DS9 Document EFTA00304934

mama Sinai Heart Cardiovascular Imaging Center 1428 Madison Avenue • New York, NY • 10024 Phone: 212-241-3000 • Fax: 646-537-9693 Name: Epstein, Jeffrey Scan Date: 04/10/2018 MRN: 7206913 Acc Number: 3578773 DOB: 01/20/1953 Ref errIngMD: Rony Shlmony, MD Age/Gender: 65/M At tendingMD: Adam Jacobi, MD Summary OA with contrast was performed for coronary artery evaluation in a patient with chest pain. Reconstructions were transferred to a workstation for further analysis. Post-processing techniques (volume rendering, maximum intensity projections and mufti-planar reformations) were employed for analysis of images. 1. Coronary atherosclerosis without significant stenosis. 2. The calcium score is 55, representing the 46th percentile adjusted for age, gender, and ethnicity. 3. No significant extracardiac findings. Scan Info General Contrast Agent Type: Isovue-370 Dose: 55 ml Rate (ml/s): 4.0mVs Bolus Technique: Biphasic Medication Administered During Scan Type: Metoprolol IV, NTG SL 0.4mg Metoprolol IV, Dose: 10 mg Vitals Height: 72 in Height: 182.9 cm Body Weight: 190 /bs Body Weight: 86 2 kg Systolic BP: 160 mmHg Diastolic BP: 88 mmHg Heart Rate: 62 BPM Heart Rhythm: Sinus Rhythm BSA: 2.1 nr2 Setup Type: Clinical Location:0utpatient ECG Gating Technique: Prospective Study Quality: Good Referring Provider: Rony Shimony, MD Attending Radiologist: Adam Jacobi, MD Attending Cardiologist: Javier Sant. MD Billing Finalized and signed by Adam Jacobi on 04/10/2018 15i3t:51 (uid:180) Page 1 of 3 EFTA00304934 Minna Sinai Ilea rt Cardiovascular Imaging Center 1428 Madison Avenue • New York, NY • 10024 Phone: 212-241-3000 • Fax: 646-537-9693 CPT Code(s) 75574 CTA Heart & Bypass Grafts (when present) w Contrast Coronary Arteries Q9967 ISOVUE 370 Code(s) General Indicators R07.9 Chest pain unspecified Cardiac Coronaries Coronary Arteries Coronary Arterial Dominance: Right ARTERIES Proximal RCA Mid RCA Donn! NCA PDA LM Proximal LAD Mod LAO Distal LAD D1 DV Proximal LCX OM 1 Mod LCX OM 2 DIAMETER STENOSIS _ . . 0 . . 0 0 0 0 <25% <25% • 0 0 0 0 Distal LCX 0 Po s terolateral 0 Oilier 0 • STENT PLAQUE C INAME1 ER ST ENOSIS: 0; <25%: 25%; 2549%; <50%; 50%.50.69%:7099%; 75%; 100%. UE = UNEVALUABLE PLAQUE: NC • NONCALC.: PNC PREDOMIN. NC: PC n PREDOMIN. C. C • CALCIFIED ST ENT: NORMAL; <50%: '50%: O = OCCLUDED: ?= CANNOT EXCLUDE Coronary Calcium Scoring Score ; Percentile Agal Mon AG Volume Finalized and signed by Adam Jacobi on 04/10/2018 15:37:51 (uld:180) Page 2 of 3 EFTA00304935 Mounl Sinai Heart Vascular Cardiovascular Imaging Center 1428 Madison Avenue • New York, NY • 10024 Phone: 212-241-3000 • Fax: 646-537-9693 Upper Vascular EVALUATION OF THE THORACIC AORTA COMMENTS (no comments) ; Evaluation Details . . . . ' ASCENDING AORTA Dimension A: 3.7 cm Dimension 6:3.7 cm ISTHMUS OF THE AORTA Dimension A: 2.7 CM Dimension 6:2,7 cm Other Findings Lung Nodules Lung Nodules?: No Finalized and signed by Adam Jacobi an 04/10/2018 15:37:51 (uid:180) Page 3 of 3 EFTA00304936