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37 years old. Overweight. Suggested angiography after positive TMT test. What to do?

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Cardiologist, Interventional
Practicing since : 1996
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I am 37 years male and weight is 93 kgs. Height is 165cm.
I went through TMT test in October which was positive and suggested angiography.
I consulted a couple of doctors who suggested to start regular walk, reduce Salt intake and keep a check on diet. Want to reconfirm the path.
Posted Sat, 2 Mar 2013 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 6 hours later
Thank you for the query.

I understand that you are 37 years old, overweight and found to be TMT positive without diabetes or hypertension.

TMT is a stress test of the heart. A positive test indicates that the heart muscle is not getting adequate blood supply during times of increased demand. The reasons include blockages of the coronary arteries that supply blood to the heart muscle, abnormalities of the microcirculation, changes in the heart muscle, anemia and other blood disorders, etc.

Ideally, coronary angiography is done when the TMT is positive to identify blockages. This is the commonest cause and the most significant one because these can be corrected with appropriate intervention. Other causes are usually managed with medicines.

It is also important to analyse the changes seen in the TMT. The type, degree and severity of changes and the time taken for the changes to come back to baseline are important.

Also, the risk profile like smoking, family history of heart disease etc should be considered. If there are additional risk factors, it would be better to do the angiogram.

There is also the option of doing a more specific test like dobutamine stress echo or a stress nuclear imaging study. Also, a noninvasive CT angiogram may be done to clarify things.

I hope this answers your query. Feel free to ask me for any further clarifications.


DR RS Varma
Interventional cardiologist
Above answer was peer-reviewed by
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