123 Main St NY, New York ph: (202) fax: (202)
|
|
- Paul Leonard
- 7 years ago
- Views:
Transcription
1 Patient Name: DOE, JOHN D. Gender: M Date of Study: 4/2/2013 Date of birth: 6/28/1962 Age: 50 Medical Record #: Ordering Physician: JANE INTERNIST, MD History: Atypical Angina, Abn ECG, High Cholesterol, Hypertension, Positive Treadmill Test Indications: Assessment of chest pain, Positive ETT 5.8 mci of Tc-99m sestamibi was administered via IV injection at rest. Approximately 45 minutes afterwards, cardiac SPECT imaging was performed. A stress test was then performed and at peak exercise, 17.9 mci of Tc-99m sestamibi was injected IV; approximately 45 minutes post injection, cardiac gated SPECT and prone cardiac gated SPECT imaging was performed. Attenuation correction was not used. STRESS PROTOCOL: Exercise Stress Test The patient exercised on a treadmill utilizing the Bruce protocol; they completed 11 minutes & 10 seconds, achieving approximately 12.9 METS. Baseline heart rate was measured at 62 bpm, and increased to 185 bpm at peak exercise; which is 108% of the maximum predicted heart rate. The heart rate response was normal. Baseline blood pressure was 142/78 mmhg and increased to 168/92 mmhg at peak exercise, which is a normal response to exercise. Resting ECG demonstrated normal sinus rhythm with diffuse non-specific ST-T wave abnormalities. During exercise, the ECG showed non-sustained V-tach. At peak stress, the ECG revealed downsloping ST-T depression of mm. During exercise, the patient developed dyspnea, chest pain level 4 of 10, fatigue. The reason for exercise termination was chest pain, fatigue, dyspnea, patient's request. Symptomatology resolved during standard recovery period. EXERCISE TEST SUMMARY: min on Bruce protocol Chest pain level 4 of 10 Dyspnea Exercise ST-T changes noted Stopped for chest pain, fatigue, dyspnea, patient's request. EXERCISE TEST IMPRESSION: Positive Study quality: suboptimal due to artifact Left Ventricle: Normal Artifacts: sub-diaphragmatic activity SPECT imaging demonstrated transient ischemic dilation of the left ventricle on the post-stress images, along with a medium size, mostly reversible perfusion abnormality of moderate severity located in the apical anterior, apical septal, mid anterior segment(s) of the left ventricle. The stress perfusion defect extent was 20%, the rest perfusion defect extent was 6%, and the stress ischemia extent was 14%. Gated SPECT imaging revealed normal left ventricular wall motion, thickening, and overall LV systolic function. The estimated post-stress ejection fraction was 52%. Abnormal myocardial perfusion: There was transient ischemic dilation of the left ventricle on the post-stress images. This is associated with severe CAD. Also, there was a medium size mostly reversible perfusion abnormality of moderate severity located in the apical anterior, apical septal, mid anterior segment(s) of the left ventricle. Stress defect extent = 20%; Rest defect extent = 6%; Stress ischemia extent = 14%. Normal left ventricular systolic function: All segments of left ventricle demonstrated normal wall motion and thickening. Ejection fraction = 52%. Results indicate that myocardial ischemia is possibly the cause of patient chest pain. Recommend cardiac catheterization, PCI if indicated. Joe Cardiologist, MD FACC Date of Final Report: 4/2/2013 cc: SALLY SPECIALIST,MD 123 Main St NY, New York ph: (202) fax: (202)
2 Patient Name: DOE, JOHN A. Gender: M Date of Study: 4/2/2013 Date of birth: 8/24/1955 Age: 57 Medical Record #: History: Fatigue, DOE, Dyslipidemia, A-Fib Indications: Assessment of anginal equivalents (Fatigue) (DOE) 5.7 mci of Tc-99m tetrofosmin was administered via IV injection at rest. Approximately 30 minutes afterwards, cardiac SPECT imaging was performed. A stress test was then performed and at peak stress, 20.3 mci of Tc-99m tetrofosmin was injected IV; approximately 30 minutes post injection, cardiac gated SPECT imaging was performed. Prone images were also acquired to mitigate attenuation artifact(s). STRESS PROTOCOL: Regadenoson Stress Test Reason for Pharmacologic Stress: V-paced, reactive airway disease The patient was intravenously infused with 5ml of regadenoson over 10 seconds for a total dose of.4 mg, followed by a 5ml saline flush over 10 seconds, followed by stress radiotracer administration seconds later. Adjunctive exercise was not used during pharmacologic stress infusion. Heart rate was 64 bpm at baseline, and changed to 89 bpm at peak stress. The heart rate response was normal. Baseline blood pressure was 120/80 mmhg and changed to 80/52 mmhg at peak stress, which is a hypotensive response to regadenoson. Resting ECG demonstrated normal sinus rhythm w/ PVCs, PACs with IVCD, LAHB. During stress the ECG revealed no additional arrythmia. At peak stress, the ECG revealed no diagnostic ST-T changes. During exercise, the patient developed a "funny" feeling, abdominal discomfort, dyspnea. The reason for infusion termination was end of protocol. 100 mgs of aminophylline was infused IV during recovery to reverse vasodilator stress agent. Symptomatology resolved approximately 3 minutes after standard recovery period. REGADENOSON STRESS IMPRESSION: Equivocal Study quality: adequate Left Ventricle: Normal Artifacts: diaphragmatic attenuation, frequent PVCs; gated study suboptimal SPECT imaging demonstrated homogeneous perfusion on the rest and stress images, with transient ischemic dilation of the left ventricle on the post-stress images. Gated SPECT imaging of the left ventricle was abnormal, demonstrating mild global hypokinesis of the left ventricle. Overall left ventricular systolic function was mildly impaired. The estimated resting ejection fraction was 55%, and the calculated post-stress ejection fraction was 43%. Abnormal myocardial perfusion: there was transient ischemic dilation of the left ventricle on the post-stress images. This is associated with severe CAD. Abnormal left ventricular systolic function: Mild global hypokinesis of the left ventricle. Ejection fraction = 43%. John Hancock, MD FACC Date of Final Report: 4/2/2013
