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Tread Mill Test (TMT)
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At Atulaya Healthcare Chandigarh RMSmachine for Treadmill test is available.TMT test is also calledExercise Stress Test, Computerised Stress Test or simply Stress test. This is the most easy, popular and common test performed on heart patients to determine the severity of the heart disease.
 What is a TMT test?
A TMT test is performed to assess the changes produced in your ECG while you are performing exercise on a treadmill (hence the name).
 What are some common uses of the procedure?
A TMT test is very useful in assessing changes in the ECG during exercise and how recovery occurs in case any changes did occur. It is particularly useful for detecting coronary artery disease. It is also useful for assessing the functional capacity of patients suffering from heart disease.
A TMT is particularly useful to determine the adequacy of a procedure that may have been performed and also in the follow up of patients who have undergone angioplasty or coronary artery bypass surgery.
 How should I prepare for the procedure?
The test is performed in the fasting state, usually after an overnight fast or at least three to four hours after the most recent meal. As in the case of an ordinary ECG small plastic or metal electrodes (conducting surfaces) are applied at different points on the chest.
Since the test is performed while walking it is necessary that the chest be either uncovered or at best covered with a loose fitting top. You will be provided with a suitable top at the centre. Please also ensure that you are wearing comfortable footwear suitable for walking on the treadmill. Canvass or sports shoes are preferable, heels are not allowed. You will be provided with suitable footwear at the centre.
Proper contact of the electrodes with the chest wall is absolutely essential for the test for which reason it may be necessary to shave off the hair on the chest if these are excessive and likely to interfere with the test. You may, of course, have the chest shaved before reporting for the test. The centre is sensitive to the religious sentiments of people and would respect these to the maximum extent possible.
Standard procedure requires that any beta-blocker drugs (atenolol, inderal, ciplar, metoprolol or similar drugs) that you may be taking should be stopped for at least two days before the test. However, if your doctor so desires, he may order that the test be performed while the patient continues to take these drugs.
Please do not take any nitrates (such as sorbitrate, nitroglycerine or monotrate) on the morning of the test since that may interfere with interpretation of the result.
 What does the equipment look like?
The equipment comprises of a standard motorized treadmill like any that you may have seen in a gymnasium. The ECG is recorded on an electronic device housed in a small box like machine. The electrodes attached to the body are connected to the machine through flexible wires. Wireless transmission of data is also possible.
 How does the procedure work?
The ECG is continuously monitored and periodically recorded before the start of exercise, during exercise and again through a variable period of recovery. A comparison of the tracings taken at different times is used to determine if there is any abnormality or not.
 How is the procedure performed?
After suitable preparation, electrodes are applied to various predetermined positions on the chest. These are then connected to the machine and a resting ECG record taken, You will then be guided about the treadmill and how best to walk on it. Once you start walking the technician is constantly monitoring the ECG and takes recordings at preset timings. Additional recordings may be made in case you experience any symptoms. Alongside your blood pressure will also be measured periodically. The speed of the treadmill, as well as the gradient, is regulated according to a set protocol.
You will be advised to report to the technician any symptoms promptly so that a judgment can be made whether or not the test needs to be terminated in your own interests. As a measure of abundant precaution a red button is provided on the bar in front of you which when pressed will stop the test whenever you so desire. Please do not touch this button if you do not wish to stop the test.
 What will I experience during the procedure?
You will not experience any particular sensation(s) during the procedure except for what may be noticed during exercise anyway. However, weakness, transient light headedness, fainting, chest pain, palpitations or shortness of breath may occur especially if you have been experiencing such symptoms prior to the test. In any case any symptoms experienced during the test must be promptly reported to the attending technician/doctor who will then determine if the test should be aborted. If you wish to terminate the test immediately please press the red button.
No pain is caused. No injections are given except in special circumstances.
 Who interprets the results and how do I get them?
The tracings are reviewed by a doctor and a report prepared. Normally the report should be ready by the evening of the day of the test.
Please remember that similar results in different clinical circumstances may have different significance. Therefore, it is in your own interests that tracings and reports be shown to your own doctor who recommended the procedure in the first place for the most useful interpretation of data. It is for this reason that our staff are under instructions to encourage you to seek proper interpretation of our reports from your own doctor.
 What are the risks and benefits of the procedure?
There is a small but definite risk associated with the procedure. Patients being evaluated for possible coronary artery disease may experience chest pain (angina), shortness of breath or palpitations. Even patients being evaluated for functional capacity may experience similar symptoms. These should be promptly reported for appropriate management.
There is a small risk that a heart attack may be precipitated during the test (2 to 3 per 10,000 tests). Very rarely sudden death may occur (1 per 10,000 tests).
The procedure is a very useful, simple and inexpensive test that helps to screen for possible coronary artery disease or to evaluate the functional capacity of a patient. Whereas in some cases the results may have diagnostic value, in many others it provides an indication for the possible line of action by the treating doctor.
 What are the limitations of the procedure?
It has been estimated that the test has a sensitivity of 75% and specificity of 80%. That means that the test is able to detect 75 out of 100 patients of coronary artery disease and that in 80% of cases a specific diagnosis can be provided. Thus, in common with many other biological tests, a small number of patients who actually have the disease may not be picked up and that in a much smaller number patients with a positive test may not in reality have the disease.

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