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Dr. Who Cardiology 123 Anystreet Lane Ellicott City, MD 21045 Phone: 410-808-1000 Fax: 410-808-1010 Myocardial Perfusion Imaging Patient Name: Doe, Jack Sex: Male ID Number: 123000 Referring Physician: Dr. Who Date of Birth: 05/07/1945 Date of Exam: 11/20/2015 Height: 64 inches Weight: 145 lbs Protocol: 1 Day Adenosine rest/stress Tc99m Myoview History: This is a 70 year old man with a history of coronary artery disease. He had coronary artery bypass surgery in 1996. Clinical Indications: Assessment of chest pain Procedure: The patient was given 32.6 mg Adenosine intravenously over 6 minutes. The patient developed shortness of breath during the procedure. Heart rate was 75 bpm at baseline decreasing to 62 bpm after Regadenoson injection. The blood pressure response was normal. The baseline blood pressure was 160/88 mmHg and 102/68 mmHg during the adenosine infusion. The resting EKG was normal and the peak EKG demonstrated no ischemic changes. There were no significant dysrhythmias noted during Adenosine infusion or recovery. At rest 9.5 mCi Tc99m Myoview was injected intravenously followed by SPECT imaging. At 3 minutes into the Adenosine infusion 30.0 mCi Tc99m Myoview was injected intravenously. SPECT imaging was performed with electrocardiographic gating. Findings: The overall quality of the study is good. Left ventricular cavity size is normal. LVH is absent. TID ratio is normal. There is no significant motion artifact. The SPECT images demonstrate a small to medium sized area of mild to moderate reduced perfusion in the anterior and anteroapical region. When comparing rest and stress images this defect is completely reversible and consistent with mid- LAD territory ischemia. The post stress gated study demonstrates a normal post stress ejection fraction of 65% with normal wall motion and normal wall thickening. Impression: 1. This is an abnormal myocardial perfusion study with evidence for LAD territory ischemia, normal wall motion, and a normal post stress ejection fraction. 2. Compared to the prior study from October 18, 2011, the current study reveals new LAD territory ischemia 3. The above results were discussed with the patient. He will be scheduled for a cardiac catheterization. Electronically signed by Maria Costello, MD 11/20/2015 10:51 MPI Pharmacologic Stress Abnormal Report (SAMPLE) Note: This is a SAMPLE only. Reports submitted with the application MUST be customized to reflect current practices of the facility.