3 Patient Name: DOE, JOHN Gender: M Date of Study: 4/2/2013 Date of birth: 3/15/1945 Age: 68 Medical Record #: History: Chest Pain, DOE, Sleep Apnea, Diabetic, Palpitations, Fam Hx of CAD Indications: Assessment of chest pain, Ischemic Equivalent (DOE) 5.6 mci of Tc-99m sestamibi was administered via IV injection at rest. Approximately 45 minutes afterwards, cardiac SPECT imaging was performed. A stress test was then performed and at mid-point of vasodilator infusion, 18.5 mci of Tc-99m sestamibi was injected IV; approximately 45 minutes post injection, cardiac gated SPECT imaging was performed. STRESS PROTOCOL: Adenosine Stress Test Reason for Pharmacologic Stress: Rate-related LBBB A dose of 140ug/kg/min of adenosine infused IV over 4 minutes for a total dose of 58.7 mg. Adjunctive exercise was used during pharmacologic stress infusion. The radiopharmaceutical was injected at 2 minutes into the infusion. Heart rate was 68 bpm at baseline, and changed to 89 bpm at midpoint of vasodilator infusion. The heart rate response was normal. Baseline blood pressure was 126/76 mmhg and changed to 112/72 mmhg at midpoint of vasodilator infusion, which is a physiologic response to adenosine. Resting ECG demonstrated normal sinus rhythm w/ PACs with rightward axis, early r-wave progression. During infusion the ECG revealed no additional arrythmia. At peak infusion, the ECG revealed no diagnostic ST-T changes. During infusion, the patient developed a "wierd" feeling, shortness of breath, flushing. The reason for infusion termination was end of protocol. 100 mgs of aminophylline was infused IV during recovery to reverse vasodilator stress agent. Symptomatology resolved during standard recovery period. ADENOSINE STRESS IMPRESSION: Nondiagnostic Study quality: suboptimal due to artifact Left Ventricle: Normal Artifacts: diaphragmatic attenuation SPECT imaging demonstrated uniform (normal) tracer distribution throughout the myocardium at rest and at peak stress. Gated SPECT images revealed normal thickening, wall motion, and overall left ventricular systolic function. The calculated post-stress ejection fraction was 57%. IMPRESSION: Normal Normal myocardial perfusion. Normal left ventricular systolic function: All segments of left ventricle demonstrated normal wall motion and thickening. Ejection fraction = 57%. John Hancock, MD FACC Date of Final Report: 4/3/2013
4 Patient Name: DOE, JANE B. Gender: F Date of Study: 4/3/2013 Date of birth: 2/9/1937 Age: 76 Medical Record #: Ordering Physician: JANE INTERNIST, MD History: Atypical Chest Pain, Depression, PVD, Positive Treadmill Test Indications: Assessment of chest pain, + ETT 5.3 mci of Tc-99m tetrofosmin was administered via IV injection at rest. Approximately 45 minutes afterwards, cardiac SPECT imaging was performed. A stress test was then performed and at ~ 3 minutes after infusion, 18.4 mci of Tc-99m tetrofosmin was injected IV; approximately 30 minutes post injection, anterior cardiac planar & cardiac gated SPECT imaging was performed. CT based attenuation correction was used. STRESS PROTOCOL: Dipyridamole Stress Test Reason for Pharmacologic Stress: V-paced The patient was intravenously infused with dipyridamole at 142ug/kg/min over 4 minutes for a total dose of 51.3 mg. Adjunctive exercise was used after the pharmocologic stress infusion; the stress dose of radiotracer injected then. The radiopharmaceutical was injected 3 minutes after the infusion. Heart rate was 69 bpm at baseline, and increased to 110 bpm at time of radiopharmaceutical injection. The heart rate response was normal. Baseline blood pressure was 138/84 mmhg and increased to 142/86 mmhg at time of radiopharmaceutical injection, which is a physiologic response to dipyridamole. Resting ECG demonstrated normal sinus rhythm w/ PVCs, PACs with lateral Q-waves. During dipyridamole infusion the ECG revealed PACs, PVCs. At peak infusion, the ECG revealed horizontal ST-T depression of mm. During infusion, the patient developed diaphoresis, nausea. The reason for infusion termination was end of protocol. Symptomatology resolved during standard recovery period. DIPYRIDAMOLE STRESS IMPRESSION: Positive by ECG criteria Study quality: adequate Left Ventricle: Normal Artifacts: none SPECT imaging demonstrated a medium size, fixed perfusion abnormality of moderate severity located in the mid inferolateral, basal inferolateral, mid anterolateral segment(s) of the left ventricle. Gated SPECT imaging of the left ventricle was abnormal, demonstrating moderate hypokinesis of the lateral segment(s) of the left ventricle (this abnormality matches a fixed perfusion defect, suggesting myocardial scarring from previous myocardial infarction). Overall left ventricular systolic function was mildly impaired. The estimated post-stress ejection fraction was 44%. Abnormal myocardial perfusion: Medium to large size fixed perfusion abnormality of moderate severity located in the mid inferolateral, basal inferolateral, mid anterolateral segment(s) of the left ventricle. Abnormal left ventricular systolic function: Moderate hypokinesis of the lateral segment(s) of the left ventricle. Ejection fraction = 44%. Compared to previous study on 1/18/2009, perfusion shows new infarction. There is new LV function abnormality. John Hancock, MD FACC Date of Final Report: 4/1/2013 cc: SALLY SPECIALIST,MD
