Q. Does variation in TMT indicate anything serious?

Answered by
Dr. Anshul Varshney
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Dec 07, 2015 and last reviewed on: Feb 27, 2019

Hi doctor,

My father has undergone angioplasty last year. He went for TMT review last week. His TMT report shows variations, but he has no symptoms. His blood profile is normal for blood sugar and cholesterol. He is currently taking the following drugs, Deplatt 75 mg (0-1-0), Rozat 5 mg (0-0-1) and Envas 2.5 mg (0-0-1). He is in proper regular diet. Does this indicate anything serious? Please say any further angiography is needed. The doctor has added tablet Starcad 12.5 mg and tablet Flavedon MR after the TMT report.

#

Hi,

Welcome to icliniq.com.

I have read your query in detail and I understand your concern. I need to know a few more details to help you better.

  1. Is there any history of diabetes or chest pain or hypertension? Does he get breathlessness on walking?
  2. Does he suffer from any swelling over the feet?
  3. Is he doing any physical activity or exercise regularly? If yes, is he able to perform them normally?
  4. TMT represents chest pain on exertion which is recorded in ECG. So, the most important concern is that whenever he walks or does his routine activities or exercises, does he feel any chest pain or heaviness?

Hi doctor,

My father is a known diabetic for more than 8 years and he was in the baseline drug Glipizide. His cardio doctor stopped the diabetic drug three months back due to normal levels of blood sugar in both fasting and postprandial. My father also complained of some dizziness and so he stopped the drug. He has no history of chest pain after angioplasty. There is no complaint of breathlessness on exertion. There is no noticeable swelling of the feet. My father is a quite active person. He does regular walking of nearly 40 minutes both morning and evening and all other daily activities. He has never complained of any fatigue or chest pain. Even while the TMT test he did not feel any heaviness. I have attached the previous year surgery reports also. Please advice.

#

Hi,

Welcome back to icliniq.com.

In my opinion, since he is asymptomatic and his angioplasty has been performed, I would not go for a repeat angiography just based on this inconclusive report of TMT (treadmill test).

My opinion for him is to get a thallium stress test done, which in the case comes positive and then he should go for angiography.

One more very good option for him is CT coronary angiography which carries a very good sensitivity compared to conventional angiography. CT coronary angiography carries the advantage of being non-invasive.

So, I would advice in such case to, first of all, get the CT coronary angiography or thallium scan done and write back to me. We would decide then, if he needs any preventive angioplasty or not.


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