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Echocardiography |
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Stress Testing/
Nuclear Cardiology
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Cardiac Catheterization/
Interventional Cardiology |
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Arrhythmia Service |
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EECP |
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Peripheral
Vascular |
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Anti-Coagulation
(Coumadin) Clinic |
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Research |
- The patient is a 68 year old male who was referred for stress thallium due to
- exertional angina.
- He exercised for 9 minutes without chest pain. He achieved a peak heart rate
- of 129 BPM (<85% predicted maximal heart rate). There was 1 mm of upsloping
- ST segment depression in the inferior leads.
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- The lung/heart ratio is elevated at 53% (normal < 50%, not shown) suggesting stress
- induced increase in pulmonary capillary wedge pressure.
- The thallium scan above shows transient left ventricular dilatation (the ventricle is
- more dilated with exercise than at rest). There is a severe anterior, septal and apical
- defect with almost complete redistribution in the rest scans.
- This study shows several high risk characteristics including the increase in lung
- heart ratio, transient LV dilatation and significant ischemia in the territory of
- the LAD coronary artery.
- At cardiac catheterization, he had a 90-95% mid LAD lesion. He susequently
- underwent stent placement.
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