Sample Report: Stress Echocardiogram
INDICATIONS: Atypical chest pain syndrome with elevated troponin levels and normal CPKs. Patient has history of hypertension. There is a strong family history of premature coronary artery disease.
MEDICATIONS: Plendil, aspirin, and p.o. nitroglycerin.
FINDINGS: Modified baseline 12-lead EKG revealed normal sinus rhythm tracing with a rightward axis.The patient exercised for 9 minutes through stage 3 of standard Bruce protocol, achieving 10.1 METs. The exercise was terminated, as adequate level of exercise had been performed. The patient did not experience any chest pain or arm pain.
The patient's maximum heart rate was 169 beats per minute, which was 94% of the age-adjusted target heart rate. Maximum blood pressure response was 184/76.
ST-segment analysis at peak exercise did not reveal any significant ST-segment depression from baseline. No significant arrhythmias or conduction abnormalities were noted.
Echocardiographic imaging was obtained at rest and following exercise using standard parasternal long and short axis, apical, 2- and 4-chamber views. Resting color flow Doppler appeared normal. Postexercise imaging revealed a normal global hypodynamic exercise response with no exercise-induced wall motion abnormalities noted.
CONCLUSIONS:
1. Negative electrocardiographic portion of stress echocardiogram exam for ischemia by standard criteria.
2. No chest pain or arm pain noted.
3. No high-grade arrhythmia noted.
4. Adequate exercise tolerance phase.
5. Normal echocardiographic portion of the examination with no evidence to suggest malignant underlying myocardial ischemia or recent infarction.
IMPRESSION:
1. Atypical chest pain syndrome, presumed noncardiac.
2. False-positive troponin level.