It is very common to find the heart patients who have normal ECG. One must remember that the ECGs are taken at rest when the heart is beating at its lowest rate. In some of cases the patient would also agree that at the time of rest there is no pain in the chest, the angina symptoms would only come when they increase the heart rate, while doing some physical exertion like walking. In this condition,where we need a TMT test. The patients might gradually increase their heart rate, thus increasing the blood requirement of the heart muscles. Simultaneously ECG records are taken. Patients have to physically bring to bear for this test which uses a computerised machine. The continuous ECG monitoring during the exercise would reflect to the blood and oxygen deficit in the muscles of the heart during the exercise. TMT test is also called as Exercise Stress Test, Computerised Stress Test or simply Stress test. It is the very easy, popular and common test performed on heart patients to determine the severity of the heart disease. Taken at an interval, this test can also show the improvement or deterioration of patient’s angina.
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A negative TMT or Stress Test is declared when the patient can reach a certain heart rate without showing any ECG changes. This rate is known as target heart rate and it is also calculated by a formula (Target Heart Rate = 220 – age of patient). If this rate is reached by the patient without producing any ECG changes, though the TMT can be called negative, but it would not mean that the blockage is zero. It is meant only by the person performing the test probably has a blockage of less than 70%.
2D Echocardiography or 2D Echo
2D Echocardiography or 2D Echo of heart is a test in which ultrasound technique is used to take pictures of heart. It will be displayed in a cross-sectional ‘slice’ of the beating heart, showing chambers, valves and the major blood vessels of heart.
‘Doppler’ is a special element of this ultrasound exam that assesses flow of blood in the heart.
How is 2D Echo done?
Patient is made to change in a front open robe and a colourless gel is applied to the chest area. Then he is asked to lay on his left side as the technician moves the transducer across the various parts of his chest to get specific/desired views of the heart. Instructions may also be given to the patient to breathe slowly or to hold it. This helps in getting superior quality pictures. The images are viewed on the monitor and recorded on paper, video or DVD. The cardiologist later reviews and interprets the recordings.
What it detects?
Echocardiography is a significant tool in providing the physician important information about heart on the following:
→ Size of the chambers, volume and the thickness of the walls
→ Pumping function, if it is normal or reduced to a mild/severe degree
→ Valve function – structure, thickness, and movement of heart’s valves
→ Volume status as low blood pressure may occur as a result of poor heart function
→ Pericardial effusion (fluid in the pericardium and the sac that surrounds the heart), congenital heart disease, blood clots or tumors, abnormal elevation of pressure within the lungs etc.
How long does 2D Echocardiography take?
A brief exam in normal case may be done within 15-20 minutes. However, when there are heart problems, it may take much longer.
How safe is echocardiography?
It is absolutely safe. There are no known risks of the ultrasound in this type of testing. To live healthy & happy, one must keep a check on the body’s functioning by going for regular health checkups. This helps in assessing risk factors and also for diagnosing diseases at an early stage, which will result in effective treatment and better management of the condition.