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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For A Heart Disease

Hi Respected doctor, My sister in law is 62 years and general medical specialist referred her to cardiologist for stress thalliumtest/debulleaine plus minusCA-RP. She is diabetic for the last 22 years.
We consulted the cardiologist who after seeing the history and on going treatment first conducted TMT and then advised and carried out angiography, Angiography report is as under
HTN, DMII, CA-DOE, TMT moderately positive(21/03/11) and CAG-Triple VesselDisease(22,03.11)
Past History k/c/o DMII 22 yrs on reglar Medicine ,
HTN since 20 yrs on regular medicine
No H.o RHD/BA.TB/ other chronicillness

angio graphy report as follows
Lmca normal
LAD MID AND DISTA lad-SEVERE CALCIFICATION,LONG TUBULAR 70 PERCENT Stenosis Ds normal
LCX Co Dominent Vessel
OMs-OMI-Diffused Diseased
RCA Dominent Vessel- Mid RCA 75 percent stenosis
PLV/PDA-Normal
LV ANGIO NOT DONE
FINAL DIAGNOSES CAD, Triple Vessel Disease
DMII,TMT POSITIVE (MODERATELY)
RECOMMENDATION Stress Thallium for Inducible Ischemia.


Now we are advised to go in for Thallium Test.
Kindly advise whether Thallium test only as recommended by medical specialist should have been carried out before Angiography or the cardiologist has used his discretion as we are laymen and did not know about thallium test . If thallium test was not available in cardiologists clinic/hospital why he did not refer us to another hospital where Nuclear Science test facility for Thallium test was available. ALso we shall be grateful for the correct advice at this stage to safeguard the interest of the patient ,.REGARDS
Mon, 20 Mar 2017
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Internal Medicine Specialist,  's  Response
After having gone through the reports and the finding of triple vessel disease on coronary angiography, i dont think stress thallium would achieve anything much as far as diagnosis is concerned. It has probably been advised because tmt has come put to be moderately positive instead of being strongly positive which wpuld be expected with the angiography findings.
She mostly needs a coronary artey by pass surgery ( CABG ).
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Suggest Treatment For A Heart Disease

After having gone through the reports and the finding of triple vessel disease on coronary angiography, i dont think stress thallium would achieve anything much as far as diagnosis is concerned. It has probably been advised because tmt has come put to be moderately positive instead of being strongly positive which wpuld be expected with the angiography findings. She mostly needs a coronary artey by pass surgery ( CABG ).