Brief Answer: More test & follow up will clarify Detailed Answer: Dear friend, Welcome to Health Care Magic Your symptoms do not suggest Coronary Artery Disease (CAD). Positive response in TMT (Treadmill Exercise ECG) is horizontal or down sloping depression of ST segment / 1 mm or more (Y-axis or vertical line) / 80 milliseconds (X-axis or horizontal line – 1 square is 40 milliseconds) The test is interpreted by the treating cardiologist / machine reports generated need to be approved by the specialist. Your cardiologist should be right – he should have seen the records and not read the report alone / he should have correlated with the total clinical picture. If in doubt have a second opinion / Better option is for further work up – 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 doubt still, the next step is to see the ANATOMY (structure) – CT angio is non-invasive study ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is the gold standard for this, but it is invasive and is not indicated here. ________________________________________________________________ For palpitation, HOLTER (24 to 48 hour ambulatory monitoring) is done to analyse and plan for further management, if a routine ECG does not show clues. It may also detect silent (no symptom) ischemia. _______________________________________________________________ Aspirin in small doses – 80 to 100 mg – is a routine. It acts on the platelets and helps to reduce clot formation. It can be taken in the meantime. _______________________________________________________________ You appear to be in good hands Keep following with your cardiologist… ______________________________________________________________ Take care Wishing all well God bless

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Brief Answer: NO waiting / Do NOW Detailed Answer: Hi You should do BOTH Earlier the better DON’T WAIT Resting ECG shows some changes – termed Early Repolarisation Changes This is usually a normal variant This may lead to confusing results in some cases… The changes in exercise appear to be more than the machine reports… 2 or more mm, as I see.. I strongly suggest to undergo further investigations / at the earliest opportunity / for further evaluation The squares are 1mm dimensions / vertical is voltage / horizontal is time Absence of symptoms is no proof of absence of disease The first symptom is many is sudden collapse or heart attack Investigations aim to diagnose at an early stage to prevent or delay Go for them Regards

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Brief Answer: Relax / do the tests Detailed Answer: Hi Appropriate treatment demands accurate diagnosis Diagnosis depends on investigations… The seriousness / and the decision for angioplasty and/or drugs depends on the result of the investigation – whether there is a block; if present, where and how severe Most probably, you will do well with drugs for a long time to come… Relax / anxiety does not serve anything good Regards

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Brief Answer: Strongly positive Detailed Answer: Hi Your TMT looks strongly positive (for inducible myocardial ischemia) Strong or otherwise, does not directly and exactly correlate TMT has limitations - false positives and false negatives As already suggested, you need further tests for further assessment... Regards

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