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TMT test shows mildly positive inducible ishemia. Next treatment step?

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Practicing since : 1998
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My recent TMT Test report shows Mildly positive for inducible ischemia. What is the next step?
Posted Thu, 13 Jun 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 20 minutes later
Dear Sir
Can you provide me a few details?
1. How much you were able to walk on treadmill (duration)?
2. What were your symptoms on treadmill and how severe they were (breathlessness/ chest discomfort/ chest pain) ?
3. Why was the test done? (What was the problem?)
Please answer these questions so that I can discuss in detail.
Sukhvinder Singh
Above answer was peer-reviewed by
Follow-up: TMT test shows mildly positive inducible ishemia. Next treatment step? 48 minutes later
Dear Sir,

Answer for your question

1.      Normally every day I walk for 15 to 20 minutes at my residence by Treadmill with speed rating of 5
2.      No symptoms.
3.     TMT test done along with other Medical test for New Insurance Policy

Answered by Dr. Sukhvinder Singh 41 minutes later

1. I have seen your reports and TMT and I am not able to decipher that why your exercise was stopped at 5 minutes? If you did not have any symptoms on treadmill, it should have been done for ~8 minutes and 30 seconds (the excellent exercise capacity for you) unless there were marked changes in your ECG.

2. If you did not have any trouble in doing the test but your ECG graph (TMT) has been reported to be positive, next step is to get a Stress ECHO or stress thallium done. Please get it done in the presence of a cardiologist rather than a physician, so that no technical glitches are there.

3. Please discuss the reports with your cardiologist in light of above facts and proceed accordingly. Stress ECHO is relatively cheaper, will tell about structure of heart too and has almost equal accuracy as that of a thallium. A stress thallium is preferred if there is problem with acoustic windows.

Hope this clarifies the issue. Feel free to write if there is anything else.
Above answer was peer-reviewed by
Follow-up: TMT test shows mildly positive inducible ishemia. Next treatment step? 1 hour later
Dear Sir,

TMT test stopped as per Lab time not in view of symptoms or change in my ECG. However just now I have consulted Cardiologist and Dr. said everything is normal do not get panic and forget the reports and do your routine work. Further Dr. instructed for every day compulsorily walking for 45 minutes and maintain the diet as per the his instruction.

Kindly send your opinion on my reports


Answered by Dr. Sukhvinder Singh 16 minutes later

Rest of the reports are fine. A final comment on TMT (Treadmill Test ) is feasible only after seeing all the graphs. Since your cardiologist is assuring you, it may not be a significant change, however you should have been made to walk for more time on TMT.

I agree with your cardiologist that you must walk and if there is in any problem in walking please consult him.

Above answer was peer-reviewed by
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