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Slight chest pain. Test showed mild positive induced reversible ischemia. What does this mean?

DOCTOR OF THE MONTH - Jan 2013
Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
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I have 50 years old. Had slight pain on chest. Could be gas. I have done yeasterday TMT and the Final Impression says: XXXXXXX Duration of Execrcise = 10 min 06 sec. METS = 13. Horozontal ST segment depression during peak exercise. No chest discomfort. Ninety seven percent of maximum heart rate achieved. TEST IS MILDLY POSITIVE FOR REVERSIBLE INDUCUBLE ISCHAEMIA" What does that mean?
Mon, 21 Jan 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. Mayank Bhargava 59 minutes later
Hi XXXXXXX,
Welcome to XXXXXXX forum.

Your tread meal test (TMT) tests was performed as you have slight chest pain.
Presence of heart symptoms along with age confirms the utility of TMT.
TMT is considered positive when 85% of maximum heart rate achieved. You have achieved 97% indicating valid TMT.

TMT is considered positive when ST segment shows downward slopping during peak exercise.
As yo have achieved adequate METS without any chest discomfort and horizontal ST segment depression signifies mildly positive TMT.
Downward slopping indicates decreased blood supply (Ischemia) and its occurrence during peak exercise indicates obstruction in coronary arteries.

You should consult with XXXXXXX medicine specialist/ cardiologist and should go for coronary angiography for better clarification of your heart arteries.
TMT is just tracing of heart activity during brisk exercise and exact position is cleared only after coronary angiography.
Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
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