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MGH/MF Waveform Database Patient Guide

This guide originally accompanied the CD edition of the MGH/MF Waveform Database. Special thanks to Ken Pierce for scanning a rare printed copy of this guide, and for converting it with great care and attention to detail into computer-readable form in order to make its contents available and searchable.

Follow the links below to jump directly to descriptions of each record in the database:

mgh001 mgh002 mgh003 mgh004 mgh005 mgh006 mgh007 mgh008 mgh009 mgh010
mgh011 mgh012 mgh013 mgh014 mgh015 mgh016 mgh017 mgh018 mgh019 mgh020
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mgh241 mgh242 mgh243 mgh244 mgh245 mgh246 mgh247 mgh248 mgh249 mgh250
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Record: mgh001


PATIENT DATA:
AGE/SEX:
  80 year old female
DIAGNOSIS/SURGERY:
  Carotid endartarectomy
PERTINENT HISTORY:
  Congenital complete heart block
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Third degree heart block with junctional escape rhythm and intra-ventricular conduction defect @ 40 bpm
RHYTHM DISTURBANCES:
  Unifocal ventricular ectopy
ECG INTERPRETATION:
  Left atrial hypertrophy
  Left ventricular hypertrophy
  Intraventricular conduction defect
  Possible old lateral myocardial infarction
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 140/50
  PAP: 56/16
  RAP: 10
WAVEFORM PATTERNS:
  "Cannon waves" in CVP due to A-V asynchrony with CHB
  Retrograde cannon wave effect in pulmonary arterial trace.
  Pulmonary hypertension.
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh002


PATIENT DATA:
AGE/SEX:
  71 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
  Aorto-bifemoral graft
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with right bundle branch block @ 80 bpm
RHYTHM DISTURBANCES:
  Junctional ectopy, occasional aberrant conduction
  Onset of junctional rhythm @ 1 min
  Conversion to NSR @ 24 min (carotid sinus massage and verapamil)
  Unifocal ventricular ectopy
ECG INTERPRETATION:
  Left atrial enlargement
  Left anterior hemiblock
  Old inferior infarct
TECHNICAL COMMENTS:
  Chest lead = V2
HEMODYNAMIC DATA:
  ART: 130/60   	MEAN: 85
  PAP: 32/8   	PCW: 6 (@ 68 min)
  RAP: 4
WAVEFORM PATTERNS:
  Cannon waves in CVP with junctional rhythm due to A-V asynchrony
  Ventricular ectopy produces "V waves" in the CVP trace
TECHNICAL COMMENTS:
  Zero, cal and pop-tests @ 24 min - 377 min
RESPIRATORY DATA:
RATE:   14 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh003


PATIENT DATA:
AGE/SEX:
  47 year old female
DIAGNOSIS/SURGERY:
  Exploratory laporatomy for small bowel obstruction
PERTINENT HISTORY:
  Terminal condition
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 140 bpm
ECG INTERPRETATION:
  Low voltage ECG
  Poor R wave progression consistent with counterclockwise rotation
  Old antero-septal infarction less likely
  Non-specific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 120/80 (pre-recording: hypotensive during recording)
  PAP: 48/28   	PCW: 19 (@ 21 min, 24 min)
  RAP: 9
WAVEFORM PATTERNS:
  Hypotension
  Pulsus paradox
  Marked respiratory variation
RESPIRATORY DATA:
RATE:   36 bpm
MODE OF VENTILATION:
  Spontaneous
COMMENTS:
  Respiratory pattern is rapid and labored
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Record: mgh004


PATIENT DATA:
AGE/SEX:
  64 year old female
DIAGNOSIS/SURGERY:
  Acute cholecystitis
  Cholecystectomy
GENERAL COMMENTS:
  Short recording due to unexpected patient transfer
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 68 bpm
RHYTHM DISTURBANCES:
  A trial ectopy
  Premature junctional beats
  Unifocal junctional ectopy
ECG INTERPRETATION:
  Low ECG voltage
  Left atrial enlargement
  Poor R wave progression; ? old antero-septal infarct
  Non-specific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 140/50
  PAP: 32/16   	PCW: 12 (@ 13 min)
  RAP: 5
WAVEFORM PATTERNS:
  Pulsus paradox
  Respiratory variation
  "Catheter whip" in PA trace with spiking in the PCW
  Enlarged "a wave" in RA trace
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh005


