Is coronary angiography needed for inducible ischemia?

Question

Hello doctor,

I am a 34-year-old male who recently underwent a master health check-up. One of the key observations from the check-up was that the TMT (stress test) was borderline positive for inducible ischemia. After consulting a cardiologist and undergoing a screening echocardiogram, it was suggested that I undergo a coronary angiogram.

I have attached my reports for your review and would appreciate a second opinion on my condition and the recommended course of action. Please let me know if you need any additional information.

A few details about my lifestyle and habits:

I engage in mild exercise (I play badminton once every one or two weeks).
I consume alcohol (beer) once a week or once every two weeks.
I do not smoke, but I used to smoke 10 years ago.
I eat non-vegetarian food once or twice a week.
There is no history of cardiac problems in my family or myself.
I have not experienced any abnormal chest pain during the TMT or physical activity.
I occasionally experience mild gastric pain (once or twice a week), which started about one to two weeks ago, possibly due to eating outside food.

Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Although you do not have any symptoms, your ECG (electrocardiogram) and TMT (treadmill test) show significant changes. Your echocardiogram is normal, but the striking changes in your ECG cannot be ignored (attachments removed to protect the patient’s identity).

Therefore, it would be prudent to undergo coronary angiography for further clarification. Sometimes, such changes may be observed in individuals with hypertension, but you do not have a history of hypertension.

Overall, in my opinion, it is advisable to proceed with a coronary angiography to obtain a clear understanding of your condition.

I hope this helps.

Please feel free to reach out if you have any further questions or concerns.

Thank you.