Go for Thallium stress
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You have an excellent effort tolerance indeed.
However ST depression
1mm or more (Horizontal or down-sloping / 80 milliseconds rom J point) is suggests ischemia
and is an indication for further work up. At times, there may be false positive or false negatives too. 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.
If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography
with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on.
Coronary arteriography is invasive but it is the gold standard for this.
CT angio is non-invasive study for the anatomy. If positive, you will need catheterisation, anyway.
At this stage, you start with aspirin
Aspirin in small doses – 75 to 150 mg – is a routine. It acts on the platelets and helps to reduce clot formation. There are others too…
Statins have actions beyond cholesterol
– like anti-oxidant and plaque
stabilising effects… and given even if the cholesterol is normal...
Your treating doctor will prescribe appropriately.
The aim of any investigation is to modify the treatment, based on the result.
With a positive family history and Dyslipidaemia, it is wiser and safer to do the test and see / rather than wait and watch
Wishing all well