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Hi My TMT report says mildly positive for excercise induced

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Posted on Thu, 28 Mar 2019
Question: Hi
My TMT report says mildly positive for excercise induced myocardial ischemia.
During peak exercise ecg showed horizontal st t depression upto 2mm in lead II, III, AVF, v4-6, normalising within 15 sec of recovery.
Echo- normal. Just diastolic relaxation abnormality present
My vitals-
LDL- 101, HDL-33, triglycerides-139, total-157
No diabetics, no high blood pressure
Weight-54 kg
Height -165 cms
Age-37
Non-smokers, no alcohol and no family history of early heart disease.
Live a sedentary life style

Symptoms- mild shoulder or chest or upper abdomen pin pointing spasms like pain on excersion that relives at rest. Breathing issues even at rest sometimes.
And yes i do suffer from anxiety

Question
1- what are the chances of CAD?
2- can low grade fever and cold just 2 days before influence, tmt changes?
3- do I really need ct angio?
doctor
Answered by Dr. Bhanu Partap (36 minutes later)
Brief Answer:
Please refer to the detailed answer below

Detailed Answer:
Hello

After going through the medical details and the medical reports attached by you I can understand your concern for your health and I would like to tell you that

1. A positive TMT carries a significant chances of having an underlying coronary artery disease.

2. No it doesn’t cause these ecg changes.

3. YES it’s highly advisable that you should get this evaluated further by getting an Angiography done as advised by your treating doctor, as you are quite young and if any underlying cad is left unattended there are high chances of getting the quality of life deteriorated.

Hope to have been helpful.

Kind Regards
Dr Bhanu partap
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Bhanu Partap (18 minutes later)
Hi
What are the chances of this being false positive? My echo is normal and have no other risk factors too.
I had stress test in 2017 which was negative. Is it possible for CAD to happen so early?
doctor
Answered by Dr. Bhanu Partap (54 minutes later)
Brief Answer:
Hello Again

Detailed Answer:
Chances of having a false positive TMT is around 20% and in your case the chances of having false positive results are even more as if we see your stress echo report it’s saying stress echo negative for inducible ischemia.

Significant CAD happening over a period of one year is highly unlikely but insignificant CAD which was present before can progress to a significant stage in this period of time.

Kind Regards
Dr Bhanu Partap



Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
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Dr. Bhanu Partap

Cardiologist

Practicing since :2010

Answered : 1628 Questions

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Hi My TMT report says mildly positive for excercise induced

Brief Answer: Please refer to the detailed answer below Detailed Answer: Hello After going through the medical details and the medical reports attached by you I can understand your concern for your health and I would like to tell you that 1. A positive TMT carries a significant chances of having an underlying coronary artery disease. 2. No it doesn’t cause these ecg changes. 3. YES it’s highly advisable that you should get this evaluated further by getting an Angiography done as advised by your treating doctor, as you are quite young and if any underlying cad is left unattended there are high chances of getting the quality of life deteriorated. Hope to have been helpful. Kind Regards Dr Bhanu partap