5 Patient Name: DOE, JANE R Gender: F Date of Study: 4/2/2013 Date of birth: 9/24/1951 Age: 61 Medical Record #: History: Abn ECG, Syncope, Diabetic, Obesity(Morbid), High triglycerides Indications: Assessment of ischemic equivalent (Syncope), Abn ECG NUCLEAR IMAGING PROTOCOL: Dual Isotope 3.1 mci of Tl-201 thallium chloride was administered via IV injection at rest. Approximately 10 minutes afterwards, anterior cardiac planar & cardiac SPECT imaging was performed. Transmission source attenuation correction was used. A stress test was then performed and at peak stress, 21.1 mci of Tc-99m Cardiolite was injected IV; approximately 45 minutes post injection, cardiac gated SPECT and prone cardiac SPECT imaging was performed. Transmission source attenuation correction was used. STRESS PROTOCOL: Dobutamine Stress Test Reason for Pharmacologic Stress: Unable to exercise, COPD Dobutamine was infused incrementally, starting at a dose of 5 mcg/kg/min, which was increased at 3-minute intervals to 20, then 30 mcg/kg/min over 10 minutes & 19 seconds for a total dose of 24.1 mg. Adjuntive atropine was infused IV for a total dose of.5 mg. Baseline heart rate was 63 bpm and increased to 147 bpm at peak stress which represents 92% of the MPHR. The heart rate response was normal. Baseline blood pressure was 124/76 mmhg and increased to 164/88 mmhg at peak stress, which is a physiologic response to dobutamine. Resting ECG demonstrated normal sinus rhythm with LAD, IVCD. During stress the ECG revealed occaisonal PVCs. At peak stress, the ECG revealed flat to upsloping ST-T depression of mm. There was T-wave inversion during stress. During stress, the patient developed shortness of breath, chest pain (level 4 of 10). The reason for infusion termination was achievement of target heart rate. Symptomatology resolved during standard recovery period. DOBUTAMINE STRESS IMPRESSION: Positive by ECG criteria Study quality: suboptimal secondary to body habitus, artifact Left Ventricle: Normal Artifacts: diaphragmatic attenuation SPECT imaging demonstrated a small to medium size, mostly reversible perfusion abnormality of severe intensity located in the anterior lateral segment(s) of the left ventricle. The 17-segment summed stress score was 8, the summed rest score was 2, and the summed difference score was 6. Gated SPECT imaging revealed normal left ventricular wall motion, thickening, and overall LV systolic function. The calculated resting ejection fraction was 52%, and the calculated post-stress ejection fraction was 55%. Abnormal myocardial perfusion: Small to medium size mostly reversible perfusion abnormality of severe intensity located in the anterior lateral segment(s) of the left ventricle. SSS= 8; SRS= 2; SDS= 6 Normal left ventricular systolic function: All segments of left ventricle demonstrated normal wall motion and thickening. Ejection fraction = 55%. John Hancock, MD FACC Date of Final Report: 4/2/2013
Part A: Structure and Organization
Part A: Structure and Organization Radioactive Materials License NRC (or State) radioactive materials license present Personnel Medical Director Meets Medical Director responsibility requirements Meets
More informationSection 8: Clinical Exercise Testing. a maximal GXT?
Section 8: Clinical Exercise Testing Maximal GXT ACSM Guidelines: Chapter 5 ACSM Manual: Chapter 8 HPHE 4450 Dr. Cheatham Outline What is the purpose of a maximal GXT? Who should have a maximal GXT (and
More information2015 Reimbursement Guide
Reimbursement Guide - Cardiology 2015 Reimbursement Guide for Myocardial Perfusion Imaging including radiopharmaceuticals and related product information 2015 Reimbursement Guide for Myocardial Perfusion
More informationMYOCARDIAL PERFUSION COMPUTED TOMOGRAPHY PhD course in Medical Imaging. Anne Günther Department of Radiology OUS Rikshospitalet
MYOCARDIAL PERFUSION COMPUTED TOMOGRAPHY PhD course in Medical Imaging Anne Günther Department of Radiology OUS Rikshospitalet CORONARY CT ANGIOGRAPHY (CTA) Accurate method in the assessment of possible
More informationEfficient Evaluation of Chest Pain
Efficient Evaluation of Chest Pain Vikranth Gongidi, DO FACC FACOI Indian River Medical Center Vero Beach, FL No Disclosures Outline Background Chest pain pathway Indications for stress test Stress test
More informationThe Role Of Early Stress Testing In Assessing Low Risk Chest Pain Patients Admitted Through The Emergency Department
The Role Of Early Stress Testing In Assessing Low Risk Chest Pain Patients Admitted Through The Emergency Department Simbo Chiadika LAY ABSTRACT A. Study purpose Cardiac stress testing has been recommended
More informationProvider Checklist-Outpatient Imaging. Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469)
Provider Checklist-Outpatient Imaging Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469) Medical Review Note: Per InterQual, if any of the following are present,
More informationDiagnostic and Therapeutic Procedures
Diagnostic and Therapeutic Procedures Diagnostic and therapeutic cardiovascular s are central to the evaluation and management of patients with cardiovascular disease. Consistent with the other sections,
More informationEffect of Spinal Cord Stimulation on Myocardial Flow Reserve in Patients with Refractory Angina Pectoris
Effect of Spinal Cord Stimulation on Myocardial Flow Reserve in Patients with Refractory Angina Pectoris Antti Varis, Heikki Ukkonen, Antti Saraste, Tuija Vasankari, Satu Tunturi, Markku Taittonen, Pirkka
More informationSociety of Nuclear Medicine Procedure Guideline for Myocardial Perfusion Imaging
Society of Nuclear Medicine Procedure Guideline for Myocardial Perfusion Imaging version 3.0, approved June 15, 2002 Authors: H. William Strauss, MD (Memorial Sloan Kettering Cancer Center, New York, NY);
More informationPharmacologic Stress Test: Adenosine
Pharmacologic Stress Test: Adenosine OVERVIEW The purpose of this document is to specifically identify the critical components involved in performing a pharmacologic stress test with adenosine. This information
More informationRb 82 Cardiac PET Scanning Protocols and Dosimetry. Deborah Tout Nuclear Medicine Department Central Manchester University Hospitals
Rb 82 Cardiac PET Scanning Protocols and Dosimetry Deborah Tout Nuclear Medicine Department Central Manchester University Hospitals Overview Rb 82 myocardial perfusion imaging protocols Acquisition Reconstruction
More informationCoronary Artery Disease leading cause of morbidity & mortality in industrialised nations.
