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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain In The Chest And Arrhythmia?

I am 41 years old male, weight 83 kg. Exercised on Bruce Protocol upto 6:15 minutes (7.30 METS). Resting heart rate 77 bpm, rose to max 136 bpm which repsesents 75 % of the maximal age predicted heart rate. Developed significant ST depression in leads I, II, aVF, V2 to V6 ( -1.6, -2.3, -1.4, -2.7, -1.8, -2.8, -3.1, -2.8 mm horizontal and downsloping ), maximal at peak exercise, whitch reverted to baseline after 6 minutes in recovery. Test was terminated due to sinificanmt ST depression. Baseline ECG within normal limits. Functional capacity : NORMAL, HR response to exercise : appropriate, BP response to exercise : normal, chest pain : none, Arryhythmias : none. Two years back got cardiac echo test and stress thellium test done which were normal. Please advise on further course of action. Is it possible to have abnormal TMT but no heart problem and normal TMT reports in future. Thanx.
posted on Fri, 14 Mar 2014
Twitter Wed, 31 Aug 2016 Answered on
Twitter Wed, 31 Aug 2016 Last reviewed on
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Cardiologist,  's  Response
Hello ,
The uploaded TMT reports suggest a positive test for ischaemia and hence should be evaluated further .
If you say that stress thallium was normal and if you don't have risk factors and symptoms ,than there might be a chance that this test was false positive .
Repeating a stress thallium would be the best way forward, if normal no need for further investigation and let it be the modality of screening for future .
If positive consider going for a conventional Coronary angiography along with optimum medical therapy .
Regards
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What Causes Pain In The Chest And Arrhythmia?

Hello , The uploaded TMT reports suggest a positive test for ischaemia and hence should be evaluated further . If you say that stress thallium was normal and if you don t have risk factors and symptoms ,than there might be a chance that this test was false positive . Repeating a stress thallium would be the best way forward, if normal no need for further investigation and let it be the modality of screening for future . If positive consider going for a conventional Coronary angiography along with optimum medical therapy . Regards