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What Causes Positive TMT Test Result Indicate?

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Posted on Sat, 21 Feb 2015
Question: i went for a TMT test for obtaining an insurance policy term plan. MY ECG was perfectly OK. but my TMT test was turned out as positive. I am 49 years old man. what precaution should I take
doctor
Answered by Dr. Devendra Kumar Tripathi (57 minutes later)
Brief Answer:
You have to take complete treatment for IHD .

Detailed Answer:
Dear I can understand your concern .

I would like to inform you that if you have positive TMT test then it is suggestive of underlying obstruction in your heart vessels . We do this test when we think of some ischemic heart disease but the symptoms are equivocal that is not very specific.

If it is positive then diagnosis of coronary heart disease should be made and you have to follow certain life style modifications and take few drugs as well that will prevent further progression of disease process .

I would like to mention about life style modifications such as
1.salt and saturated fat restricted diet .
2.diet rich in fruits and vegetables are good for you.
3.regular 30 minutes brisk walk if you can do without any chest discomfort .
4.maintain your BMI less than 25
5.stop smoking
6.drink alcohol, if any, in moderation or you can stop that too.

Apart from this certain medicines are must to be taken that will include beta blocker and anti platelet and drugs for lipid control. For that you discus with your physician and get proper advice .

Hope this will help you . If you have any other concerns please feel free to message me . Thanks for contacting HCM .


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Devendra Kumar Tripathi (6 days later)
Thanks for answering my query.

I met a cardiac physician in my city, who is a very reputed doctor and I narrated the facts which i mentioned in my previous query.
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He suggested me to again go for a TMT test and an echo test also. This time also TMT test result was positive but echo test was perfectly ok. He recommended for angio graphy. He told that this test will clear the level of blockage as well as further course of treatment. He also prescribed my following medicines for 2 weeks.
a) ecosprin 75 after breakfast and b) Metolar XR -25 after lunch.
1) I don't find any symptoms of heart problem. I can walk briskly for 3-4 kilometers without any fatigue or pain.
2) By nature I avoid oily foods. I am a strict vegetation. I have neither smoked nor consumed any alcoholic drinks so far.
3) I never went for morning walk, which I started immediately after knowing about this problem.
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Now my questions are:
1) During TMT, after some time, the assistants told me to stop jogging, but I was perfectly right, I did not feel any fatigue or pain.
1-A) Is angio gram the only way to know the position of blocks in heart?
2) Can I take chance that after taking medicines for some time, again I should go for TMT test?
3) How much will be the side effect of angio gram on my body. Shall I be able to lead a normal life.
4) Some of my friends told that during angio graphy itself doctors suggest for angio plastry, and after that it will be difficult to recover.
5) If I upload my TMT and Echo report, will u give me your advise.

doctor
Answered by Dr. Devendra Kumar Tripathi (1 hour later)
Brief Answer:
TMT suggestive of some blockade.

Detailed Answer:
Dear,

I can understand your concern.

I would like to inform you that TMT can be stopped if you develop any chest discomfort or shortness of breath or if there is any ECG changes suggestive of decreased oxygen supply to any part of heart. The positive TMT means that you have developed such changes during test.

Yes, angiography is the only definite way to look for any blocked artery and it's exact site.
I don't think there is any need for repeated TMT. Angiography is the next investigation that should be done and proper medicine should be taken.

As such there is no side effects of angiography on your body. There is no need to panic. It's very safe procedure. You will be absolutely all right after that. There is no long term harmful effects of this.

There are definite indication for angioplasty. This is not done in every case. This will depend on severity of blockade of your artery. Your cardiologist will explain you everything. He will do anything after your complete understanding of procedure and need for procedure and with your consent.

Hope this will help you. If you have any other concerns please feel free to message me. Thanks for contacting HCM.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Devendra Kumar Tripathi (15 hours later)
Thanks for your reply,
this gives me confidence.
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What is the meaning of blockade. Can blockade in artery can be removed with the help of medicines?
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Why doctor has prescribed me Ecosprin 75 and Metolar- XR 25? (what are the roles of these medicines.)
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If I upload my TMT and ECHO report, can u advise me after after viewing these reports.
doctor
Answered by Dr. Devendra Kumar Tripathi (11 hours later)
Brief Answer:
Take these medicines and upload your reports .

