Cardiac Stress Test Medical Transcription Transcribed Sample Reports


DATE OF STUDY / DATE OF TEST:  MM/DD/YYYY

DATE OF INTERPRETATION:  MM/DD/YYYY

REFERRING PHYSICIAN:  John Doe, MD

CONSENT:  Informed consent was obtained from the patient.

DETAILS OF STUDY:  First, the patient had resting perfusion images with Cardiolite.  The patient was brought to the stress test laboratory and was given adenosine 54.7 mg over 4 minutes.  Two minutes after the infusion of adenosine, Cardiolite was reinjected per protocol.

Resting hemodynamics, blood pressure is 151/81.  Pulse rate is 71 per minute and regular.  Resting EKG shows normal sinus rhythm, normal axis.  EKG is basically within normal limits.

After the infusion of adenosine, the patient became markedly short of breath, requiring intravenous aminophylline and nebulizer treatment.  The patient was taken to the emergency room for breathing treatment and further management.  The test was completed without any major complications.  The patient was taken to nuclear medicine for acquisition of perfusion images, which are interpreted separately by the radiologist.

Resting EKG showed normal sinus rhythm, normal axis.  EKG is basically within normal limits.  EKG was recorded every one minute, both during infusion of adenosine and post infusion.  No ischemic ST depression or elevation was noted.  One PVC was noted after infusion of adenosine.  Once the patient was treated with nebulizer treatment and intravenous aminophylline, his breathing improved.

Thank you for this kind referral.


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DATE OF STUDY:  MM/DD/YYYY

DATE OF INTERPRETATION:  MM/DD/YYYY

REASON FOR STUDY:  Cardiolite adenosine stress testing was performed for evaluation of chest pain and risk stratification.

CONSENT:  Informed consent was obtained from the patient.

DETAILS OF STUDY:  First, the patient had resting perfusion images with Cardiolite.  The patient was brought to the stress test laboratory and was given adenosine 48.5 mg over 4 minutes.  Two minutes after the infusion of adenosine, Cardiolite was reinjected per protocol.

Resting hemodynamics.  Blood pressure is 160/90.  Pulse rate is 70 per minute and regular.  Resting EKG shows normal sinus rhythm, normal axis.  EKG is basically within normal limit.

EKG was recorded every 2 minutes, both during infusion of adenosine and post infusion.  No ischemic ST depression or elevation was noted.  The patient reported symptom of pressure feeling in the chest, which subsided after the adenosine was infused.

The test was completed without any complication.  The patient was taken to nuclear medicine for acquisition of perfusion images.

Thank you for this kind referral


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DATE OF STUDY:  MM/DD/YYYY

DATE OF BIRTH:  MM/DD/YYYY

REFERRING PHYSICIAN:  John Doe, MD

NAME OF STUDY:  Stress echo (treadmill).

PROTOCOL:  Standard Bruce protocol.

RESTING EKG:  Resting EKG demonstrates normal sinus rhythm, nonspecific ST-T wave changes, poor R wave progression.

DURATION OF STUDY:  The patient exercised for a total duration of 7 minutes and 15 seconds on the standard Bruce protocol.

REASON FOR TERMINATING THE TEST:  The patient stopped secondary to leg fatigue. The patient denied chest pain.

EKG RESULTS:  With exercise, there were upsloping ST segments with an additional 1.6 mm depression in the inferior leads and 1.0 mm of horizontal ST segment depression in lead V6 which persisted less than 1 minute into recovery. Stress EKG is positive for ischemia. There were no arrhythmias.

FINDINGS OF STUDY:  The resting heart rate was 72 beats per minute. The patient attained a maximal heart rate of 186 beats per minute which is greater than 100% of the predicted maximal heart rate. Resting blood pressure was 130/90, and at peak exercise, the blood pressure was 150/82, which is normal blood pressure response to exercise.

Resting echocardiographic images demonstrate normal left ventricular size and thickness with normal left ventricular contractility. Estimated left ventricular ejection fraction is 65%. Post stress echocardiographic images demonstrated normal left ventricular contractility.

CONCLUSIONS OF STUDY:
1.  Stress EKG is positive for ischemia with 1.6 mm additional upsloping ST segment depression in the inferior leads and 1.0 mm of additional horizontal ST segment depression in lead V6. There was less than 1.0 mm of depression at 1 minute into recovery.
2.  No chest pain.
3.  No arrhythmias.
4.  Good exercise capacity.
5.  Normal stress echocardiography.

Thank you for this kind referral.


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DATE OF STUDY:  MM/DD/YYYY

NAME OF STUDY:  Stress echocardiogram.

REFERRING PHYSICIAN:  John Doe, MD

FINDINGS OF STUDY:  Resting electrocardiogram demonstrates sinus rhythm, left axis deviation, poor R-wave progression. The patient was exercised on a standard Bruce protocol for a total of 9 minutes and 20 seconds. Exercise was terminated secondary to dizziness and general fatigue. The patient did not complain of chest discomfort during exercise. Peak blood pressure was 190/92, peak heart rate was 130 beats per minute. This represents 74% of the age-predicted heart rate maximum for this patient. There were no ischemic changes seen on the electrocardiogram during exercise.

