Did you get the tmt test positive (exercise stress test)? You may have wondered what this means and what you should do next. Here’s what you need to know.
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What To Do If You Get A Positive tmt Test
Suppose you’ve been suspected of coronary artery disease. In that case, your doctor may have given you an exercise stress test (tmt test) to see how well your heart performs under stress. Unfortunately, you may have gotten a positive tmt test. But do not panic. You go through our article and decide.
Consult with your doctor when your tmt tests positive
An exercise stress test could indicate that you have a problem with your heart. Still, in many cases, it’s not a medical emergency. It does not mean that shortly you will get a heart attack. The tmt test is done to see if your chest pain or shortness of breath is due to coronary artery disease. Tmt test is not done to predict near-term heart attacks.
The tmt test or treadmill stress test is frequently done for patients with heart disease symptoms. The tmt test is usually denied for asymptomatic patients. About 50 % of patients with coronary artery disease present with a heart attack or sudden cardiac arrest as their first symptom of CAD. They will not have chest pain, shortness of breath, or fainting before a heart attack or death. tmt test, if done shortly before these events (which will not be done as they are asymptomatic), is not relevant to predicting a heart attack in most patients.
It’s good to discuss your doubts with your cardiologist after undergoing any testing—whether it’s an echocardiogram, treadmill stress test, or CT coronary angiogram. Discussing an exercise stress test result with a cardiologist can help ensure that you make proper decisions for further line of management.
Exercise stress testing or tmt test has a sensitivity and specificity of about 70% and 75%, respectively.
Accuracy of tmt test
As a tmt test has a sensitivity of 70%, it can correctly identify 70% of people who have CAD, but it misses 30%. This smaller group of people have coronary artery disease, but the tmt test failed to detect them. This is called a false negative tmt test.
Similarly, as a tmt test that has a 75% specificity, it can correctly identify 75% of people in a group that does not have coronary artery disease. Still, it will misidentify 25% of people. 25% of people will be identified as having coronary artery disease when they do not. This 25% of patients will have no or insignificant coronary artery disease on coronary angiogram. This is referred to as a false positive.
Unfortunately, the diagnostic accuracy of the tmt test is still lower in women. The sensitivity and specificity of the tmt test for coronary artery disease are just 61% and 70%. It means 30% of women will have coronary artery disease when they do not have it.
Accuracy further decreases if you have
Low hemoglobin or anemia
High blood pressure
Young age (less than 40%)
Have no risk factors like diabetes, high blood pressure, smoking, or family history
Absence of symptoms
If you are taking certain drugs like digoxin
Mitral valve prolapse or MVP
Pectus excavatum or caved-in chest
If you have heart diseases other than coronary artery disease
Certain electrolyte disturbances
FALSE-POSITIVE TMT TEST
All of the condition mentioned above decreases the specificity of the tmt test. It means they increase false-positive results. This group of patients is often identified as having coronary artery disease with a tmt test when they do not have it.
Follow your cardiologist’s instructions in case your tmt tests positive.
Go to your heart doctor’s office and discuss the positive tmt test result, and they will decide the further line of action. He decides if you need a coronary angiogram after studying your medical history.
Address any underlying medical issues if your tmt tests positive
Before you are diagnosed as a CAD patient, addressing any underlying medical issues that led to your positive tmt test report is essential. The best way to do that is to talk with your heart doctor. He considers your age, sex, race, family history, symptoms, and risk factors. He decides whether it is a true positive result or a false-positive result.
Accordingly, he will advise further tests to confirm coronary artery disease. The tests that are used to confirm CAD is
Coronary angiogram
CT coronary angiogram
The following tests have no value in confirming coronary artery disease after a positive tmt test.
CT calcium score
Lipid profile
Hs CRP
Lipoprotein A
Homocysteine
Symptoms of coronary artery disease are chest pain, shortness of breath, and swelling of the feet. Risk factors for CAD are diabetes, old age, high blood pressure, smoking, positive family history, high cholesterol in the blood, and obesity.
Conclusion: don’t panic if you have got the tmt test positive
Patients with a positive tmt test (stress testing) may or may not have coronary artery disease depending upon the diagnostic accuracy of the test performed and the pretest likelihood of each patient. Though your first response after a positive tmt test report may be to assume that you have a heart attack, that’s not necessarily true. An exercise stress test aims to determine whether there are underlying cardiac problems causing your chest pain. It is not meant to predict heart attacks in the near future. Most heart attacks occur in those unaware of their heart disease.
Even if you are found to have coronary artery disease, you can lead a normal life with proper medical care. All you have to do is follow a healthy lifestyle and take medicines for CAD regularly.
Here are a few more ideas to reduce heart attacks if you have a positive tmt test report:
-Listen to your cardiologist
-Eat healthier foods
-Reduce alcohol intake
-Quit smoking
-Get enough sleep
-Get enough exercise
-Lose weight if necessary
-Use medications without fail
– Control your blood pressure, sugar, and cholesterol levels
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