Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

188 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Reports show positive for inducible ischaemia. What does this mean? What should be the next step?

Answered by
Dr.
Dr. Pratap VGM

Diabetologist

Practicing since :2006

Answered : 869 Questions

default
Posted on Fri, 13 Dec 2013 in Hypertension and Heart Disease
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 ? Regards, XXXXXXX
doctor
Answered by Dr. Pratap VGM 1 hour later
Brief Answer: Suspected blockage in coronary arteries Detailed Answer: Dear Query reviewed, blood investigations appearing normal. Treadmill test positive for inducible ischemia with high systolic blood pressure, let me explain to you. In normal resting state circulation to heart will be normal due to low oxygen demand, which means less circulation. Heart muscles are supplied by coronary arteries but when even there is more exercise and physical activity there is increased demand of oxygen by heart muscles, so there will be increased circulation.. If there is blockage in the coronary artery circulation then during resting state there will be normal blood flow. But whenever there is increased load there will be decreased blood flow to the cardiac muscles. It will be reflected as inducible ischemia. The followin steps are very important 1. Strictly control your blood pressure, try to add a beta blocker group of drug after consulting your doctor 2. Advised to do coronary artery angiogram to know the position and degree of blockage. 3. Antiplatelet therapy consideration after reviewing with your doctor Proceed with the tests without hesitation Thanks
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
default
Follow up: Dr. Pratap VGM 3 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
doctor
Answered by Dr. Pratap VGM 1 hour later
Brief Answer: Antiplatelet and dual antihypertensive drug therap Detailed Answer: Dear XXXXXXX I reviewed your query The main problem is high blood pressure.. he is been advised to take repace 50 mg, but I don’t think it would be enough.. You need to add one more drug for better control.. Consult your doctor and ask him about starting betablocker ideally metaprolol, which has beneficial effects on heart. Secondly its recommended for your father to start antiplatelet therapy, like clopidegril and aspirin.. so speak to your doctor once.. Corronary angiogram is usually recommended but it is left to the discretion of treating doctor, consulting cardiologist and patient affordability to undergo the test, but its recommended.. Patient has little high post prandial sugars, recommended to do glycated hemoglobin testing once. Thanks
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,  
Medical Topics ,   ,  

Recent questions on  High blood pressure

doctor1 MD

i have high blood pressure and i have taken my medicine. i have a bump on the side of my head. it havent got big or anything. and my doctor told me to not bother it if it is not bothering me. well it is starting to bother me a little. and the side of my head by my ear keeps jumping and like numbness go towards my teeth. what that might be

doctor1 MD

Dr. Oz, I know you're show is geared mostly towards women but I really am in dyer need of help. I'm a 22 year old male and I'm currently taking two 20mg instant release Adderalls a day. My blood pressure is normal on a daily basis, but high blood pressure and heart disease does run in my family. My concern is in regards to Erectile Disfunction. It is a real self confidence killer! My penis doesn't get fully erect when I'm about to have sex, its hard but not where it can stay up the air hard..excuse the reference. Also some other times it will get hard, but it will not stay that way for long amounts of time. Does anyone know why this could be? I also have trouble staying hard. For example if it slips out, there is a switch of positions,or the slightest distraction, it wont remain hard. I take adderall but don't notice a difference in this when I take it and when I don't. I exercise regularly (4-5x a week) and eat relatively healthy(for a college student). I am stressed a lot and i know that could be a cause of my problems. but does anyone have any ideas? Also is it to early for someone my age (22) to take pills such as viagra or cialis? What are the long term side effects?

doctor1 MD

i TAKE WARFARIN FOR AN ARTIFICAL HEART VALVE I HAVE HAD FOR 20 YEARS. i AM WANTING TO TAKE A PILL THAT HAS POMEGRANATE, ACAI BERRY, GREEN TEA, GOJI BERRY AND RESVERATROL IN IT TO HELP LOSE WEIGHT. THE BERRIES HAVE HAVE AN ANTIOXADENT ORAC RATING OF 8687 THE HIGHEST O OF ANY FOOD AND 12.6 TIMES THE ANTIOXIDANT RATING OF ACAI BERRIES. IT IS CALLED mAQUI-6. IT IS JUST A BALANCE OF 1 PILL AT MEAL TIME AND I WOULD REALLY LIKE TO TRY IT. IT IS A SLOW WEIGHT LOSE PROGRAM WITH WALKING A NO MORE THAN 2 LBS A WEEK OR LESS. I KNOW ALOT OF THESE DON'T WORK OR ARE NOT GOOD FOR YOU BUT NEITHER IS 35 LBS OVER WEIGHT WITH HEART DISEASE. I HAVE TRIED WEIGHT WATCHERS AND LA WEIGHT LOSS. I AM AMOST 60 AND DO NOT HAVE HIGH BLOOD PRESSURE. I TAKE 2 MG. COUNEDAN AND LIPITOR.. I WOULD APPRECIATE YOUR IN PUT.

doctor1 MD

Dear Dr.



I'm from Sri Lanka. My mother is 68+ & having PKD. It was found in 79' and was under medication for High Blood Pressure since 85'. She started hemo-dialysing April/09 once a month and at present doing dialysis once a week. But she is continously having disnia. What can be the reason behind it ? What can we do about it ? Is this her final stages ?

                                   

                                                                 

doctor1 MD

Hi Doctor, I have started taking Losar 50 since last 5 days for Blood Pressure. Is it a very strong medicine or is it normal one to take since I have started having high blood pressure only recently. And shd i continue it life long or shd I stop...

doctor1 MD

I am sick and shaking my right foot is numb and chest hurts vomiting feeling overwhelmed and about to black out scared. I wake up with panick attacks. My blood pressure is 151 over 94 before it was 184 over 100 taking the blood pressure medicine....

doctor1 MD

Hello Doctor, I don't feel good. Feel a little bit dizzy, What's wrong with me? What can I do? XXXX