Charles Tew Research Paper
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 …show more content…
Dissection was carried down beneath the major pectoralis muscle and a pocket created deep to this. This extended medially and up toward the clavicle. Bleeding was controlled using cautery. A pocket was created large enough to contain the internal pulse generator. Then a tunneler was used to tunnel the leads from the neck down to the pocket over the clavicle on the left. These leads were connected to the generator. The generator was tucked into this pocket and closure begun.
All wounds were copiously irrigated with normal saline. The fascia was closed using interrupted 3–0 Vicryl sutures followed by a running 4–0 subcuticular stitch for the skin incisions. Dermabond was applied over both incisions and a sterile dressing.
ESTIMATED BLOOD
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 …show more content…
Dissection was carried down beneath the major pectoralis muscle and a pocket created deep to this. This extended medially and up toward the clavicle. Bleeding was controlled using cautery. A pocket was created large enough to contain the internal pulse generator. Then a tunneler was used to tunnel the leads from the neck down to the pocket over the clavicle on the left. These leads were connected to the generator. The generator was tucked into this pocket and closure begun.
All wounds were copiously irrigated with normal saline. The fascia was closed using interrupted 3–0 Vicryl sutures followed by a running 4–0 subcuticular stitch for the skin incisions. Dermabond was applied over both incisions and a sterile dressing.
ESTIMATED BLOOD