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Echocardiogram and stress echo results? Cardiomyopathy?

Echo cardiogram SUMMARY:
Left ventricle: Systolic function was normal by visual assessment.
Ejection fraction was estimated to be 65 % in the range of 60 % to 65 %.
There were no regional wall motion abnormalities. Wall thickness was at
the upper limits of normal.

INDICATIONS: Palpatation, murmur

PROCEDURE: This was a routine study. The study included complete 2D
imaging, M-mode, complete spectral Doppler, and color Doppler. The heart
rate was 96 bpm, at the start of the study. Systolic blood pressure was
118 mmHg, at the start of the study. Diastolic blood pressure was 74 mmHg,
at the start of the study. Images were obtained from the parasternal,
apical, subcostal, and suprasternal notch acoustic windows. Image quality
was good.

LEFT VENTRICLE: Size was normal. Systolic function was normal by visual
assessment. Ejection fraction was estimated to be 65 % in the range of 60
% to 65 %. There were no regional wall motion abnormalities. Wall
thickness was at the upper limits of normal.

RIGHT VENTRICLE: The size was normal. Systolic function was normal. Wall
thickness was normal.

LEFT ATRIUM: Size was at the upper limits of normal.

ATRIAL SEPTUM: The atrial septum appeared intact.

RIGHT ATRIUM: Size was normal.

MITRAL VALVE: Normal valve structure. There was normal leaflet separation.
DOPPLER: The transmitral velocity was within the normal range. There was
no evidence for stenosis. There was trivial regurgitation.

AORTIC VALVE: The valve was trileaflet. Leaflets exhibited normal
thickness and normal cuspal separation. DOPPLER: Transaortic velocity was
within the normal range. There was no stenosis. There was no regurgitation.

TRICUSPID VALVE: Normal valve structure. There was normal leaflet
separation. DOPPLER: The transtricuspid velocity was within the normal
range. There was no evidence for tricuspid stenosis. There was no
regurgitation.

PULMONIC VALVE: Leaflets exhibited normal thickness, no calcification, and
normal cuspal separation. DOPPLER: The transpulmonic velocity was within
the normal range. There was no regurgitation.

AORTA: The root exhibited normal size.

PERICARDIUM: There was no pericardial effusion.



Stress echocardiogram summary:
Exercise Stress Echocardiography

Stress summary: Duration of exercise was 10 min and 15 sec. The patient
exercised to protocol stage 4. Maximal work rate was 11.9 METs. Maximal
heart rate during stress was 182 bpm ( 92 % of maximal predicted heart
rate). There was no chest pain during stress. The stress test was
terminated due to fatigue. Maximal systolic blood pressure during stress
was 160 mmHg. Maximal diastolic blood pressure during stress was 84 mmHg.
There were no stress arrhythmias or conduction abnormalities.

Impressions: Normal study.

Summary:
Stress results: Duration of exercise was 10 min and 15 sec. Maximal work
rate was 11.9 METs. Target heart rate was achieved. There was no chest
pain during stress. Maximal systolic blood pressure during stress was 160
mmHg. Maximal diastolic blood pressure during stress was 84 mmHg.

Baseline: Estimated left ventricular ejection fraction was 70 %, in the
range of 65 % to 70 %.

Indications: Detection of coronary artery disease. Chest pain.

Rest ECG: sinus tachycardia

Procedure: The procedure was explained to the patient and informed consent
was obtained. Treadmill exercise testing was performed, using the Bruce
protocol. Stress and rest echocardiographic evaluation with 2D imaging was
performed from multiple acoustic windows for evaluation of ventricular
function. The heart rate was 105 at the start of the study. Systolic blood
pressure was 140 mmHg at the start of the study. Diastolic blood pressure
was 96 mmHg at the start of the study.

Stress 2D echocardiographic results
Baseline: Left ventricular size was normal. Overall left ventricular
systolic function was hyperdynamic. Estimated left ventricular ejection
fraction was 70 %, in the range of 65 % to 70 %.

Peak stress: LV size was markedly reduced. Excessive augmentation in LV
function LVEF 75-80% Echocardiographic imaging done immediately post
exercise. Demonstrates enhanced contractility of all segments and a
decrease in left ventricular cavity.
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