What Does My TMT Test Report Indicate?

Posted on Wed, 20 Apr 2016

Wed, 20 Apr 2016 Answered on

Fri, 10 Jun 2016 Last reviewed on

Question : Male, age 51 yrs, no medicine for sugar and BP,
Find below my detailed TMT report, pls advise, what should I do for my better cardiac health as per report.

TMT
Test protocol - XXXXXXX on Treadmill
Resting EKG (SUPINE) - NSR, No significant ST-T changes
Resting BP - 130/80 mmHg
Maximum BP - 180/80 mmHg at peak Exercise
MPHR - 169 BPM
THR - 143 BPM (85% of MPHR) XXXXXXX HR ACHIEVED - 160BPM (94% of MPHR)
Total exercise time - 8:30 min. XXXXXXX Work Load - 10.1 Mets
Comments-
Maximum 01 - 01.5 mm asymptomatic up sloping ST depression noted in leads II, III & avF during peak exercise. Same leads showed 01 mm dowm sloping ST depression in recovery.
Normal HR & BP response to exercise.
No arrhythmia.
Fair exercise tolerance.
FINAL IMPRESSION - TMT IS MILD POSITIVE FOR REVERSIBLE MYOCARDIAL ISCHEMIA.

Answered by Dr. Priyank Mody (18 hours later)

Brief Answer:
Either repeat a TMT after 3 months for dynamic change or CT coronary angiog

Detailed Answer:
Hello XXXXXXX ,
In terms of you not having diabetes or hypertension , puts you at low risk of cardiac disease .
However if other factors like if you smoke , have high cholesterol, are obese, bad lifestyle and if you have a strong family history for heart events , further cardiac evaluation is justified.
Now let me help you interpret the TMT .
Your baseline blood pressure and pulse are nomral which increases appropriately with exercise suggestive healthy and we'll compensated heart .
Now about ST changes , in your TMT they occur at peach exercise and normalise in recovery , suggesting that there might be a minor disease or its a false positive test .

So the way forward for you is either of the two .
1) if you have none of the above mentioned risk factors , repeat a TMT after 3 months , if any dynamic change than we would need further evaluation.
2) if you have above risk factors , we would need a angiography, however as your TMT is not very strongly positive, a CT coronary angiogram, where a CT scan will evaluate your heart arteries would be a better and non invasive way of evaluation in your case .
Hoping I could help you resolve your doubts .
Let me know if any clarification needed and I would be happy to help.
Do rate for others reference.
Regards Dr Priyank Mody, XXXXXXX

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Naveen Kumar