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What Does My Angiography Test Report Indicate?

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Posted on Mon, 7 Dec 2015
Question: Hi

My uncle went under Routine eveluation in 2014 where his tress test was positive. Doctor advised for Angiography which was done & came normal.

Now again in 2015 my uncle undergone though routine health check-up where stress test is again positive.

request you to help me to understand conclusion ;

conclusion is "Asymptomatic positive stress test for ischamia at 12.5 METS"
ADVISE : "CONSIDER FALSE POSITIVE REPORT"

My questions are :
should we consider this report normal or abnormal ?

doctor
Answered by Dr. Anantharamakrishnan (2 hours later)
Brief Answer:
Stress ECG Report not normal ...

Detailed Answer:
Hi friend
Welcome to Health Care Magic

The stress ECG is positive / the question is whether there is underlying coronary artery disease
Angiography is negative – it is the gold standard for delineating the ANATOMY (structure). There is no obvious demonstrable block.

There are a few possibilities in such a situation…

     The TMT (Treadmill Exercise ECG) may be false positive - changes in the absence of disease…. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
     It is not a fixed obstruction / a dynamic episodic event – from spasm. .. which is not evident in the angio. Provocative tests may also be risky.
     Some like vessel wall issues like metabolism of the endothelium (innermost lining), may be responsible

In such situation, it may be given the benefit of doubt and deemed to be the disease and treated as such – with antiplatelet agents, metabolic modifiers, calcium channel blockers …
The treating doctor alone could conclude better based on total clinical picture and dispense appropriate prescription … He is obviously in good hands - follow up...

Good luck
God bless you
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4505 Questions

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What Does My Angiography Test Report Indicate?

Brief Answer: Stress ECG Report not normal ... Detailed Answer: Hi friend Welcome to Health Care Magic The stress ECG is positive / the question is whether there is underlying coronary artery disease Angiography is negative – it is the gold standard for delineating the ANATOMY (structure). There is no obvious demonstrable block. There are a few possibilities in such a situation… The TMT (Treadmill Exercise ECG) may be false positive - changes in the absence of disease…. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. It is not a fixed obstruction / a dynamic episodic event – from spasm. .. which is not evident in the angio. Provocative tests may also be risky. Some like vessel wall issues like metabolism of the endothelium (innermost lining), may be responsible In such situation, it may be given the benefit of doubt and deemed to be the disease and treated as such – with antiplatelet agents, metabolic modifiers, calcium channel blockers … The treating doctor alone could conclude better based on total clinical picture and dispense appropriate prescription … He is obviously in good hands - follow up... Good luck God bless you