as clearly shows in report of T M T. Now consult a physician and get in an examination of left ventricle. Hope I have answered your query. If further any question I will reply happily. Good luck. Dr. HET.