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Can a TMT test be false positive?

Tuesday, 16 March 2004
Answered by: Dr. U. Kaul
Director, Interventional Cardiology & Cardiac Electrophysiology,
Batra Hospital,
New Delhi
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Q. My father, aged 64, exercises every day with a 45 min. brisk walk and an hour of volley ball game. Recently he got all the tests done. His 2-D echocardiography says that the heart size, chambers and valves are all normal with DVEF = 55%. His TMT, however, says : HR/BP Response Normal, Poor exercise tolerance, Baseline ST/T changes present, Increase in ST/T changes after 2 min. of exercise, TMT positive for induced Ischaemia. My father says, he was not tired when he was made to run on the tread mill, however the doctors preferred him to stop. His resting BP is 130/80 and while exercising it came upto 140/80. He has been prescribed some medicines and has been given sorbitrate, in case he ever feels breathless. My worry is, he has been exercising all his life regularly, he is a fitness freak, then how come a TMT shows a positive result?

A.  The information provided by you suggests that your father has no complaints of chest discomfort or shortness of breath etc. The heart function is normal but TMT shows an abnormality on exercise. In this setting there is no need for a panic, he needs further evaluation by tests which give more specific information. The test should be a stress echo or a stress thallium. In addition, tests for other risk factors like a complete lipid profile, blood sugar profile etc and periodic BP check are required and management of all the risk factors under supervision is required if there are any associated problems. Regular exercise is a good habit and always helps in the long run but problems can still occur and periodic assessment and health checks are directed to diagnose abnormalities before major problems occur. A TMT test can be false positive also especially in asymptomatic individuals.

A.  The information provided by you suggests that your father has no complaints of chest discomfort or shortness of breath etc. The heart function is normal but TMT shows an abnormality on exercise. In this setting there is no need for a panic, he needs further evaluation by tests which give more specific information. The test should be a stress echo or a stress thallium. In addition, tests for other risk factors like a complete lipid profile, blood sugar profile etc and periodic BP check are required and management of all the risk factors under supervision is required if there are any associated problems. Regular exercise is a good habit and always helps in the long run but problems can still occur and periodic assessment and health checks are directed to diagnose abnormalities before major problems occur. A TMT test can be false positive also especially in asymptomatic individuals.

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