Detailed Answer:
Dear ,
I can understand your concern .
I would like to inform you that blockade means there is some obstruction or simply we can say clot in artery. And because of this obstruction there is decreased blood supply to part of heart supplied by that artery .
Ecosprin is a antiplatelet drug. Platelets are main factor in causing obstruction so this drug will help in dissolving that clot and this will stop progression of that obstruction and prevent new clot or obstruction formation . So these are to be used in every patients .
Metolar decreases heart rate and thus helps in reducing heart work. So are beneficial in your case.
Please upload your reports , I will message you after reading that.
Hope this will help you . If you have any other concerns please feel free to message me . Thanks for contacting HCM .
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Devendra Kumar Tripathi (3 days later)
Thanks doctor,
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i have already uploaded my TMT report and ECO report. I request you to please peruse the same and advise me.
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Meanwhile after meeting doctor on 22.01.2015, i daily get up at 5.00 am in the morning and doing brisk walking for 45 minutes. I only take green tea now. after breakfast in morning i am taking Ecosprin 75 and after lunch in office i am taking Metolar XR 25. I am not taking any oily food. Can i go for Angiography after completing the course of these medicins for two weeks.
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I am staying in Trivendrum. Which hospital or doctor is best in Trivendrum or XXXXXXX where I can go for angiography.
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Thanks & Regards




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doctor
Answered by Dr. Devendra Kumar Tripathi (2 hours later)
Brief Answer:
You need angiography.

Detailed Answer:
Dear,

I can understand your concern.

On the basis of these investigations, I would like to emphasise that you need angiography and further management.

Please continue medicines that you are taking. I practise in UP, so would be difficult to suggest you a good doctor in the mentioned locations. I feel you can consult Cardiology department in any good hospitals in the area like Fortis, Apollo.

Thanks for contacting HCM.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Devendra Kumar Tripathi (5 hours later)
Thanks Sir,

As per your advises I will continue these medicines. I can come to UP for treatment, because before coming to Trivendrum I was in UP for last 40 years, and till September 2014 I was in XXXXXXX

I only want to know that due to some problem(not financial), I am not in a position to undergo angiography immediately. How much time I can continue with existing medicines. Should I continue my brisk walking every morning for 40 minutes, or I have to take some precaution. Any particular food items or restricted for me at this stage?

I once again thank you for clearing my doubts.

With Regards
doctor
Answered by Dr. Devendra Kumar Tripathi (10 minutes later)
Brief Answer:
Follow lifestyle modifications and take medicines

Detailed Answer:
Dear
I can understand your concern .
I would like to inform you that there is no immediate need of angiography. You follow the life style modifications as we have discussed in our previous answers .
You continue your exercise, if you don't feel any discomfort or pain.
You have to take these medicines continuously . If you develop any symptoms suggestive of functional limitations because of decreased blood supply to heart then we can add few more medicines. If your symptoms are not controlled on these medicines, then this will be an absolute indication for angiography without delay. As you have mentioned you don't have any symptoms at present, you don't need an angiography on emergency basis. You just follow lifestyle modifications and take regular treatment.

Hope this will help you .
Thanks for contacting HCM .
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Devendra Kumar Tripathi

Internal Medicine Specialist

Practicing since :2008

Answered : 275 Questions

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What Causes Positive TMT Test Result Indicate?

Brief Answer: You have to take complete treatment for IHD . Detailed Answer: Dear I can understand your concern . I would like to inform you that if you have positive TMT test then it is suggestive of underlying obstruction in your heart vessels . We do this test when we think of some ischemic heart disease but the symptoms are equivocal that is not very specific. If it is positive then diagnosis of coronary heart disease should be made and you have to follow certain life style modifications and take few drugs as well that will prevent further progression of disease process . I would like to mention about life style modifications such as 1.salt and saturated fat restricted diet . 2.diet rich in fruits and vegetables are good for you. 3.regular 30 minutes brisk walk if you can do without any chest discomfort . 4.maintain your BMI less than 25 5.stop smoking 6.drink alcohol, if any, in moderation or you can stop that too. Apart from this certain medicines are must to be taken that will include beta blocker and anti platelet and drugs for lipid control. For that you discus with your physician and get proper advice . Hope this will help you . If you have any other concerns please feel free to message me . Thanks for contacting HCM .