Memorial Regional Medical CenterCARDIAC CATH LAB

                                  HEART CENTER HOSPITAL

Procedure Report

 

Hospital logo                                                                                        Report date: 2-5-01

                                                                                                             Proc. Date: 2-5-01

Patient: Thomas, Harry        ID: 12345678 Procedure: Right and Left Heart Cath                  

Age: 55 BD: 1-1-46  Ht: 5’10 ft.    Wt: 200 lbs.     BSA: 2.08

Referring Physician: Dr. Adams

Cath Physician: Dr. Margolis

 

MEDICAL HISTORY:

General:  Diabetes  COPD 

Cardiac:  Valvular heart disease  Angina pectoris 

 

CARDIAC EXAM:

ECG: NSR  BP: 145/88  Cardiac Sounds:  Stress Echo 11/22/00

Stress Echo findings: Maximum stage achieved was 3. Patient reached 80% of predicted heart rate. Milt ST abnormalities during exercise.

 

INDICATION FOR CATH:

Aortic stenosis. Evaluation of ventricular function and LV function. 

 

OPERATIVE PROCEDURE: Mr. Thomas came to the cath lab for evaluation of coronary arteries, ventricular function. The patient underwent a Right and Left Heart Cath. Selective LV and Coronary Angiography was performed utilizing the Judkins technique. The procedure was tolerated well.

 

CATHETERIZATION FINDINGS:

 

HEMODYNAMICS:    

 

HR: 77 RHYTHM: NSR

PRESSURES:

RA (a/v/m): 2/4/6 mm/Hg.            PA (s/d):  26/12/16 mm/Hg.  

RV(s/d): 26/6 mm/Hg.                   PCW (s/d/m): 16 mm/Hg.     

 

LV (s/edp): 165/12 mm/Hg.          AO (s/d/m): 145/90/112 mm/Hg.

 

PRESSURE GRADIENTS:

Aortic mean gradient: 20 mm/Hg.

 

VALVE AREA: Aortic valve area: 2.30 cm.2   Index: 1.10 cm2/M2

 

CARDIAC OUTPUT: 5.60 L/min.      Index: 2.70 L/min./M2

 

 

RESISTANCES [ARU]:

Systemic Vascular: 1170  Index: 2434

Pulmonary Vascular: 67   Index: 139

 

 

ANGIOGRAPHIC FINDINGS:

LV ANGIOGRAM:  The RAO projection showed a Mildly Impaired overall LV function with an ejection fraction of 35%.  Mild Hypokenis was found in the Anterobasal Section.  Hyperkinesis was found in the Apical Section.  Akinesis was found in the Diaphragmatic Section.  Dyskinesis was found in the Posterobasal Section.  In addition, the RAO projection showed 2+ Regurgitation and a Mild Stenosis in the Mitral valve, and 1+ Regurgitation and a Moderate Stenosis in the Aortic valve.

   

                     End-diastole                                                 Systole

 

 

CORONARY ANGIOGRAPHY:

 

Overall Dominance: Right

 

Right Coronary Artery: A Complex, 99% occlusion was found in the Distal RCA region.

 

Left Main: The left main artery is angiographically unremarkable.

 

Left Anterior Descending: There were 2 lesions found in the Left Anterior Descending.  An Eccentric, <30% occlusion was found in the Prox LAD region.  An Eccentric, <30%  occlusion was found in the Mid LAD region.

 

 

Left Circumflex: A Concentric, 75-80% occlusion was found. in the Prox Cx region.

 

 

 

                    Right Coronary Artery                 Left Coronary Artery

 

 

 

CONCLUSIONS:

    Mild mitral and aortic valves stenosis.  

RECOMMENDATIONS:

The patient should be  . Valvular disease should continue to be monitored.  

                                                                                   

                                                                                   

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                                                                        Cath or interpreting physician’s name