Editing Assignment 5: Radiology Report 56
ANGIOGRAPHY REPORT
Date:
Physician:
Room No.:
November 25, 2014
Maureen J. Smith, MD
422
Patient:
EKG No.:
Hospital No.:
John C. Cooper
43021
560213
HEMODYNAMIC MEASUREMENTS
Aortic pressure 110/75 mean 95. Left ventricular pressure 110/0-20. Left ventricular end-diastolic pressure pre-atrial
systole: 8 mmHg; and post-atrial systole: 18 mmHg. These parameters are indicative of impairment in left ventricular
function.
VENTRICULOGRAM
Left ventricular function is impaired to a severe degree with an ejection fraction of .15%. There is akinesis anteriorly with
dyskinesia apically and infero-apical aneurysm as well as the akinesis extending up the inferior surface to the midportion. There are filling defects in the inferior apical aneurysm consistent with the thrombi. The ventricular chamber is
dilated, and there is a grade 1 mitral insufficiency.
(Now continue with this coronary arteriographic analysis).
LEFT MAIN AND ANTERIOR DESCENDING
The anterior descending is totally occluded at its origin. The distal vessel is seen on the left coronary injection, thready
and most likely a diagonal branch rather than the main anterior descending.
CIRCUMFLEX
Circumflex vessel proximally, as well as a branch in the atrioventricular groove and circumflex intermediate, are normal.
RIGHT CORONARY
There is a small plaque in this dominant vessel, proximally. The distal anatomy is normal.
DIAGNOSES
1.
Arteriosclerotic heart disease with severe impairment in left ventricular function, EF.15.
2.
Ventricular aneurysm and thrombi.
3.
Mitral insufficiency, mild.
4.
Total occlusion of the anterior descending coronary.
The vessel obstructing distal diameter values are as follows: LMC: 0; AD: 100-0; DG: 100-0.3; CX: 0; CX PL: 0; CX INT: 0;
RC: 0; PD: 0.
William B. Waxman, MD
kms
D: 11/25/2013
T: 11/25/2013