Cardiac Imaging Teresa Mann

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  • Topic: Vagus nerve, Vagus nerve stimulation, Common carotid artery
  • Pages : 4 (732 words )
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  • Published : June 28, 2011
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CARDIAC IMAGING
Teresa Mann
19372634
1196782
Charles Tew, MD
BD: 10 November 60
2 January — —

HISTORY
CHEST PAIN.

CARDIAC IMAGING (Dobutrex/Myoview)
RESTING IMAGES WERE OBTAINED AFTER THE INJECTION OF 10 MCI OF MYOVIEW. SUBSEQUENTLY, THE PATIENT HAD DOBUTREX INFUSION ACCORDING TO OUR STANDARD PROTOCOL, REACHING A MAXIMUM HEART RATE ,WITH THE HELP OF 0.5 MG OF ATROPINE IV, OF 144 BPM WITH A TARGET HEART RATE OF 135 BPM. THERE WAS A RESTING LEFT BUNDLE BRANCH BLOCK WITH NO ISCHEMIC CHANGE FROM BASELINE WITH DOBUTREX AS MONITORED BY DR. RABB, WHO MONITORED THE TEST. POST STRESS, THE PATIENT DEVELOPED CHEST DISCOMFORT THAT WAS RELIEVED BY NITROGLYCERIN AND A SIGNIFICANT DOSAGE OF NUBAIN—10 MG IV. SHE HAD NO EKG CHANGES BUT DID START WITH A RESTING LEFT BUNDLE BRANCH BLOCK. THE STRESS PORTION OF THE TEST WAS MONITORED BY DR. RABB.

FINDINGS
COMPARISON OF THE REST AND STRESS IMAGES IN THE STANDARD CORONAL, TRANSVERSE, AND SAGITTAL VIEWS SHOWS A WORRISOME FOCUS OF INFEROLATERAL ATTENUATION, SUGGESTING REPERFUSION OR ISCHEMIA AND SOME DISTAL ANTERIOR WALL BLUSH, WHICH COULD BE ACCOUNTED FOR ON THE BASIS OF BODY SIZE, BUT IS ALSO SUSPICIOUS FOR REPERFUSION OR ISCHEMIA.

IMPRESSION
ABNORMAL PERFUSION STUDY SUGGESTING INFEROLATERAL AND ANTEROAPICAL REPERFUSION OF ISCHEMIA.

Charles Tew, MD
Radiologist

CT:RE

D:1/02/ — —
T:1/02/ — —

OPERATIVE REPORT
JENKINS, AMANDA
2967898
Hal Russo, MD
June 29, 20 — —

PREOPERATIVE DIAGNOSIS
MEDICALLY REFRACTORY SEIZURES.

POSTOPERATIVE DIAGNOSIS
MEDICALLY REFRACTORY SEIZURES.

OPERATION
INSERTION OF LEFT VAGAL NERVE STIMULATOR.

SURGEON: Hal Russo, MD

1ST ASSISTANT: Wendy Quimby, MD

2ND ASSISTANT: Justin Dunn, MD

ANESTHESIA
GENERAL ENDOTRACHEAL.

HISTORY
THIS IS A SIX-YEAR-OLD, WHITE FEMALE WHO HAS HAD MEDICALLY REFRACTORY SEIZURES FOR MOST OF HER LIFE. SHE ARRIVES HERE AFTER FAILING MULTIPLE MEDICAL THERAPIES FOR INSERTION OF A VAGAL NERVE STIMULATOR IN THE PALLIATIVE...
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