INTRODUCTION Coronary Artery Disease leading cause of morbidity & mortality in industrialised nations. Although decrease in cardiovascular mortality still major cause of morbidity & burden of disease.
More informationCHEST PAIN EVALUATION TOOL
CHEST PAIN EVALUATION TOOL Chest pain or discomfort is one of the commonest causes for presentation to the Emergency Room (ER) or physicians office. There are many causes for chest discomfort. The serious
More information38 year old female with mild obesity. She is planning an exercise program to loose weight. She has no other known risk factors for CAD.
Stress Testing: Wael A. Jaber, MD,FACC 38 year old female with mild obesity She is planning an exercise program to loose weight. She has no other known risk factors for CAD. You recommend: A. Exercise
More informationPharmacologic Stress Agents
Pharmacologic Stress Agents Donna Lesniak, RN, CCRC Mallinckrodt Institute of Radiology Washington University School of Medicine Saint Louis, Missouri Disclosure Neither I nor my immediate family members
More informationNuclear Medicine Coding 101 June 16, 2008 Contac me: DENISE@MERLINOHCCC.COM 1-888-60M-HCCC, 1-888-606-4222
Nuclear Medicine Coding 101 June 16, 2008 Contac me: DENISE@MERLINOHCCC.COM 1-888-60M-HCCC, 1-888-606-4222 Presented by: Denise A. Merlino, MBA, CNMT, CPC, FSNMTS Disclosures SNM ASNC Bracco Diagnostics
More information6/5/2014. Objectives. Acute Coronary Syndromes. Epidemiology. Epidemiology. Epidemiology and Health Care Impact Pathophysiology
Objectives Acute Coronary Syndromes Epidemiology and Health Care Impact Pathophysiology Unstable Angina NSTEMI STEMI Clinical Clues Pre-hospital Spokane County EMS Epidemiology About 600,000 people die
More information12-Lead EKG Interpretation. Judith M. Haluka BS, RCIS, EMT-P
12-Lead EKG Interpretation Judith M. Haluka BS, RCIS, EMT-P ECG Grid Left to Right = Time/duration Vertical measure of voltage (amplitude) Expressed in mm P-Wave Depolarization of atrial muscle Low voltage
More information2/20/2015. Cardiac Evaluation of Potential Solid Organ Transplant Recipients. Issues Specific to Transplantation. Kidney Transplantation.
DISCLOSURES I have no relevant financial relationships to disclose. Cardiac Evaluation of Potential Solid Organ Transplant Recipients Michele Hamilton, MD Director, Heart Failure Program Cedars Sinai Heart
More informationObjectives. The ECG in Pulmonary and Congenital Heart Disease. Lead II P-Wave Amplitude during COPD Exacerbation and after Treatment (50 pts.
The ECG in Pulmonary and Congenital Heart Disease Gabriel Gregoratos, MD Objectives Review the pathophysiology and ECG signs of pulmonary dysfunction Review the ECG findings in patients with: COPD (chronic
More informationIs it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics. Yen Tibayan, M.D. Division of Cardiovascular Medicine
Is it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics Yen Tibayan, M.D. Division of Cardiovascular Medicine Case Presentation 69 y.o. woman calls 911 with the complaint of
More informationCV Disease : A Major Threat to Public Health
CV Disease : A Major Threat to Public Health International Atomic Energy Agency United Nations, Vienna - Austria João V. Vitola, MD, PhD Cardiologist and Nuclear Medicine Physician QUANTA Diagnostico &
More informationCardiovascular Guidelines for DOT Physical Exams By Maureen Collins MSN, APRN, BC
Cardiovascular Guidelines for DOT Physical Exams By Maureen Collins MSN, APRN, BC The Federal Motor Carrier Safety Administration (FMCSA) administers the Federal Motor Carrier Safety Regulations (FMCSRs)
More informationScott Hubbell, MHSc, RRT-NPS, C-NPT, CCT Clinical Education Coordinator/Flight RRT EagleMed
Scott Hubbell, MHSc, RRT-NPS, C-NPT, CCT Clinical Education Coordinator/Flight RRT EagleMed Identify the 12-Lead Views Explain the vessels of occlusion Describe the three I s Basic Interpretation of 12-Lead
More informationElectrocardiography Review and the Normal EKG Response to Exercise
Electrocardiography Review and the Normal EKG Response to Exercise Cardiac Anatomy Electrical Pathways in the Heart Which valves are the a-v valves? Closure of the a-v valves is associated with which heart
More informationNovartis Gilenya FDO Program Clinical Protocol and Highlights from Prescribing Information (PI)
Novartis Gilenya FDO Program Clinical Protocol and Highlights from Prescribing Information (PI) Highlights from Prescribing Information - the link to the full text PI is as follows: http://www.pharma.us.novartis.com/product/pi/pdf/gilenya.pdf
More informationPET PROS PET Professional Resources and Outreach Source. A summary of the recommendations and practice guidelines of professional groups
PET PROS PET Professional Resources and Outreach Source A summary of the recommendations and practice guidelines of professional groups Background: The SNMMI PET/CT Utilization Task Force (UTF) was formed
More informationNon Invasive Testing for CAD
