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What Do You Mean By Test Is Positive For Inducible Ischemia And What Are The Findings From The Cholesterol Report?

Posted on Fri, 27 Dec 2013

Question: Dear doctor, my father 65 years age undergone executive health check up in a corporate hospital, BIOCHEMISTRY REPORT : CHOLESTEROL-SERUM/PLASMA -211, HDL CHOLESTEROL - SERUM / PLASMA - 50, TOTAL CHOLESTEROL / HDL CHOLESTEROL RATIO - 4.2, TRIGLYCERIDES - SERUM - 146, LDL CHOLESTEROL - SERUM / PLASMA - 132, TMT Test Report - The patient exercised according to the XXXXXXX for 5.04 mins, achieving a work level of XXXXXXX METS: 7.00 resting heart rate of 61 bpm XXXXXXX to a maximal heart rate of 142 bpm. The value represented 91% of the maximal, age-predicted heart rate. The resting blood pressure of 120/80 mm Hg, XXXXXXX to a maximum blood pressure of 200/90 mmHg. The exercise test was stopped due to Fatigue / SOB. CONCLUSIONS: 1) SYSTOLIC HIGH BP RESPONSE 2) NO CHEST PAIN / ARRHYTHMIA 3) AVERAGE EFFORT TOLERANCE 4)TEST IS POSITIVE FOR INDUCIBLE ISCHAEMIA. Based on the above reports 1) What do it mean, test is positive for inducible ischaemia 2) What should be my next step ?

Answered by Dr. Sudhir Kumar (41 minutes later)

Brief Answer: Thank you for posting your query. Detailed Answer: I have gone through the reports posted by you regarding your father. The cholesterol values are marginally high, for which diet control and exercise is needed. If values remain high even after three months, then, medications may be required to lower the cholesterol. Regarding the positive tread mill test (TMT), your father needs to be evaluated for coronary artery disease (CAD). This can be done by doing either CT coronary angiogram or catheter angiogram. You can discuss this with your cardiologist. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/

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

Follow up: Dr. Sudhir Kumar (33 hours later)

Thanks doctor for your valuable suggestions and advise, sending TMT report and final impression given by doctor. 1) It will be helpful ,if you can explain TMT report , in which page, where we can see TMT IS POSITIVE INDUCIBLE ISCHEMIA. 2) If you were in that place, what would be your final impression report. 3) What would you have suggested to patient , in written. Regards, XXXXXXX

Answered by Dr. Sudhir Kumar (7 hours later)

Brief Answer: Thank you for getting back. Detailed Answer: Hi Mr XXXXXXX Thank you for asking more queries. My replies are below: 1. TMT positive means that the blood supply to heart is lesser than normal, and there is a risk of getting heart attack in the future. 2. I would agree with the report. 3. I would like to confirm the diagnosis, and find out which blood vessels of heart are affected. This can be done by doing either CT scan or catheter coronary angiogram. Based on the findings, we would decide whether the patient needs medical treatment, stenting or bypass surgery. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (11 hours later)

Thanks doctor for your suggestions and advice. 1) As you said, i agree with report means does it mean TMT report shows problem in heart? 2) You said take CT scan or angiogram , it should be done immediately or can i take some time. 3) Checkup , Doctor atleast not suggesting patient to CT scan or Consult cardiologist, in written or oral.How far this is correct. 4)TMT report shows positive and doctor report says TMT Negative. Doctor please do answer , to be fair not keeping other doctor or medical system in mind. Regards, XXXXXXX

Answered by Dr. Sudhir Kumar (19 minutes later)

Brief Answer: Thank you for getting back. Detailed Answer: My answers are below. 1. Yes, TMT report shows that blood flow to heart is less. 2. It should be done as early as possible. 3. If I was your doctor, I would suggest to consult cardiologist and get CT or catheter angiogram done. 4. TMT report is positive. Best wishes, Dr Sudhir Kumar MD DM

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