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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat TMT With Positive For Induced Ischemia?

M y brother in law is diagnosed with TMT and result says that he is positive for induced ischemia. He is 35 yrs age, St - 80 Kgs and Ht is 5.4 Ft. No habits of smoking or alcoholic. Have history of Diabetes Milletes. His chest X Ray and Lung has no problem. He does not complain about chest pain. He stays in 2nd floor and had to frequently ascends / Descend and sometimes feels tired. He had cough a week back and had blood stains in his sputum and thereby this diagnosis started. Pls advice
Thu, 10 Apr 2014
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Cardiologist 's  Response
Dear friend,
Welcome to Health Care Magic

     If TMT (Treadmill Exercise ECG) is positive for inducible ischemia, it is an indication for further work up – because it is an indication of Coronary Artery Disease / However, at times, there may be false positive or false negatives.
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, she will need catheterisation, anyway.]

The aim of any investigation is to modify the treatment, based on the result.
Intervention – dilatation with balloon and placing a stent (Angioplasty) - or CABG (Coronary Artery Bypass Graft) may be advised based on the results.

Aspirin in small doses – 80 to 100 mg – is a routine. It acts on the platelets and helps to reduce clot formation. There are several others – At this stage, you start with aspirin and statin..
Your treating doctor will prescribe appropriately.

Take care     
Wishing all well
God bless
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How To Treat TMT With Positive For Induced Ischemia?

Dear friend, Welcome to Health Care Magic If TMT (Treadmill Exercise ECG) is positive for inducible ischemia, it is an indication for further work up – because it is an indication of Coronary Artery Disease / However, at times, there may be false positive or false negatives. 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, she will need catheterisation, anyway.] The aim of any investigation is to modify the treatment, based on the result. Intervention – dilatation with balloon and placing a stent (Angioplasty) - or CABG (Coronary Artery Bypass Graft) may be advised based on the results. Aspirin in small doses – 80 to 100 mg – is a routine. It acts on the platelets and helps to reduce clot formation. There are several others – At this stage, you start with aspirin and statin.. Your treating doctor will prescribe appropriately. Take care Wishing all well God bless