Non Invasive Testing for CAD Wael A. Jaber, MD Section of Cardiac Imaging Heart and Vascular Institute Cleveland Clinic 38 year old female with mild obesity She is planning an exercise program to loose
More informationBIPOLAR LIMB LEADS UNIPOLAR LIMB LEADS PRECORDIAL (UNIPOLAR) LEADS VIEW OF EACH LEAD INDICATIVE ECG CHANGES
BIPOLAR LIMB LEADS Have both a distinctive positive and negative pole. Lead I LA (positive) RA (negative) Lead II LL (positive) RA (negative) Lead III LL (positive) LA (negative) UNIPOLAR LIMB LEADS Have
More informationSystematic Approach to 12 Lead EKG Interpretation
Systematic Approach to 12 Lead EKG Interpretation Maureen Knechtel MPAS, PA-C Wellmont CVA Heart Institute Disclosure Statement of Financial Interest I, Maureen Knechtel, do not have a financial interest/arrangement
More informationThe P Wave: Indicator of Atrial Enlargement
Marquette University e-publications@marquette Physician Assistant Studies Faculty Research and Publications Health Sciences, College of 8-12-2010 The P Wave: Indicator of Atrial Enlargement Patrick Loftis
More information12 Lead ECGs: Ischemia, Injury & Infarction Part 2
12 Lead ECGs: Ischemia, Injury & Infarction Part 2 McHenry Western Lake County EMS Localization: Left Coronary Artery Right Coronary Artery Right Ventricle Septal Wall Anterior Descending Artery Left Main
More informationComputed Tomography, Head Or Brain; Without Contrast Material, Followed By Contrast Material(S) And Further Sections
1199SEIU BENEFIT AND PENSION FUNDS High Tech Diagnostic Radiology and s # 1 70336 Magnetic Resonance (Eg, Proton) Imaging, Temporomandibular Joint(S) 2 70450 Computed Tomography, Head Or Brain; Without
More informationAccurate Coding of Nuclear Medicine Procedures. Unravel Coding Basics
Accurate Coding of Nuclear Medicine Procedures Presented by: Denise A. Merlino, MBA, CNMT, CPC Merlino Healthcare Consulting Corp. 1 Unravel Coding Basics October 27, 2009 2 1 Coding Basic Steps diagnosis
More informationST Segment Elevation Nothing is ever as hard (or easy) as it looks
ST Segment Elevation Nothing is ever as hard (or easy) as it looks Cameron Guild, MD Division of Cardiology University of Mississippi Medical Center February 17, 2012 Objectives 1. Describe the electrical
More informationTips and Tricks to Demystify 12 Lead ECG Interpretation
Tips and Tricks to Demystify 12 Lead ECG Interpretation Mission: Lifeline North Dakota Regional EMS and Hospital Conference Samantha Kapphahn, DO Essentia Health- Interventional Cardiology June 5th, 2014
More informationPharmacologic Stress Agents: Protocol and Safety
Pharmacologic Stress Agents: Protocol and Safety Donna Lesniak, RN, CCRC Mallinckrodt Institute of Radiology Washington University School of Medicine Saint Louis, Missouri Disclosure Neither I nor my immediate
More informationHEART MONITOR TREADMILL 12 LEAD EKG
2 HEART MONITOR TREADMILL 12 LEAD EKG Portable ambulatory monitoring system Continuously records electrical activity of the heart for 24 hours or more Also known as ambulatory electrocardiographic monitor
More informationMarilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL
Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL www.goldcopd.com GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT
More informationObjectives. Cardiac Substrate Metabolism. 2004 SNM Mid-Winter Educational Symposium
Myocardial Viability Imaging With PET Marcelo F. Di Carli,, MD Brigham and Women s Hospital Harvard Medical School Boston, MA Conflict of Interest: : No Relations to disclose To review: Basic principles
More informationANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY. Guidelines for Use of Intravenous Isoproterenol
ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY Guidelines for Use of Intravenous Isoproterenol Major Indications Status Asthmaticus As a last resort for
More informationSpecific Basic Standards for Osteopathic Fellowship Training in Cardiology
Specific Basic Standards for Osteopathic Fellowship Training in Cardiology American Osteopathic Association and American College of Osteopathic Internists BOT 07/2006 Rev. BOT 03/2009 Rev. BOT 07/2011
More informationNEONATAL & PEDIATRIC ECG BASICS RHYTHM INTERPRETATION
NEONATAL & PEDIATRIC ECG BASICS & RHYTHM INTERPRETATION VIKAS KOHLI MD FAAP FACC SENIOR CONSULATANT PEDIATRIC CARDIOLOGY APOLLO HOSPITAL MOB: 9891362233 ECG FAX LINE: 011-26941746 THE BASICS: GRAPH PAPER
More informationPerioperative Cardiac Evaluation
Perioperative Cardiac Evaluation Caroline McKillop Advisor: Dr. Tam Psenka 10-3-2007 Importance of Cardiac Guidelines -Used multiple times every day -Patient Safety -Part of Surgical Care Improvement Project
More informationTreating AF: The Newest Recommendations. CardioCase presentation. Ethel s Case. Wayne Warnica, MD, FACC, FACP, FRCPC
Treating AF: The Newest Recommendations Wayne Warnica, MD, FACC, FACP, FRCPC CardioCase presentation Ethel s Case Ethel, 73, presents with rapid heart beating and mild chest discomfort. In the ED, ECG
More informationACLS RHYTHM TEST. 2. A 74-year-old woman with chest pain. Blood pressure 192/90 and rates her pain 9/10.
