45m diabetic on OHA,controlled,bp normal rarely upto140/90 has no any complaints ecg after 5killometer walking routine checkup…… plz expert opinion if there is any future warning…………… history only genetical diabetics

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Evaluating asymptomatic diabetic for coronary artery disease, has no shown any benefits, so stress testing like TMT is not recommended in asymptomatic patient control sugars with what ever feasible, only drug that has shownn cardiovascular benefits is metformin give ace or arb for hypertension give intermediate intensity statin eg rosuvastatin 10 to 20 mg and ecgs also looks ok

sinus tachycardia,. may be be due to 5 km walking, if one can walk 5 km or 1 km brisk walking without any problem ,suggest that pt. is free from cardiac illness

S.tachycrdia Resting ecg will not predict future cardiac events better to do tmt control of sugar & pressure & cholesterol much important

Just for the help of everyone...Treadmill stress testing is indicated for diagnosis and prognosis of cardiovascular disease, specifically CAD. This is the initial procedure of choice in patients with a normal or near-normal resting electrocardiogram who are capable of adequate exercise.[7]Contraindications have been outlined in guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA). Absolute contraindications include the following: Acute myocardial infarction(MI; within 2 days) Unstable anginanot previously stabilized by medical therapy Appropriate timing of tests depends on the level of risk of unstable angina as defined by the Agency for Health Care Policy and Research Unstable Angina Guidelines Uncontrolled cardiac arrhythmias causing symptoms or hemodynamic compromise Symptomatic severeaortic stenosis Uncontrolled symptomaticheart failure Acute pulmonary embolus or pulmonary infarction Acutemyocarditisor pericarditis Acute aortic dissection Relative contraindications can be superseded if the benefits of exercise outweigh the risks. They include the following: Left main coronary stenosis Moderate stenotic valvular heart disease Electrolyte abnormalities Severe arterial hypertension In the absence of definite evidence, the committee suggests an SBP higher than 200 mm Hg, a DBP higher than 110 mm Hg, or both Tachyarrhythmias or bradyarrhythmias Hypertrophic cardiomyopathyand any other forms of outflow tract obstruction Mental or physical impairment leading to an inability to exercise adequately High-degreeatrioventricular (AV) block The vast majority of treadmill exercise tests are performed on adults with symptoms of known or probable ischemic heart disease. Candidates for exercise stress testing may have stable symptoms of chest pain, may be stabilized by medical therapy after experiencing symptoms of unstable chest pain, or may have already had an MI or undergone a vascularization procedure. For patients with prior revascularization, uninterpretable electrocardiograms, or inability to adequately exercise, stress imaging is recommended.[7] The clinical suggestion of CAD on the basis of patient history findings, ECG tracings, and symptoms of chest pain must be established and used as a guide to determine if treadmill exercise testing may be useful according to the Bayes theorem, which states that the diagnostic power of exercise stress testing is maximal when the pretest probability of CAD is intermediate (30-70%) as indicated by age, sex, and nature of chest pain. When the diagnosis of CAD is confirmed on the basis of age, sex, description of chest pain, and history of previous MI, a clinical need may arise for risk or prognostic assessment to reach a decision regarding possible coronary angiography or revascularization to guide further medical management. MI (see the images below) is a common first presentation of ischemic heart disease. This subset of patients also may require prognostic or risk assessment.

Small q waves in leads II III avf though they r not significant Beacuse of Diabetis pt can be evaluated for CAD so TMT cardiac & renal profile should be done

sinus tachycardia ..otherwise normal ecg....but resting sinus tachy cardia is not normal. ..can not be expected of angina in diabetic patients as there is chance for autonomic neuropathy. either tachy cardia or bradycardia can be due to autonomic neuropathy.. if this patient persistently having sinus resting tachy cardia he should be evaluated further ...and if the patients on sulfonyl urea group of OHA those drugs will prevent ischemic preconditioning effect. so tachycardia is not good for this patient. .. precipitating factor for tachycardia to be evaluated and he may be under regularb observation with anxiolytics .

This is a case of sinus tachycardia.

Pic not clear still ecg s/o AVNRT,give inj adenosine

just being a Diabetic with nonspecific ST-T changes, does not give you liberty to impose unnecessary testing. There are scientific guidelines for different tests including Stress testing. http://emedicine.medscape.com/article/1827089-overview#a5

Appears normal EKG,tachycardia donot forecaste cardiac event. Since he is middile aged diabetic should keep regular check on blood glucose and blood pressure

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