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***** What would you use for a diagnosis for " mild troponin leak " ??
DATE OF SERVICE:
PROCEDURE PERFORMED: Exercise treadmill test.
REFERRING PHYSICIAN:
INDICATION: Mild troponin leak.
PROTOCOL: Bruce.
TEST DURATION: 6 min and 17 seconds.
FINDINGS: Peak heart rate of 173, which is actually above her predicted
maximal heart rate at 7.0 METS.
Symptoms: None.
Test stopped due to: Heart rate response.
Hemodynamic response: Baseline.
Blood pressure: 172/80, rising to 204/84, peak exercise 210/60 early in
recovery.
Rest EKG: Sinus rhythm with mild nonspecific ST-segment depression,
consistent with LVH or ischemia.
Stress EKG: There was further ST-segment depression with stress. The
remainder upsloping and because of the baseline changes and the upsloping
nature, it is technically nonspecific.
CONCLUSIONS:
1. Limited exercise tolerance.
2. Baseline hypertension that became aggravated with treadmill stress.
3. Baseline electrocardiogram changes that became somewhat more impressive
with stress.
4. Patient did not develop chest pain at a high cardiac workload. This
test does not have imaging confirmation of ischemic threshold and was
suggested imaging test if there is a clinical indication for that.
DATE OF SERVICE:
PROCEDURE PERFORMED: Exercise treadmill test.
REFERRING PHYSICIAN:
INDICATION: Mild troponin leak.
PROTOCOL: Bruce.
TEST DURATION: 6 min and 17 seconds.
FINDINGS: Peak heart rate of 173, which is actually above her predicted
maximal heart rate at 7.0 METS.
Symptoms: None.
Test stopped due to: Heart rate response.
Hemodynamic response: Baseline.
Blood pressure: 172/80, rising to 204/84, peak exercise 210/60 early in
recovery.
Rest EKG: Sinus rhythm with mild nonspecific ST-segment depression,
consistent with LVH or ischemia.
Stress EKG: There was further ST-segment depression with stress. The
remainder upsloping and because of the baseline changes and the upsloping
nature, it is technically nonspecific.
CONCLUSIONS:
1. Limited exercise tolerance.
2. Baseline hypertension that became aggravated with treadmill stress.
3. Baseline electrocardiogram changes that became somewhat more impressive
with stress.
4. Patient did not develop chest pain at a high cardiac workload. This
test does not have imaging confirmation of ischemic threshold and was
suggested imaging test if there is a clinical indication for that.