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What Causes Pain In The Chest?
Question: My father is suffering pain in heart , but not regular, all ECG and tread mill reports are normal, He is diabetic, and but very much control.
Brief Answer:
please provide following details
Detailed Answer:
Dear Sir
1. I would request you to share the TMT report too including all the ECG graphs. Please also let us know that why TMT test was terminated and what were his symptoms during TMT test.
2. A pain or discomfort in chest which comes on exertion/ exercise/ using stairs/ walking after meals and disappears on rest is highly typical of angina chest pain. it is usually felt as heaviness rather than chest pain. It may radiate from lower jaw to umbilicus including both arms. Keeping these points in mind kindly send details of his chest pain including what provokes it, how lasts it long, where it radiates and how is it relieved?
Waiting for your reply
Sincerely
Sukhvinder
please provide following details
Detailed Answer:
Dear Sir
1. I would request you to share the TMT report too including all the ECG graphs. Please also let us know that why TMT test was terminated and what were his symptoms during TMT test.
2. A pain or discomfort in chest which comes on exertion/ exercise/ using stairs/ walking after meals and disappears on rest is highly typical of angina chest pain. it is usually felt as heaviness rather than chest pain. It may radiate from lower jaw to umbilicus including both arms. Keeping these points in mind kindly send details of his chest pain including what provokes it, how lasts it long, where it radiates and how is it relieved?
Waiting for your reply
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Dear sir
Thank you very much,Please find below answer for your question.
1. TMT test was not terminated and it was completed, result was very mild positive.
2. pain and discomfort in chest normally stay for a day, may be once in week since from last 6 months, but he is quite comfortable in exercise, using stairs, walk after meal, dont find any discomfort.
3. All reports are attached
regards XXXXXXX XXXXXXX
Thank you very much,Please find below answer for your question.
1. TMT test was not terminated and it was completed, result was very mild positive.
2. pain and discomfort in chest normally stay for a day, may be once in week since from last 6 months, but he is quite comfortable in exercise, using stairs, walk after meal, dont find any discomfort.
3. All reports are attached
regards XXXXXXX XXXXXXX
Brief Answer:
please provide ECGs taken during TMT.
Detailed Answer:
Dear XXXXXXX
1. The patient could do TMT on XXXXXXX protocol for 9-14 minutes. For a male of age of 56 years it is excellent exercise capacity as he did not have any problem during the test. Such group of patients have good prognosis.
2. The pain which is there for a whole day and is not exacerbated by exercise / using stairs/ walking after meals is not typical of anginal pain.
3. His CT angiogram also did not reveal any severe/ critical lesion. The only thing which is not normal is the report of TMT. That's why i requested you to upload actual ECG graphs of TMT so that I can re-evaluate them. Otherwise everything else points to a non-anginal pain. If you can upload all ECGs taken during TMT, I will review them too.
4. I will deliberate more on further management in such a scenario, once you upload all ECG graphs.
Sincerely
Sukhvinder
please provide ECGs taken during TMT.
Detailed Answer:
Dear XXXXXXX
1. The patient could do TMT on XXXXXXX protocol for 9-14 minutes. For a male of age of 56 years it is excellent exercise capacity as he did not have any problem during the test. Such group of patients have good prognosis.
2. The pain which is there for a whole day and is not exacerbated by exercise / using stairs/ walking after meals is not typical of anginal pain.
3. His CT angiogram also did not reveal any severe/ critical lesion. The only thing which is not normal is the report of TMT. That's why i requested you to upload actual ECG graphs of TMT so that I can re-evaluate them. Otherwise everything else points to a non-anginal pain. If you can upload all ECGs taken during TMT, I will review them too.
4. I will deliberate more on further management in such a scenario, once you upload all ECG graphs.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Dear sir
I am very happy from your guidance , sir because I belong to small city of XXXXXXX and I try to upload all reports but it is not supporting, so I upload only summary.
Thank you
Regards XXXXXXX
I am very happy from your guidance , sir because I belong to small city of XXXXXXX and I try to upload all reports but it is not supporting, so I upload only summary.
Thank you
Regards XXXXXXX
Brief Answer:
Seek opinion of another cardiologist before angiogram.
Detailed Answer:
Dear XXXXXXX
In such a scenario (if you can not upload complete TMT graphs), my only advice is that since everything favors that this patient is not likely to have significant disease at present, you must seek a second opinion before opting for coronary angiogram.
Sincerely
Sukhvinder
Seek opinion of another cardiologist before angiogram.
Detailed Answer:
Dear XXXXXXX
In such a scenario (if you can not upload complete TMT graphs), my only advice is that since everything favors that this patient is not likely to have significant disease at present, you must seek a second opinion before opting for coronary angiogram.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Dear sir
Please find new attachment, all details of TMT REPORTS are attached.
Regards XXXXXXX
Please find new attachment, all details of TMT REPORTS are attached.
Regards XXXXXXX
Brief Answer:
please see details
Detailed Answer:
Dear XXXXXXX
All the five attachments carry the same graphs. These are medians and not raw ECGs. However the medians also do no show significant changes in main leads i.e. V4-V6.
Overall, the type of pain, the TMT findings, Exercise capacity, absence of symptoms on TMT and CT angiogram report do not favor presence of significant CAD. Hence before getting a conventional angiogram, get him reevaluated.
Sincerely
Sukhvinder
please see details
Detailed Answer:
Dear XXXXXXX
All the five attachments carry the same graphs. These are medians and not raw ECGs. However the medians also do no show significant changes in main leads i.e. V4-V6.
Overall, the type of pain, the TMT findings, Exercise capacity, absence of symptoms on TMT and CT angiogram report do not favor presence of significant CAD. Hence before getting a conventional angiogram, get him reevaluated.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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