ACLS RHYTHM TEST Name Date Choose the best answer for each of the following questions. Each of the following strips is 6 seconds in length. 1. Identify the following rhythm a. Sinus bradycardia with 2
More informationAI CPT Codes. x x. 70336 MRI Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)
Code Category Description Auth Required Medicaid Medicare 0126T IMT Testing Common carotid intima-media thickness (IMT) study for evaluation of atherosclerotic burden or coronary heart disease risk factor
More informationINTERDISCIPLINARY CLINICAL MANUAL Policy and Procedure
INTERDISCIPLINARY CLINICAL MANUAL Policy and Procedure TITLE: Management of Angina in NUMBER: Effective Date: January 2014 Page 1 of 6 Applies To: Interdisciplinary Clinical Manual Cardiac Rehabilitation
More informationAdult Drug Reference. Dopamine Drip Chart. Pediatric Drug Reference. Pediatric Drug Dosage Charts DRUG REFERENCES
Adult Drug Reference Dopamine Drip Chart Pediatric Drug Reference Pediatric Drug Dosage Charts DRUG REFERENCES ADULT DRUG REFERENCE Drug Indication Adult Dosage Precautions / Comments ADENOSINE Paroxysmal
More informationACLS PRE-TEST ANNOTATED ANSWER KEY
ACLS PRE-TEST ANNOTATED ANSWER KEY June, 2011 Question 1: Question 2: There is no pulse with this rhythm. Question 3: Question 4: Question 5: Question 6: Question 7: Question 8: Question 9: Question 10:
More informationListen to your heart: Good Cardiovascular Health for Life
Listen to your heart: Good Cardiovascular Health for Life Luis R. Castellanos MD, MPH Assistant Clinical Professor of Medicine University of California San Diego School of Medicine Sulpizio Family Cardiovascular
More informationAtrial & Junctional Dysrhythmias
Atrial & Junctional Dysrhythmias Atrial & Junctional Dysrhythmias Atrial Premature Atrial Complex Wandering Atrial Pacemaker Atrial Tachycardia (ectopic) Multifocal Atrial Tachycardia Atrial Flutter Atrial
More informationDiagnosis Code Crosswalk : ICD-9-CM to ICD-10-CM Cardiac Rhythm and Heart Failure Diagnoses
Diagnosis Code Crosswalk : to 402.01 Hypertensive heart disease, malignant, with heart failure 402.11 Hypertensive heart disease, benign, with heart failure 402.91 Hypertensive heart disease, unspecified,
More informationACLS PHARMACOLOGY 2011 Guidelines
ACLS PHARMACOLOGY 2011 Guidelines ADENOSINE Narrow complex tachycardias or wide complex tachycardias that may be supraventricular in nature. It is effective in treating 90% of the reentry arrhythmias.
More informationAcute Coronary Syndromes Education for Healthcare Providers. Hani Kozman, MD Cardiology Division SUNY Upstate Medical University
Acute Coronary Syndromes Education for Healthcare Providers Hani Kozman, MD Cardiology Division SUNY Upstate Medical University NSTEMI 2 Types ACS: Chest pain related to a progressively enlarging intracoronary
More informationProcedure for Inotrope Administration in the home
Procedure for Inotrope Administration in the home Purpose This purpose of this procedure is to define the care used when administering inotropic agents intravenously in the home This includes: A. Practice
More informationSignal-averaged electrocardiography late potentials
SIGNAL AVERAGED ECG INTRODUCTION Signal-averaged electrocardiography (SAECG) is a special electrocardiographic technique, in which multiple electric signals from the heart are averaged to remove interference
More informationOsama Jarkas. in Chest Pain Patients. STUDENT NAME: Osama Jarkas DATE: August 10 th, 2015
STUDENT NAME: Osama Jarkas DATE: August 10 th, 2015 PROJECT TITLE: Analysis of ECG Exercise Stress Testing and Framingham Risk Score in Chest Pain Patients PRIMARY SUPERVISOR NAME: Dr. Edward Tan DEPARTMENT:
More informationtable of contents drug reference
table of contents drug reference ADULT DRUG REFERENCE...155 161 PEDIATRIC DRUG REFERENCE...162 164 PEDIATRIC WEIGHT-BASED DOSING CHARTS...165 180 Adenosine...165 Amiodarone...166 Atropine...167 Defibrillation...168
More informationDiagnostic Imaging Prior Review Code List 3 rd Quarter 2016
Computerized Tomography (CT) Abdomen 6 Abdomen/Pelvis Combination 101 Service 74150 CT abdomen; w/o 74160 CT abdomen; with 74170 CT abdomen; w/o followed by 74176 Computed tomography, abdomen and pelvis;
More informationCardiac Arrest Pediatric Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008
Cardiac Arrest Pediatric Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008 Preamble In contrast to cardiac arrest in adults, cardiopulmonary arrest in pediatric
More informationINTRODUCTION TO EECP THERAPY
INTRODUCTION TO EECP THERAPY is an FDA cleared, Medicare approved, non-invasive medical therapy for the treatment of stable and unstable angina, congestive heart failure, acute myocardial infarction, and
More informationFlash, Rocking on others Added value in DCM and CRT. C. Parsai Polyclinique des Fleurs France
Flash, Rocking on others Added value in DCM and CRT C. Parsai Polyclinique des Fleurs France Cleland JGF et al. (2007) Nat Clin Pract Cardiovasc Med 4: 90 101 Predicting CRT Response Device Related Patient
More informationAcute Coronary Syndrome. What Every Healthcare Professional Needs To Know
Acute Coronary Syndrome What Every Healthcare Professional Needs To Know Background of ACS Acute Coronary Syndrome (ACS) is an umbrella term used to cover a spectrum of clinical conditions that are caused
More informationNAME OF THE HOSPITAL: 1. Coronary Balloon Angioplasty: M7F1.1/ Angioplasty with Stent(PTCA with Stent): M7F1.3
1. Coronary Balloon Angioplasty: M7F1.1/ Angioplasty with Stent(PTCA with Stent): M7F1.3 1. Name of the Procedure: Coronary Balloon Angioplasty 2. Select the Indication from the drop down of various indications
More informationProcedure Codes. RadConsult provides real-time decision support for physicians who order high-cost imaging procedures RADIATION THERAPY
Procedure Codes 2011 RadConsult provides real-time decision support for physicians who order high-cost imaging procedures RADIATION THERAPY 2D3D Therapeutic radiology treatment planning; simple 77261 Therapeutic
More informationWhat are some common uses of the procedure?
