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What does inducible ischaemia mean?

Q: My 61 years old father-in-law weighs 72 kg. His recent blood pressure report reads 130/80 mmHg. He has been suffering from chest pain, which moves towards his jaws and then the jaws get tightened. Fearing a heart problem, we got various tests done and the treadmill stress test reported: normal B response, no chest pain, good effort tolerance but the test was positive for inducible ischaemia. What does it mean? Does he need to go for an angiography and then an angioplasty? How much do these treatments cost?

A:Stress Test being positive for inducible ischaemia suggests that there is a high chance of blockages in the arteries of the heart. In a very small percentage of patients, the test can be falsely positive that is the arteries may be normal, even though the test is positive but in your father-in-law’s case, as he is getting classical angina in form of chest pain radiating to the jaw and the stress test is positive, the chances of the blockage of the arteries of the heart are extremely high and therefore, he must go for angiography. Treatment cost can not be decided till the angiography has been performed because cost of angioplasty is around Rs.1.0 lac but then the cost of stents is extra and the total cost will depend on, how many blockages are detected, how many stents are going to be used, what kind of stent will be used (Bare Metal Stent or Medicated Stent etc.). Also the cost vary from institution to institution. So I suggest, you first undergo the coronary angiography and after the angiography, the treating doctor will be able to provide you the costs involved for treatment.

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