What do my TMT results say about my chest pain?

Question

Hello doctor,

I was experiencing occasional chest pain and wanted to confirm its cause. My 2D echo was normal. Here are the findings from my TMT exercise:

Exercise duration: 6:04 minutes.
Maximum heart rate attained: 148 bpm (77% of max predicted HR of 191).
Maximum blood pressure: 140/90 mmHg.
Workload achieved: 7.2 (fair effort tolerance).
Significant ST segment changes were noted during exercise and recovery.
Presence of angina, arrhythmia, S3 heart sound, and murmur.
Final impression: The test is positive for exercise-induced ischemia.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

Could you please attach the complete TMT (treadmill test) tracings? The final impression of the TMT indicates a positive result, which suggests that your chest pain may be caused by blockages in the heart. The echo only shows abnormalities in later stages or in cases of severe disease. However, given your age and the fact that the pain occurs only occasionally, the likelihood of disease is generally low. Patients with cardiac pain typically experience consistent pain on exertion, which is relieved by rest. Considering these factors, I would like to review the TMT tracings and confirm any ECG (electrocardiogram) changes.

Assuming the final report is accurate, you will need angiography to confirm and assess the extent of any blockages. Alternatively, you may undergo CT (computed tomography) coronary angiography to either confirm or rule out the TMT findings. Therefore, the TMT should be reviewed first, and further tests are necessary to confirm the findings.

Thank you.