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What Does This TMT Report Indicate?

Posted on Thu, 15 Dec 2016

Question: Hi,

My TMT report says as below;
" CSA is POSITIVE for Inducible Myocardial Ischemia at 11.7 Work Load and 88% of MHRR. would you kindly let me know what does it mean??

Answered by Dr. Prof. Kunal Saha (2 hours later)

Brief Answer:
Consider it acceptable.

Detailed Answer:
Thanks for asking on healthcaremagic.

I have gone through your query and have checked the attached report. The report indicates a good tolerance (this is good) although there is some inadequacy in the cardiac blood flow after a good amount of effort. I would consider this normal. Unless you are having episodes of severe chest pain every now and then, the mainstay of management would be regular morning walk. Morning walk in gradually progressive amounts (you walk for a certain distance till you get exhausted, walk the same distance for next few days, then slightly increase it, stick to it for some time, extend it again as per your tolerance, stick to it for some time, extend it again). This causes physiological conditioning of your heart and improves the blood flow to the heart by opening collaterals.

Let me know if I could help further.

Regards

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

Follow up: Dr. Prof. Kunal Saha (18 minutes later)

Thank you very much sir, bit worried after seeing the report now got relief with your kind explanation. currently i'm doing morning walk foe 1hr (6km) But ofcourse it is not daily. Whenever i get a chance use to walk. Monthly around 15days. Do i need to undergo angiogram or MRC??

Answered by Dr. Prof. Kunal Saha (25 minutes later)

Brief Answer:
Lifestyle modification is primary.

Detailed Answer:
Thanks for writing back. Try to walk daily in the morning. If you do not have intermittent chest pain you need not go for an angiogram or MRC.

Regards

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

Follow up: Dr. Prof. Kunal Saha (14 hours later)

Thanks sir, have one more question.
Cholesterol - Serum/Plasma shows 202mg/dL. I believe this is high and need some medication. Do you suggest any medicenes for control this cholesteral.

Answered by Dr. Prof. Kunal Saha (4 minutes later)

Brief Answer:
Statins can be considered necessary in case of family history of heart dis

Detailed Answer:
Thanks for writing back.

The cholesterol level is indeed high and needs to be controlled. A detailed lipid profile report would be more helpful. Could you please upload it? Medicines like atorvastatin or rosuvastatin help in reducing cholesterol levels. Fenofibrate might need to be added if the triglyceride levels are high as well. Family history is also very important.

Do not forget the morning walk.

Regards

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

Follow up: Dr. Prof. Kunal Saha (48 minutes later)

Kindly find the attached reports.
And my father had Bypass 7yrs ago (around 68yrs of his age).
Yes i'll not skip morning walk now onwards.

Looking forward your kind guidance sir.

Thanks & Regards,
XXXX XXXXXXX

Answered by Dr. Prof. Kunal Saha (5 hours later)

Brief Answer:
No need to worry.

Detailed Answer:
Thanks for writing back. I have gone through the attache report. If I had a patient like you I would have advised him to take rosuvastatin or atorvastatin once daily on regular basis. Please discuss with your treating physician about it.

I would not insist you to worry about cardiac bypass. Regular morning walk should help. It is only if you have frequent episodes of chest pain that you should go for further workup, and not otherwise.

Regards

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

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