Reversible myocardial ischemia

Questions and answers on "Reversible myocardial ischemia"

I am Male, 53 yrs of Age with 85 Kg weight and have been brisk-walking regularly for half an hour since last 10 yrs covering around 4 Kms every day. My BP remains in the range of 87 to 94(Diastolic) and 125 to 140 (Systolic). My lipid profile readings are all within range. I am not on any medication . Since last 1 year occassionally I have been getting pain on my left chest side which comes only for 2 seconds and then goes away. This happens on an average of once or twice a month. So I got my TMT done and RESULTS ARE : Exercise Duration - 8:30 minutes, Max Heart Rate 178 BPM 106% OF TARGET HEART RATE 167 BPM; Max BP 170/100 mm Hg; Max Work Load 9.53 METS; IMPRESSIONS - TMT is negative for reversible myocardial ischemia . I eat everything including fried, Carb, fruits, fibre, eggs , etc. Kindly advise - 1. Are the TMT RESULTS Fair, Good, or Very Good? 2. Do I need to start medication or still try to maintain through exercise?.3. Do I need to go for any other test to be very sure of the reason for the occassional pain on the left Chest side. - Vinod, Delhi, India
your TMT is very good, this chest pain is atypical ( non cardiac chest pain).
you are overweight - if you loose 6 kg weight , your blood pressure will down by 10 mmhg
other natural ways to control BP are - less salt intake, avoid non veg diet, increase vegetables, fruits, fiber diet, yoga,...
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My mother has undergone Echo and TMT tests
Echo was normal but TMT showed positive hence doctor asked her to get CT Angiogram done (64 Slice) but one of my friend said his mother also went through 64 Slice CT Angio done but then the doctors said it could not detect the blocks successfully and hence adviced for a regular angiogram. Please advice which angiogram is the best to get the blocks detected (if any)
Welcome to HCM,
Thanks for posting query to this forum
Your mother's TMT is positive for reversible myocardial Ischemia, that is why she has been advised to go for CT angiography.
CT angiography is non invasive investigation and once if there are blocks in coronary then regular catheter...
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Dear Doctor, I am 51 year old and male. I have been smoking about 8/9 cigarettes a day for over 20 years now. Since a week, I am experiencing severe burning in the center of the chest when I walk up a gradient for about 50 steps. It will subside after a few minutes. My BP was normal (130/90) when checked about a month ago and am not diabetic. Kindly advise on the cuase of my problem and the course of diagnosis and treatment.

Welcome to HCM,

With your symptoms there is strong possibility of that this is Angina Pectoris. Please visit your Cardiologist and get EKG done and then future course of action depends on result if abnormal treatment can be started and further testing is done with complete blood test like...
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execised for 3.3 minuts on bruce protocol at a orkload of 5.2 METS and achieved 102 % of maximum predicted HR. Exercise was terminated due to achived MPHR & BREATHLESSNESS.
my tmt report says developd asymptomatic 1mm hzst dep. in leads II,III,aVF, AND V-V6 during stage 1 at HR of 141BPM, WHICH PROGRESSED TO 1.5-2 mm USST dep. in leads II,III,aVF, AND V-V6 during stage 2 at HR of 166 BPM
ST-T changes reverted to basal pattern within 14.0 min in recovery period.
Welcome to HCM,
Your details about Stress test, with available information your test is positive for reversible myocardial ischemia on exercise.
This means that you have silent ischemia as you did not have chest pain but breathlessness could be angina equivalent.
I would recommend you to...
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I am a 53 yr old overweight male, BMI 34%. I recently had a CT scan and was told I have a cardiac calcium score of 661 with calcification primarily in my left anterior artery. I visited a cardiologist who has ordered a transthoracic echocardiogram to be followed by a nuclear stress test. A friend of similar age and diagnosis and factors had an angiogram without having these two tests. What is the normal protocol? Why can't I just get an angiogram?

Welcome to HCM,

You are overweight and you have suspected coronary artery disease, You should go for 2D Echocardiography and stress test ( Nuclear stress test or TMT) will let us know if there is reversible myocardial ischemia is there or not.

Your calcium score is high and there is...
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could exercise for 06 minutes and 44 seconds of the Bruce Protocol and achieved a work load of 08.10 mets. He attained a peak heart rate of 141 beats/minute which is 87 % of the predicted maximum. There was no classical angina. There was mild increase in blood pressure from 120/80 to 150/90 and there was no S3 and S4 gallop in the recovery period. In the pre exercise there was no significant ST segment change. At peak execise there was 3.1 to 3.6 mm segment depression inleads II, III, aVF and 1.5 to 2.3 mm in leads V3-V6. Increased ST segment response inleads II,III, aVF and in leads V3-V6 appeared in the 3-4th minute of the exercise and lasted 1 minute into recovery period. What does it mean ?
Welcome to HCM,
With information you have provided this is Stress test report and this is positive for exercise induced reversible myocardial ischemia.
This test is done to detect and confirm ischemic heart disease.
Please visit your cardiologist and he/she will guide you further with result...
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I went to the cardiologist last week for an irregular EKG and he said it showed an old heart attack which is common in diabetics. I have been having an irregular phulse on and off and nervous feeling in my chest. That feeling has become more frequent and prevents me from falling asleep at frequently in the past week. I also get the symptoms during the day. My echo was normal and I am waiting on insurance approval for nuclear stress test. I don't know if I should be going to the ER when these symptoms start. My bp is normal at those times.

Welcome to HCM,

You are diabetic and irregular pulse and your EKG revealed old myocardial infarct which is possible in diabetic what is called silent myocardial infarct.

This abnormality in should be investigated for cause like significant ischemia and coronary lesion.

You're Echo study was...
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I have done my TMT test last week. the results are as follows.. I do it Every alternate Yr. No Dr has asked me to do it.

(Bp Rate after 2 Hr of TMT Test was 130/ 80 )

TMT test:

Age : 68
Sex : Male
Height : 160 CM
WT :61 kg
Date : 7.05.2013

Max Mets 6.4 (8.5) Mets (75) %
Max Heart Rate : 153 (154) /min (99 ) %
Max BP 210 /90 mmHg
Max BP X HR 288 mmHg/Min
Min BP XHR 132 mmHg/min
DP-Factor 2.2
Body Surface 1.633 m2

End Criteria : Target HR attained

Protocol : BRUCE
Ergo / BP : TM-400/425 Digital

Rest time : 1:27
Work Time : 8.22
Recovery Time :6:17
Total Time :16:06

Please advice what should be the further course of action.

kulada Mohapatra

Welcome to HCM,
You are 68 years and your Treadmill test is normal that means it is negative for reversible myocardial ischemia.
We need to see ST -T wave changes there is no mention of that but I presume there were none as Target heart rate was reached and test was stopped because of that ....
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