The treadmill ECG stress test (TMT) is part of health check packages recommended for asymptomatic people to detect diseases at an early age that can prevent or reduce future morbidity and mortality. The TMT test has an average sensitivity of 68% and a specificity of 77%. In this article, learn about the TMT test for the heart, why it is done, and the normal range of TMT for people.

Heart-related complications are often life threatening, if not fatal. Rapid heart rate, shortness of breath, discomfort and pain in the chest – all of these are common signs of cardiovascular complications that you are likely taking for granted. Routine and complete screening allows you to live a carefree life without the burden of worries in your head. Get routine tests to stay updated about your heart function.

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What is the need for the TMT Test for Heart?

The TMT test helps diagnose heart conditions and see how well your heart handles the workload. Your doctor might suggest you a TMT test if you are undergoing heart surgery, heart treatment, or starting some vigorous exercise program. Other reasons for which a doctor might recommend a TMT test are-

  • Diagnosis of the damage or disease in the coronary arteries due to the accumulation of cholesterol or other substances (plaques).
  • Diagnosis of cardiac arrhythmia that can occur due to improper coordination of the electrical impulses.
  • Plan the treatment of heart disorders
  • Diagnose cardiovascular health

You might also be recommended a TMT test if you have one or more of the following symptoms that indicate a heart disease:

  • Fast heartbeat
  • Irregular heartbeat
  • Dizziness 
  • Chest pain
  • Breathing difficulty 

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What is the normal range of TMT?

During a TMT test, you will be asked to exercise at approximately 85% of your maximum heart rate. The maximum heart rate is calculated by subtracting your age from 220. The TMT test can be either negative or positive. A negative TMT test indicates that the patient could reach a certain heart rate without showing any changes in the ECG result. Whereas a positive TMT result indicates that there were changes in the ECG report were obtained post-workload. 

Doctors also evaluate how well your heart rate recovers post-exercise. The recovery is calculated by subtracting the heart rate one minute after exercise from the peak heart rate. The inferences drawn are tabulated below:

S.No.Peak heart rate minus the heart rate 1 minute after intense exerciseInference 
1.< 12 bpm in a walking recoveryAbnormal 
2.> 12 bpm in a walking recoveryNormal 
3.< 18 bpm while lying on the backabnormal
4.> 18 bpm while lying on the backNormal 

During a TMT test, your blood pressure is also monitored. The changes in the diastolic and systolic blood pressure can be an indication of certain health conditions. The major inferences that can be drawn from blood pressure readings are

S.No.Blood pressure readingsInference 
1.Less than 10 mm Hg increase in the blood pressureThis might be due to the blood pressure reduction medications
2.Less than 10 mm Hg change in the diastolic blood pressurePeripheral vasodilation
3.Drop in the systolic blood pressure of more than 10 mm HgSevere left ventricle dysfunction or coronary artery disease
4.Systolic blood pressure greater than 250 mm Hg and diastolic blood pressure greater than 120 mm HgSevere hypertension

Your tolerance to exercise can also be calculated through the TMT test. These values are calculated in terms of metabolic equivalents or METS. METS refers to the uptake of oxygen expressed in kg/minute. The inferences that can be drawn from the TMT test are listed below:

S.No.METS ReadingInference
1.< 5 METSPoor 
2.5 – 8 METSFair 
3.9 – 11 METSGood 
4.> 12 METSAny METS score above 10 indicates a 5-year survival rate of around 95%.
 

Takeaway 

The TMT or treadmill stress test is a safe, non-invasive and affordable screening test for the diagnosis of coronary artery diseases (CAD). It is an essential diagnostic test for people at a higher risk of developing cardiovascular diseases. Now that you know what a TMT test is, who are the best candidate for the test and what the values of the test report mean, you will be able to analyze your health status better.

 

Frequently Asked Questions (FAQs)

  • Who should not go for a TMT test?

The TMT test is not suggested for people who have any heart or cardiovascular conditions, arthritis, or had a stroke or heart attack in the recent past.

  • What are the risks of getting a TMT test done?

Generally, a TMT test is safe. However, some of the rare risks of the TMT test include collapse, chest pain, heart attack, getting fainted, or irregular heartbeat.

  • What is the normal TMT report?

The normal maximum TMT heart rate for adults is 220 minus your age. 85% of this predicted maximum heart rate is considered normal.

 

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Ms. Srujana is Managing Editor of Cogito137, one of India’s leading student-run science communication magazines. I have been working in scientific and medical writing and editing since 2018. I am also associated with the quality assurance team of scientific journal editing. I am majoring in Chemistry with a minor in Biology at IISER Kolkata.

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