Scan for mobile link. Cardiac Nuclear Medicine Cardiac nuclear medicine imaging evaluates the heart for coronary artery disease and cardiomyopathy. It also may be used to help determine whether the heart
More informationCPT Radiology Codes Requiring Review by AIM Effective 01/01/2016
CPT Radiology Codes Requiring Review by AIM Effective 01/01/2016 When a service is authorized only one test per group is payable. *Secondary codes or add-on codes do not require preauthorization or separate
More informationPulmonary Artery Hypertension
Pulmonary Artery Hypertension Janet M. Pinson, RN, MSN, ACNP Maureen P. Flattery, RN, MS, ANP Virginia Commonwealth University Health System Richmond, VA Pulmonary artery hypertension (PAH) is defined
More informationGENERAL HEART DISEASE KNOW THE FACTS
GENERAL HEART DISEASE KNOW THE FACTS WHAT IS Heart disease is a broad term meaning any disease affecting the heart. It is commonly used to refer to coronary heart disease (CHD), a more specific term to
More information4/7/2015. Cardiac Rehabilitation: From the other side of the glass door. Chicago, circa 1999. Objectives. No disclosures, no conflicts
Cardiac Rehabilitation: From the other side of the glass door No disclosures, no conflicts Charles X. Kim, MD, FACC, ABVM Objectives 1. Illustrate common CV benefits of CV rehab in real world practice.
More informationCARDIOLOGY PROCEDURES REQUIRING PRECERTIFICATION
CLINICAL POLICY CARDIOLOGY PROCEDURES REQUIRING PRECERTIFICATION Policy Number: CARDIOLOGY 026.6 T2 Effective Date: May 1, 2015 Table of Contents CONDITIONS OF COVERAGE... COVERAGE RATIONALE... BENEFIT
More information12/15-Lead ECG Protocol approved October 2005 revised October 2008
approved October 2005 revised October 2008 Preamble Rapid diagnosis of acute myocardial infarction is essential to initiating appropriate treatment and improving outcomes. In selected practice environments
More informationCPT * Codes Included in AIM Preauthorization Program for 2013 With Grouper Numbers
CPT * Codes Included in AIM Preauthorization Program for 2013 With Grouper Numbers Computerized Tomography (CT) CPT Description Abdomen 74150 CT abdomen; w/o contrast 6 74160 CT abdomen; with contrast
More informationQuiz 5 Heart Failure scores (n=163)
Quiz 5 Heart Failure summary statistics The correct answers to questions are indicated by *. Students were awarded 2 points for question #3 for either selecting spironolactone or eplerenone. However, the
More informationQuiz 4 Arrhythmias summary statistics and question answers
1 Quiz 4 Arrhythmias summary statistics and question answers The correct answers to questions are indicated by *. All students were awarded 2 points for question #2 due to no appropriate responses for
More informationHow To Understand What You Know
Heart Disorders Glossary ABG (Arterial Blood Gas) Test: A test that measures how much oxygen and carbon dioxide are in the blood. Anemia: A condition in which there are low levels of red blood cells in
More informationName: Age: Resting BP: Wt. kg: Est. HR max : 85%HR max : Resting HR:
Bruce Protocol - Submaximal GXT Name: Age: Resting BP: Wt. kg: Est. HR max : 85%HR max : Resting HR: Stage Min. % Grade MPH METs 2min HR 3min HR BP RPE 1 0-3 10 1.7 4.7 2 3-6 12 2.5 7.0 3 6-9 14 3.4 10.1
More informationModified Bruce Protocol: Treadmill Testing for Cardiac Health. Purpose
Modified Bruce Protocol: Treadmill Testing for Cardiac Health Purpose The purpose of this investigation was three-fold: 1) for Dr. Carman to be come acquainted with the Hewlett-Packard 4755 AU Page Writer
More informationChristopher M. Wright, MD, MBA Pioneer Cardiovascular Consultants Tempe, Arizona
Christopher M. Wright, MD, MBA Pioneer Cardiovascular Consultants Tempe, Arizona Areas to be covered Historical, current, and future treatments for various cardiovascular disease: Atherosclerosis (Coronary
More informationExchange solutes and water with cells of the body
Chapter 8 Heart and Blood Vessels Three Types of Blood Vessels Transport Blood Arteries Carry blood away from the heart Transport blood under high pressure Capillaries Exchange solutes and water with cells
More informationCPT CODE PROCEDURE DESCRIPTION. CT Scans 70450 CT HEAD/BRAIN W/O CONTRAST 70460 CT HEAD/BRAIN W/ CONTRAST 70470 CT HEAD/BRAIN W/O & W/ CONTRAST
CPT CODE PROCEDURE DESCRIPTION CT Scans 70450 CT HEAD/BRAIN W/O CONTRAST 70460 CT HEAD/BRAIN W/ CONTRAST 70470 CT HEAD/BRAIN W/O & W/ CONTRAST 70480 CT ORBIT W/O CONTRAST 70481 CT ORBIT W/ CONTRAST 70482
More informationPHYSICIAN ORDERS TRANSIENT ISCHEMIC ATTACK (TIA) OBSERVATION
