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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 63 year old male with a known history for coronary artery disease
- who was referred for stress thallium due to chest pain.
- He exercised for 12 minutes and had no chest pain. His peak heart rate was 142 BPM
- ( < 85% of his predicted maximal HR). There was 3 mm horizontal ST depression in
- leads V3-5.
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- The thallium scan above shows a moderate inferolateral defect with significant
- redistribution in the rest scans, consistent with moderate inferolateral ischemia.
- At cardiac catheterization, he had 100% occlusion of the left circumflex coronary
- artery with collateral flow from the circumflex and LAD territories. The likely
- reason for ischemia (as opposed to myocardial infarction with a 100%
- occluded artery) is that collateral circulation cannot meet the increased
- myocardial demand during exercise.
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