PATIENT DATA:
AGE/SEX:
  56 year old male
DIAGNOSIS/SURGERY:
  Aortobifemoral graft
  GI bleed
  Exploratory laporotomy
  Sepsis
PHARMACOLOGIC SUPPORT:
  Dopamine @ 213 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 100 bpm
ECG INTERPRETATION:
  Old antero-lateral infarct
  Anterior ST segment elevation consistent with aneurysm
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 90
  PAP: 28/20   	PCW: 14 (@ 26 min, 31 min, 42 min, 58 min)
  RAP: 12   	CO: 9.2
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  ART pop-test unusual; tracing damped during recording
  Transducer dome noted to be defective at end of case
RESPIRATORY DATA:
RATE:   12 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING:
  Sidestream sensor with Datex unit on @ 55 min
[top]  

Record: mgh006


PATIENT DATA:
AGE/SEX:
  72 year old male
DIAGNOSIS/SURGERY:
  Endocarditis
  Sepsis
PHARMACOLOGIC SUPPORT:
  Dopamine @ 950 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Ventricular pacing @ 100 bpm for sinus rhythm with A-V dissociation
PACEMAKER INFORMATION:
  Temporary ventricular fixed rate pacing (VOO)
  Transvenous wires (USCI bipolar #4)
  Medtronic generator (output 5 mv)
  Non-functional permanent coplin lithium pacer
TECHNICAL COMMENTS:
  Pacer mode (CH2) activated @ 22 min
  Persistent ECG interference
HEMODYNAMIC DATA:
  ART: 120/50   	MEAN: 72
  PAP: 47/20   	PCW: 17(@ 20 min, 32 min, 39 min)
  RAP: 11
WAVEFORM PATTERNS:
  Intermittent cannon waves in CVP and PCW due to A-V asynchrony
TECHNICAL COMMENTS:
  CVP transduced with medications infusing simultaneously via pump
  CVP on without medications @ 9 min - 11 min
  Simultaneous CVP and PCW recording @ 20 min
RESPIRATORY DATA:
RATE:   8/22 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING:
  Datex sidestream sensor
  CO2 monitor malfunction @ 36 min, turned off
[top]  

Record: mgh007


PATIENT DATA:
AGE/SEX:
  60 year old female
DIAGNOSIS/SURGERY:
  Multiple trauma
  Aortic graft
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with first degree heart block @ 85 bpm
ECG INTERPRETATION:
  Counterclockwise rotation
HEMODYNAMIC DATA:
  ART: 120/80   	MEAN: 92
  PAP: 32/18   	PCW: 12(@ 22 min, 31 min, 40 min)
  RAP: 12
WAVEFORM PATTERNS:
  Classic hemodynamic traces
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh008


PATIENT DATA:
AGE/SEX:
  71 year old female
DIAGNOSIS/SURGERY:
  Colon resection
  Prosthetic valve
  Endocarditis
PERTINENT HISTORY:
  Aortic stenosis and regurgitation
  Slight tricuspid regurgitation
  s/p mitral valve replacement
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation with ventricular demand pacing @ 80 bpm
PACEMAKER DATA:
  Permanent ventricular demand pacing (VVI)
  Unipolar wire
  Specifics unavailable
ECG INTERPRETATION:
  minor nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 100/60   	MEAN: 70
  PAP: 34/16   	PCW: 14 (@ 9 min, 16 min, 21 min, 30 min, 33 min)
  RAP: 10
WAVEFORM PATTERNS:
  "V waves" in PCW due to reduced atrial compliance with atrial hypertropy
  "V waves" in CVP due to tricuspid regurgitation
  Retrograde V wave spikes in the PA trace
  Intermittent "overwedge" configuration is noted in PCW @ 30 min
  Respiratory variation
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh009


PATIENT DATA:
AGE/SEX:
  56 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of thoraco-abdominal aneurysm
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 105 bpm
ECG INTERPRETATION:
  Left axis deviation
  Minor nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  6O-cycle interference in Lead I
  Movement artifact in V lead
HEMODYNAMIC DATA:
  ART: 150/80   	MEAN: 103
  PAP: 26/16   	PCW: 12 (@ 12 min, 27 min, 59 min)
  RAP: 12
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  CVP re-zeroed @ 11 min
RESPIRATORY DATA:
RATE:   6/20 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh010