SCREENING- ABCD-2 Score The ABCD2 score is a risk assessment tool designed to improve the prediction of short-term stroke risk after a transient ischemic attack (TIA). Higher ABCD2 scores are associated
More informationDISCHARGE CRITERIA FOR PHASE I & II- POST ANESTHESIA CARE
REFERENCES: The Joint Commission Accreditation Manual for Hospitals American Society of Post Anesthesia Nurses: Standards of Post Anesthesia Nursing Practice (1991, 2002). RELATED DOCUMENTS: SHC Administrative
More informationEXHIBIT H SETTLEMENT ELIGIBILITY CRITERIA. a) pharmacy records reflecting the dispensing of Bextra and/or Celebrex to the Class Member; or
EXHIBIT H SETTLEMENT ELIGIBILITY CRITERIA 1. PRODUCT IDENTIFICATION DOCUMENTATION In order to be eligible for compensation under the Settlement Agreement, each Claimant must provide evidence of the Class
More informationImportant information regarding your Medical Examiners Certificate (DOT card). Please read carefully! Driver name:
Important information regarding your Medical Examiners Certificate (DOT card). Please read carefully! Driver name: Expiration date of current DOT card: / / Please contact Kingston Worx at 845-331-7751
More informationCardiac Assessment for Renal Transplantation: Pre-Operative Clearance is Only the Tip of the Iceberg
Cardiac Assessment for Renal Transplantation: Pre-Operative Clearance is Only the Tip of the Iceberg 2 nd Annual Duke Renal Transplant Symposium March 1, 2014 Durham, NC Joseph G. Rogers, M.D. Associate
More informationRedefining the NSTEACS pathway in London
Redefining the NSTEACS pathway in London Sotiris Antoniou Consultant Pharmacist, Cardiovascular Medicine, Barts and The London NHS Trust and Project Lead, North East London Cardiovascular and Stroke Network
More information510(k) Summary May 7, 2012
510(k) Summary Medicalgorithmics 510(k) Premarket Notification 510(k) Summary May 7, 2012 1. Submitter Name and Address Medicalgorithmics LLC 245 West 107th St., Suite 11A New York, NY 10025, USA Contact
More informationAtrial Fibrillation Peter Santucci, MD Revised May, 2008
Atrial Fibrillation Peter Santucci, MD Revised May, 2008 Atrial fibrillation (AF) is an irregular, disorganized rhythm characterized by a lack of organized mechanical atrial activity. The atrial rate is
More information!!! BOLUS DOSE IV. Use 5-10 mcg IV boluses STD ADRENALINE INFUSION. Use IM adrenaline in advance of IV dosing!
ADRENALINE IVI BOLUS IV Open a vial of 1:1000 ADRENALINE 1 mg /ml Add 1 ml to 9 ml N/Saline = 1mg adrenaline in 10 ml (or 100 mcg/ml) Add 1 ml 1:10,000 to 9 ml N/Saline = 100 mcg adrenaline in 10 ml (or
More informationCARDIAC REHABILITATION PROGRAM
CARDIAC REHABILITATION PROGRAM Preparation for the Cardiac Rehabilitation Program After your heart problem is stable, your physician or cardiologist will refer you to the Cardiac Rehabilitation program.
More informationCardiac Arrest - Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008
Cardiac Arrest - Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008 Preamble Survival from cardiorespiratory arrest for patients who present with ventricular fibrillation
More informationPre-Screening and Risk Stratification
Pre-Screening and Risk Stratification Chapter 1, 2 and 3 ACSM What is involved in the prescreening process? The Basic Goal To determine if it is safe for an individual to start an exercise program, what
More informationPHARMACOLOGIC STRESS MYOCARDIAL PERFUSION IMAGING IN An Elderly Woman With Type 2 Diabetes Mellitus
CASE LIBRARY SERIES NO. 09 CASE DISCUSSION PROVIDED BY RAYMOND RUSSELL III, MD, PHD, FASNC ASSOCIATE PROFESSOR OF MEDICINE AND DIAGNOSTIC RADIOLOGY ASSOCIATE DIRECTOR OF NUCLEAR CARDIOLOGY LABORATORY CO-DIRECTOR
More informationEAE TEACHING COURSE Aorta and aortic valve 2012
EAE TEACHING COURSE Aorta and aortic valve 2012 31th March 2012 Szczecin, Poland EP EAE TEACHING COURSE: aorta and aortic valve Szczecin, 31st March 2012 Prof. Luigi Badano, Italy Prof. Patrizio Lancellotti,
More informationManagement of the Patient with Aortic Stenosis undergoing Non-cardiac Surgery
Management of the Patient with Aortic Stenosis undergoing Non-cardiac Surgery Srinivasan Rajagopal M.D. Assistant Professor Division of Cardiothoracic Anesthesia Objectives Describe the pathophysiology
More informationOfficial Online ACLS Exam
\ Official Online ACLS Exam Please fill out this form before you take the exam. Name : Email : Phone : 1. Hypovolemia initially produces which arrhythmia? A. PEA B. Sinus tachycardia C. Symptomatic bradyarrhythmia
More information