Resting echocardiogram is technically fair quality study. Definity contrast was therefore utilized. At rest, a normal size left ventricle with normal contractility is demonstrated. Estimated ejection fraction is 70%. A normal augmentation of contractility is seen with exercise. No exercise-induced regional wall motion abnormality is detected.

CONCLUSIONS:
1.  Electrocardiographically negative for ischemia at workload achieved.
2.  Blunted heart rate response to exercise secondary to beta blocker.
3.  Echocardiographically negative for ischemia.

Thank you for this kind referral.


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DATE OF STUDY:  MM/DD/YYYY

NAME OF STUDY:  Stress echocardiogram

REFERRING PHYSICIAN:  John Doe, MD

REASON FOR STUDY:  Chest pain.

STUDY FINDINGS:  Resting EKG revealed normal sinus rhythm and was within normal limits. No changes noted on standing or post hyperventilation.  The patient exercised a total of 11 minutes on the standard Bruce protocol, stopping for shortness of breath. No chest pain was reported.  Review of the EKGs performed with exercise revealed less than 1 mm of upsloping ST depression 0.09 seconds past the J point, peak exercise.  No arrhythmias were seen during exercise.  Frequent PVCs were seen in the recovery phase, including a few brief bigeminal cycles.

The patient attained a peak heart rate of 150, which exceeded 85% of his predicted maximum.  Maximum blood pressure noted was 188/96 at the end of the third stage of exercise, relative to his baseline pressure of 120/72. This represented an appropriate hypertensive response.

Review of the resting echocardiographic images revealed normal left ventricular size and wall motion.  Following exercise, repeat echocardiographic images demonstrated uniform hypokinesia of all wall segments.

CONCLUSIONS:
1.  Negative for ischemia by electrocardiogram criteria.
2.  No chest pain with exercise.
3.  Normal rest and stress echocardiogram for wall motion analysis.

Thank you for this kind referral.


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DATE OF STUDY:  MM/DD/YYYY

NAME OF STUDY:  Dobutamine stress echocardiogram.

REFERRING PHYSICIAN:  John Doe, MD

REASON FOR STUDY:  Chest pain.

STUDY AND FINDINGS:  The patient received standard infusion of IV dobutamine, administered in incremental increasing dosages at 3 minute intervals beginning at 10 mcg per kg per minute during the first 3 minute stage, followed by 20 mcg per kg per minute and subsequently 30 mcg per kg per minute during the third and final stage of the infusion.  The infusion was stopped after the patient's target heart rate was exceeded.  No chest pain was reported by the patient during the infusion process.  The patient's heart rate increased in appropriate fashion with dobutamine.  No major hypotension was noted during the procedure.

Review of the resting EKG revealed sinus bradycardia with delayed R-wave progression anteriorly along with borderline first-degree AV block.  Review of the EKGs performed during the dobutamine infusion revealed less than 1 mm of ST depression 20 seconds after the J point.  At peak dobutamine infusion, occasional PVCs were seen.  No major arrhythmias were noted in recovery.

Review of the resting echocardiographic images revealed normal left ventricular size and wall motion.  Low-dose dobutamine infusion repeat echocardiographic images demonstrated uniform augmentation motion of all visualized wall segments.  At peak dose dobutamine infusion, repeat echocardiographic images demonstrated uniform hyperkinesia of all visualized wall segments.  In the recovery phase, wall motion remained uniform.

STUDY CONCLUSIONS:
1.  Negative for ischemia by electrocardiogram criteria.
2.  Normal resting dobutamine stress echocardiogram for wall motion analysis.

Thank you for this kind referral.


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DATE OF STUDY:  MM/DD/YYYY

DATE OF INTERPRETATION:  MM/DD/YYYY

REASON FOR STUDY:  Cardiolite stress testing was performed for evaluation of chest pain.

CONSENT:  Informed consent was obtained from the patient.

DETAILS OF STUDY:  First, the patient had resting perfusion images with Cardiolite.  The patient was brought to the stress test laboratory and was exercised on regular Bruce protocol.  Resting EKG showed normal sinus rhythm, normal axis.  There is LVH by voltage.   There is also poor R-wave progression noted over the precordial leads.  The patient exercised for a total duration of 7 minutes.  He achieved a heart rate of 144 beats per minute, which is under 3% of the maximal predicted heart rate.  Maximum blood pressure response was 200/110.  Maximum workload attained was 8 METS.  Reason for termination of stress testing was shortness of breath and tiredness.  

Review of the stress EKG at the peak of exercise demonstrated 0.5 mm flat to downsloping ST depression 80 millisecond after the J-point in lead III and aVF.  This ST depression lasted for about 6 minutes into recovery stage.  One minute before the termination of stress testing, Cardiolite was reinjected per protocol.

CONCLUSION:  Borderline positive exercise electrocardiogram for ischemia at a workload of 8 METS.

Thank you for this kind referral.


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