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Suggest Treatment For Provocable Myocardial Ischemia

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Posted on Wed, 30 Sep 2015
Question: Hi, in a recent routine check up , my findings in TMT was borderline Provocable myocardial ischemia .
What should I do next ?
doctor
Answered by Dr. Anantharamakrishnan (15 minutes later)
Brief Answer:
need further test...

Detailed Answer:
Hi friend
Welcome to Health Care Magic

You need to be investigated further for Coronary Artery Disease.
     It is an indication for further work up – because it is borderline / at times, there may be false positive or false negatives. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
     If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this.
[CT angio is non-invasive study for the anatomy. If positive, she will need catheterisation, anyway.]

The aim of any investigation is to modify the treatment, based on the result.
Intervention – dilatation with balloon and placing a stent (Angioplasty) - or CABG (Coronary Artery Bypass Graft) may be advised based on the results.

Good luck
God bless you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan (1 hour later)
Do I need to take urgent action or it is not such an emergency. I hv the ECG report also. Should I upload for better assessment ?
doctor
Answered by Dr. Anantharamakrishnan (29 minutes later)
Brief Answer:
Sooner, the safer

Detailed Answer:
Hi

Earlier the better, even though it is not an emergency
Appropriate treatment demands accurate diagnosis / And that demands the investigation
Till then, take aspirin 75 or 100 mg / once a day / after food

There will be an automated report, generated by the machine, that is reviewed by the physician / Reviewing the records may not throw further light, as it is borderline… the physician monitoring the procedure is better placed to judge from the overall picture

Regards
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4505 Questions

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Suggest Treatment For Provocable Myocardial Ischemia

Brief Answer: need further test... Detailed Answer: Hi friend Welcome to Health Care Magic You need to be investigated further for Coronary Artery Disease. It is an indication for further work up – because it is borderline / at times, there may be false positive or false negatives. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this. [CT angio is non-invasive study for the anatomy. If positive, she will need catheterisation, anyway.] The aim of any investigation is to modify the treatment, based on the result. Intervention – dilatation with balloon and placing a stent (Angioplasty) - or CABG (Coronary Artery Bypass Graft) may be advised based on the results. Good luck God bless you