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What Do HDL Level Of 39.77 And LDL Level Of 146.9 Indicate?
Question: I had been to a hospital for general heart checkup. I am vegetarian, and daily I walk for 3 kms. My ECG, Echo tests were normal. My cholesterol and trigycerides were 226.6 mg/dl and 199.63 mg/dl. HDL 39.77 mg/dl and LDL 146.90 mg/dl. But my treadmill test showeBP normal, chest pain nil, arrhythmis nil ST changes in lead II,III, AVF,V$-V6 . Conclusion TMT is mild positive for provocable ischemia. What is your opinion?
Brief Answer:
A stress thallim will make things clear.
Detailed Answer:
Hi,
Thanks for asking the query dear.
I am a Cardiologist and would be answering your query.
Frankly speaking there can be to approaches for you.
Firstly as you can by youself also see TMT is mildly positive for ischemia so we can assume that coronaries are normal and no further investigations are required.However to mention tread mill test is one of the basic tests of cardiology and is about 70% sensitive to rule out coronary artery disease.In lay mans language this means that in 30 out of 100 cases TMT misses a coronary problem.
Standard recommended protocol is-
As per the latest XXXXXXX guidelines changes in lead 2,3 and avf have no significance in a stress test however even changes less then 0.5mm in lateral leads V5 and V6 are highly significant and further testings should be done to rule out the involvement of Coronaries.
As in your case there are ST-T changes in lateral leads V4,V5 and V6 i would recommend you to go for a test called stress thallium.
Stress thallium is a nuclear based test and will take about 2 hours.Its a painless non invasive test and is almost 99% sensitive to rule out coronary artery disease(almost equivalent to angiogram).It has no major complications and is very safe.
So if i were your primary i would have asked you to go for Stress thallium.
When we have facilities and investigations why to keep a doubt in mind.
Regards
A stress thallim will make things clear.
Detailed Answer:
Hi,
Thanks for asking the query dear.
I am a Cardiologist and would be answering your query.
Frankly speaking there can be to approaches for you.
Firstly as you can by youself also see TMT is mildly positive for ischemia so we can assume that coronaries are normal and no further investigations are required.However to mention tread mill test is one of the basic tests of cardiology and is about 70% sensitive to rule out coronary artery disease.In lay mans language this means that in 30 out of 100 cases TMT misses a coronary problem.
Standard recommended protocol is-
As per the latest XXXXXXX guidelines changes in lead 2,3 and avf have no significance in a stress test however even changes less then 0.5mm in lateral leads V5 and V6 are highly significant and further testings should be done to rule out the involvement of Coronaries.
As in your case there are ST-T changes in lateral leads V4,V5 and V6 i would recommend you to go for a test called stress thallium.
Stress thallium is a nuclear based test and will take about 2 hours.Its a painless non invasive test and is almost 99% sensitive to rule out coronary artery disease(almost equivalent to angiogram).It has no major complications and is very safe.
So if i were your primary i would have asked you to go for Stress thallium.
When we have facilities and investigations why to keep a doubt in mind.
Regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
First of all thank you very much for your kind reply. Please inform me how can I attach my report to you for closure inspection and comments.
Brief Answer:
Follow up.
Detailed Answer:
Hello again,
You can contact the customer care or mail the reports directly to me YYYY@YYYY
(Please attach all graphs of stress test).
Regards.
Follow up.
Detailed Answer:
Hello again,
You can contact the customer care or mail the reports directly to me YYYY@YYYY
(Please attach all graphs of stress test).
Regards.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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