PATIENT DATA:
AGE/SEX:
  56 year old female
DIAGNOSIS/SURGERY:
  Mitral regurgitation
  Prosthetic mitral valve endocarditis
  Pneumonia
PERTINENT HISTORY:
  sip mitral valve replacement (porcine)
PHARMACOLOGIC SUPPORT:
  Initial rates: Nipride @ 125 mcg/mln; Dobutamine @ 686 mcg/min
  Adjusted rates: Nipride to 50 mcg/min; Dopamine @ 150 mcg/min;
  Dobutamine unchanged
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with first degree heart block @ 120 bpm
RHYTHM DISTURBANCES:
  Multifocal ventricular ectopy
  Occasional couplets
  Short runs of ventricular tachycardia
  Changing P-R ? Wenckebach pattern
ECG INTERPRETATION:
  Non-specific STT wave changes
  Probable right ventricular hypertrophy
HEMODYNAMIC DATA:
  ART: 98/60
  PAP: 80/35   	PCW: 36 (V wave = 42) (@ 30 min, 42 min, 47 min, 61 min, 61 min)
  RAP: 16
WAVEFORM PATTERNS:
  Intermittent "V waves" in pulmonary capillary wedge tracing
  Unusual CVP trace due to heart block
  Intermittent cannon waves
  Pulmonary hypertension
  Respiratory variation
TECHNICAL COMMENTS:
  CVP off @ 57 min
RESPIRATORY DATA:
RATE:   17 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh011


PATIENT DATA:
AGE/SEX:
  70 year old female
DIAGNOSIS/SURGERY:
  Nephrectomy
  Renal artery bypass graft
PERTINENT HISTORY:
  Mitral regurgitation
PHARMACOLOGIC SUPPORT:
  TNG paste
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with intraventricular conduction defect @ 70 bpm
RHYTHM DISTURBANCES:
  Unifocal ventricular ectopy occasionally in a quadrageminal pattern
ECG INTERPRETATION:
  Left atrial enlargement
  Probable left ventricular hypertrophy
  Old inferior infarct of indeterminate age with persistent ST segment elevation
  Apicolateral ST segment and T wave abnormalities consistent with subendocardial ischemia
HEMODYNAMIC DATA:
  ART: 150/60   	MEAN: 102
  PAP: 32/16   	PCW: 10 (@ 9 min, 19 min, 36 min, 36 min)
  RAP: 6   	CO: 4.3
WAVEFORM PATTERNS:
  V waves in right atrial tracing due to ventricular ectopy
  Pulsus paradox
  Respiratory variation
TECHNICAL COMMENTS:
  Bolus of 200 ml volume (Ringers Lactate) @ 23 min
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh012


PATIENT DATA:
AGE/SEX:
  77 year old female
DIAGNOSIS/SURGERY:
  Burn trauma
PHARMACOLOGIC SUPPORT:
  Aminophylline @ 20 mgm/hr
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Multifocal atrial tachycardia @ 120 bpm
RHYTHM CHANGES:
  Occasional aberrant conduction
  Acceleration of rate particularly during IMV breaths
ECG INTERPRETATION:
  Low voltage
  Diffuse nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 123/54
  PAP: 42/20   	PCW: 14 (@ 17 min, 26 min, 44 min)
  RAP: 16 (not recorded)
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
  Marked respiratory variation
RESPIRATORY DATA:
RATE:   11/21 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh013


PATIENT DATA:
AGE/SEX:
  73 year old male
DIAGNOSIS/SURGERY:
  Angioplasty of right external iliac artery
PATIENT HISTORY:
  Coronary disease (unstable angina)
  Cerebral vascular disease
  Smoking
PHARMACOLOGIC SUPPORT:
  TNG @ 30 mcg/min
GENERAL COMMENTS:
  Recording in vascular angiography suite
  Movement artifact due to patient re-positioning and agitation
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation with incomplete left bundle branch block @ 78 bpm
RHYTHM CHANGES:
  Ventricular ectopy
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities consistent with digitalis effect
TECHNICAL COMMENTS:
  Chest lead = V6 (re-positioned for angiography)
HEMODYNAMIC DATA:
  ART: 140/60   	MEAN: 87
  PAP: 56/32
  RAP: 10   	CO:5
WAVEFORM PATTERNS:
  Pulmonary artery catheter migrates into right ventricle @ 66 min
  Catheter re-positioned until end of trace
  Pulmonary hypertension
TECHNICAL COMMENTS:
  No initial cal and pop-tests
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh014


PATIENT DATA:
AGE/SEX:
  58 year Old male
DIAGNOSIS/SURGERY:
  Coronary artery bypass graft
PHARMACOLOGIC SUPPORT:
  Dopamine @ 150 mcg/min
GENERAL COMMENTS:
  Stop/FFW @ 70 min - 71 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial pacing @ 95 bpm
RHYTHM DISTURBANCES:
  Unifocal ventricular ectopy
PACEMAKER DATA:
  Temporary atrial fixed rate pacing (AOO)
  Epicardial wires
  Medtronic 5330 pulse generator
  MA 15
ECG INTERPRETATION:
  Anterior infarct
  ? subendocardial apico-lateral infarct
  Nonspecific ST segment and T wave abnormalities consistent with digitalis effect or ischemia
TECHNICAL COMMENTS:
  Chest lead = V3
HEMODYNAMIC DATA:
  ART: 114/58   	MEAN: 84
  PAP: 41/13
  RAP: 13
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Aries console
  1:8 balloon ratio (1: 1.1 :2.1:4 during timing sequence)
WAVEFORM INTERPRETATION:
  Radial and aortic lumen IABP traces are recorded.
  Timing sequences @ 14 min- 18 min and 29 min-33 min
  Late deflation and early inflation during timing sequence
TECHNICAL COMMENTS:
  Zero to RAD lumen @ 11 min
  Zero to AO lumen @ 12 min
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh015


