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Dr. Andrew Rynne

Family Physician

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Suggest treatment for myocardial ischaemia

Answered by
Dr. Sukhvinder Singh


Practicing since :1998

Answered : 1306 Questions

Posted on Tue, 19 Aug 2014 in Hypertension and Heart Disease
Question: I have undergone a routine complete health check up. while all tests are fine, my TMT test shows positive for inducible myocardial ischaemia. The report says: Good effort tolerance, normal HR and BP response, No Angina, ST-T changes mainly in lateral leads at peak exercise.Estd work load was 10.3 mets, maximum HR achieved 162bpm (87% of THR).

Lipid profile:
S Cholesterol (oxidase method) 118mg/dl; S Triglyceride(GPO-PAP) is 55mg/dl; S VLDL is 11 mg/dl; S HDL Cholestrol(direct method) is 29.7 mg/dl; S LDL is 77.3 mg/dl; Ratio Cholestrol/HDL is 4 and ratio od LDL/HDL is 2.6

Please advise if it is serious or could be a false positive. there is no history of heart diseases in my family. My blood pressure, sugar, liver, kidney, thyroid, urine tests are all fine.
Answered by Dr. Sukhvinder Singh 6 hours later
Brief Answer:
please see below.

Detailed Answer:
Dear sir
1. If you can upload the ecgs of tmt , it would be great. I will be able to throw more light on issue .
2. If you had no chest discomfort or undue shortness of breath during the test, then with good exercise capacity, chances of test being false positive increase but can not be presumed so. In such a case we advise imaging based stress test like stress ECHO or stress thallium to our patients. These tests are helpful in filtering out false positive tmt tests.
Hope that helps.
Feel free to discuss further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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