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Sample Report Cardiac Catheterization

Title of Procedure 1. Left heart catheterization. 2. Coronary angiography. 3. Left ventriculography. 4. Saphenous vein graft angiography. 5. Left internal mammary graft angiography. Procedure in Detail: After informed consent was obtained and premedications...

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Sample Report Suboccipital Craniotomy

Preoperative Diagnosis: Left suboccipital depressed skull fracture. Postoperative Diagnosis: Left suboccipital depressed skull fracture. Procedure Performed: Left suboccipital craniotomy for elevation of depressed skull fracture. Anesthesia: General endotracheal....

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Sample Report Polysomnography Study

Clinical History: The patient is a 50-year-old female who presents with a chief complaint of, "I have trouble falling asleep and staying asleep. Once I wake up at night, I have trouble going back to sleep. I often wake up with a headache." She measures...

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Sample Report Herniated Disk Repair

Preoperative Diagnosis: Herniated disk with left sciatica. Postoperative Diagnosis: Herniated disk with left sciatica. Procedure Performed: Left L4-5 laminotomy, medial facetectomy, and diskectomy with microscope. Anesthesia: General endotracheal anesthesia....

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Sample Report Evoked Potential Study

Clinical History: The patient is a 45-year-old male who presents with back pain and sensory disturbance, particularly involving the left side of the body. Apparently, he has tingling sensation in the hands and feet. No medications are listed. Details...

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