DATE OF STUDY: MM/DD/YYYY
INDICATION FOR STUDY: Shortness of breath on exertion, which might indicate anginal equivalent, history of hypertension, and hyperlipidemia.
PROCEDURE: After informed consent was obtained, a baseline EKG was obtained that demonstrated normal sinus rhythm with one premature atrial contraction. The patient had a baseline blood pressure of 142/80 mmHg and a baseline heart rate of 66 bpm. The patient was given 11 mCi of 99mTc Cardiolite IV at rest, and after an appropriate delay resting, SPECT images were obtained.
The patient was then exercised for 11 minutes 54 seconds using the Bruce protocol. The test was terminated due to maximum effort and fatigue. One minute prior to terminating the exercise portion, the patient was injected with 30 mCi of 99mTc Cardiolite.
FINDINGS: The patient achieved a maximum heart rate of 152 bpm, which was 87% of the maximum heart rate, and a blood pressure of 176/90 mmHg. A maximum of 1.7 mm of ST depression with a negative slope was observed. However, this was seen only in lead V3 and lasted only about 10 seconds. During the exercise portion, the patient experienced no angina, shortness of breath, dizziness or ventricular ectopy.
CONCLUSION: Equivocal electrocardiographic evidence for significant ischemia was observed. Exercise tolerance was excellent. Blood pressure response to exercise was normal. The patient had Duke treadmill score of 3, which indicates 1% annual cardiovascular mortality and an a five-year survival rate of 93%.
Nuclear Stress Test Sample # 2
DATE OF STUDY: MM/DD/YYYY
INDICATION FOR STUDY: Edema, hypertension, and abnormal EKG in a patient scheduled for preoperative evaluation for right hip surgery.
PROCEDURE: After informed consent was obtained, a baseline EKG was obtained that demonstrated T inversions in V1 and V2. The patient had a baseline blood pressure of 128/80 mmHg and a baseline heart rate of 78 bpm. The patient was given 11 mCi of 99mTc Cardiolite IV at rest, and after an appropriate delay resting, SPECT images were obtained. The patient was not a candidate for treadmill testing due to arthritis in both hips with inability to walk on the treadmill. The patient was given 54.7 mg adenosine IV over 4 minutes. After 2 minutes of adenosine infusion, the patient was given 30 mCi of 99mTc Cardiolite.
FINDINGS: The patient achieved a maximum heart rate of 106 bpm, which was 62% of maximum heart rate and a blood pressure of 150/86 mmHg. A maximum of 0.2 mm of ST depression with a positive slope was observed. During the exercise portion, the patient experienced no angina, shortness of breath, dizziness or ventricular ectopy.
CONCLUSION: Negative electrocardiographic evidence for significant ischemia was observed. Blood pressure response to exercise was hypertensive.
