s30661 3 250 21368246 12:15:00 11/02/1999 s30661.dat 212 200/mV 12 0 6 1837 0 V4 s30661.dat 212 200/mV 12 0 2 -457 0 V3 s30661.dat 212 200/mV 12 0 10 -29342 0 II #Age: 72 Sex: M #Comments: # This patient with extensive CAD shows a number of ST # depressions associated with paroxysms of atrial # tachycardia (PAT). Some ischemic changes were also # seen in associations with increased heart rate which # was not PAT. The patient has high-grade atrial ectopic # activity with many bursts of PAT. Ischemia is most # prominent in signal 0 (V4). #Symptoms during Holter recording: No data #Diagnoses: # 2-vessel coronary artery disease # Unstable angina # Previous coronary artery bypass grafting # Left internal mammary artery graft to left anterior descending coronary artery # Chronic obstructive pulmonary disease # Hypertension # Benign prostatic hypertrophy #Treatment: # Medications: # Aspirin # Enalapril # Metoprolol # Prilosec # Cardura # Azmacort # Ventolin # Ipratropium # Balloon Angioplasty: No # Coronary Artery bypass Grafting: Four grafts in 1995 #History: # Unstable angina and coronary artery bypass grafting in 1995 # Hypertension: Yes # Left ventricular hypertrophy: No # Cardiomyopathy: No # Valve disease: No # Electrolyte abnormalities: No # Hypercapnia, anemia, hypotension, hyperventilation: No # Atrioventricular nodal conduction delay: No # Intraventricular conduction block: No # Previous Myocardial Infarction: No # Previous tests: # ECG stress test: Yes # Date: October, 1998 # Findings: 2 mm ST depression, stopped due to dyspnea # Thallium/Stress echo: 1993 - no ischemia # Left ventricular function: # Normal - ejection fraction = 60% # Echocardiogram: # Normal left ventricular function # Coronary Arteriography: # 1992: lesions in left anterior descending coronary artery, right coronary artery disease # Baseline ECG: # Normal sinus rhythm # Nonspecific ST changes # Atrial premature beats #Holter Recording: # Date: 11/02/1999 # Recorder: Zymed