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Mild hypertension, not diabetic, TMT positive with reversible ischemia, cholesterol good, ECG normal

I am 47 years old male. I am suffering from mild hypertension since 10 years but is not diabetic. My chlorestrol results are very good, my ECG was normal. My TMT reult showed positive with reversible ischemia . Please suggest.
Asked On : Fri, 23 Mar 2012
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Cardiologist 's  Response
Hi Mr Roy,

The TMT can be false positive meaning thereby it can occur in about 20% patients with normal coronaries. Therefore, in one out of five it does not exclude coronary artery heart disease. If I were you, I would want something which is 100% specific and that is coronary angiography. The other slightly less invasive test which gives almost as accurate result - there is concern of side effects of radiation though- is CT angiogram. One can not do a TMT and stop investigating if it is positive and you being 47 year old would like to be treated for coronary artery heart disease if it is there and would not want unnecessary medications if it is not there. Stress Thallium will add 5-10% more thus combined being about 90% specific to make a positive diagnosis and if the later is negative then we are back to about 80% specific for excluding coronary artery disease in presence of positive TMT.

With Best Wishes

Dr Anil Grover, MD (Medicine) DM(Cardiology)
Answered: Thu, 24 May 2012
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