Cardiac Diagnostic Test
Title of Procedure: Cardiolite treadmill.
Procedure in Detail: The electrocardiogram prior to exercise revealed sinus rhythm with bigeminal ventricular premature beats. The intervals and frontal axis were within normal limits. There were minor nondiagnostic ST-T changes at rest. Blood pressure prior to exercise was 91/44.
The patient walked a total of 4 minutes 10 seconds according to a greatly modified protocol completing exercise 2 mph, 0% grade, obtaining a peak heart rate of 121 beats per minute equaling 85% of predicted age-adjusted maximum heart rate. The test was stopped due to fatigue and shortness of breath. There was no complaint of exercise-induced chest pain. Blood pressure had risen to 131/61 and an energy expenditure of 4 METS is estimated.
A predetermined dose of Cardiolite was injected 40 seconds prior to the completion of exercise. The electrocardiogram during exercise revealed sinus rhythm with periods of ventricular premature beats. As exercise proceeded, there was minimal, i.e., 0.5 mm or less, additional ST-segment depression inferolaterally. This does not fulfill criteria for inducible myocardial ischemia. No additional changes of significance were noted as the heart rate decelerated in the recovery phase.
Title of Procedure: Color venous duplex.
Description of Procedure: On the transverse view, the veins were compressible at the common femoral. It was technically difficult to visualize the superficial femoral vein and parts of the popliteal vein.
On the longitudinal view, however, the color flow was considered adequate at the common femoral vein and parts of the superficial femoral vein. However, distally the flow decreased to very minimal. Deep vein thrombosis could not be completely ruled out with this test.
Title of Procedure: Tilt table test.
Procedure in Detail: The exam was started at 10:15 a.m. Blood pressure was 114/98, heart rate 59. The head of the bed was elevated to 70 degrees at 10:29 a.m. Blood pressure was 110/70; heart rate 59, paced rhythm. At 10:32, blood pressure dropped to 84/53. Heart rate continued at 60, paced rhythm. The patient was symptomatic with lightheadedness, dizziness, and room spinning.
Conclusion: Positive tilt table exam for cardioneurogenic syncope.
Procedure in Detail: The electrocardiogram prior to exercise revealed sinus rhythm with bigeminal ventricular premature beats. The intervals and frontal axis were within normal limits. There were minor nondiagnostic ST-T changes at rest. Blood pressure prior to exercise was 91/44.
The patient walked a total of 4 minutes 10 seconds according to a greatly modified protocol completing exercise 2 mph, 0% grade, obtaining a peak heart rate of 121 beats per minute equaling 85% of predicted age-adjusted maximum heart rate. The test was stopped due to fatigue and shortness of breath. There was no complaint of exercise-induced chest pain. Blood pressure had risen to 131/61 and an energy expenditure of 4 METS is estimated.
A predetermined dose of Cardiolite was injected 40 seconds prior to the completion of exercise. The electrocardiogram during exercise revealed sinus rhythm with periods of ventricular premature beats. As exercise proceeded, there was minimal, i.e., 0.5 mm or less, additional ST-segment depression inferolaterally. This does not fulfill criteria for inducible myocardial ischemia. No additional changes of significance were noted as the heart rate decelerated in the recovery phase.
Title of Procedure: Color venous duplex.
Description of Procedure: On the transverse view, the veins were compressible at the common femoral. It was technically difficult to visualize the superficial femoral vein and parts of the popliteal vein.
On the longitudinal view, however, the color flow was considered adequate at the common femoral vein and parts of the superficial femoral vein. However, distally the flow decreased to very minimal. Deep vein thrombosis could not be completely ruled out with this test.
Title of Procedure: Tilt table test.
Procedure in Detail: The exam was started at 10:15 a.m. Blood pressure was 114/98, heart rate 59. The head of the bed was elevated to 70 degrees at 10:29 a.m. Blood pressure was 110/70; heart rate 59, paced rhythm. At 10:32, blood pressure dropped to 84/53. Heart rate continued at 60, paced rhythm. The patient was symptomatic with lightheadedness, dizziness, and room spinning.
Conclusion: Positive tilt table exam for cardioneurogenic syncope.
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