PATIENT DATA:
AGE/SEX:
  73 year Old male
DIAGNOSIS/SURGERY:
  Femoral-popliteal bypass graft
PERTINENT HISTORY:
  Coronary disease (unstable angina)
  Cerebral vascular disease
  Smoking
PHARMACOLOGIC SUPPORT:
  TNG @ 50 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with first degree A-V block and incomplete left bundle branch block @ 75 bpm
RHYTHM DISTURBANCES:
  Atrial tachycardia with 2: 1 block
  ? Mobitz II 2: 1 to 4: 1 block
  Unifocal ventricular ectopy (rare)
ECG INTERPRETATION:
  Diffuse ST segment and T wave abnormalities consistent with digitalis effect.
  subendocardial ischemia
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 71
  PAP: 36/16   	PCW: 16 (@ 13 min, 39 min, 44 min)
  RAP: 11   	CO: 3.6
WAVEFORM PATTERNS:
  "Catheter Whip" in PA trace
RESPIRATORY DATA:
RATE:   6/24 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh016


PATIENT DATA:
AGE/SEX:
  82 year old male
DIAGNOSIS/SURGERY:
  Abdominal aortic aneurysm resection and grafting
PERTINENT HISTORY:
  Coronary disease (MI, angina)
  Carotid disease
  Smoking
PHARMACOLOGIC SUPPORT:
  TNG @ 60 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  1: 1 ventricular pacing @ 50 bpm for tachy-brady syndrome
PACEMAKER DATA:
  Permanent ventricular demand pacer
  Specifics unavailable
ECG INTERPRETATION:
  Non-specific STT wave changes
  ? Old infarct
HEMODYNAMIC DATA:
  ART: 150/70   	MEAN: 83
  PAP: 20/8   	PCW: 6 (@ 11 min, 15 min, 41 min, 44 min)
  RAP: 3   	CO: 3.5
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   2/18 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh017


PATIENT DATA:
AGE/SEX:
  74 year old male
DIAGNOSIS/SURGERY:
  Mitral valve replacement and coronary artery bypass graft
PERTINENT HISTORY:
  Systemic and pulmonary hypertension
  COPD
  Peripheral vascular disease
PHARMACOLOGIC SUPPORT:
  Dopamine @ 208 mcg/min
  Regitine @ 28 mcg/min
  Inocor
GENERAL COMMENTS:
  Suctioned and ambued @ 48 min - 63 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with right bundle branch block @ 100 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
ECG INTERPRETATION:
  Inferior infarct
  Right ventricular hypertrophy
  Right axis deviation
  Non-specific sn wave changes
  Counterclockwise rotation
HEMODYNAMIC DATA:
  ART: 123/56   	MEAN: 95
  PAP: 66/28
  RAP: 13   	Cl:2.5
INTRA-AORTIC BALLOON DATA:
  40 cc balloon (transthoracic insertion)
  Aries console
  1: 1 balloon ratio
WAVEFORM PATTERNS:
  Radial and femoral arterial IABP traces
  Pulmonary hypertension
  Respiratory variation; variation disappears during transient disconnection of ventilator
  V wave in LA trace
TECHNICAL COMMENTS:
  LA/CVP/PAP on same transducer
  LA recordings: 13 min, 30 min - 36 min, 66 min - 67 min
  CVP recordings: 14 min, 69 min - 70 min
  PAP recordings: (wedge non-functional) 14 min, 38 min - 42 min, 67 min - 68 min
  Art pop-test: 16 min
  CVP zero: 15 min
RESPIRATORY DATA:
RATE:   6 bpm
MODE OF VENTILATION:
  Controlled with rare spontaneous breaths
COMMENTS:
  Impedance on @ 41 min
[top]  

Record: mgh018


PATIENT DATA:
AGE/SEX:
  67 year old male
DIAGNOSIS/SURGERY:
  Repair of duodenal ulcer
PERTINENT HISTORY:
  COPD
GENERAL COMMENTS:
  Bedmaking
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 98 bpm
RHYTHM DISTURBANCES:
  Multifocal atrial ectopy
  Junctional escape beats
  Multifocal ventricular ectopy
  Ventricular bigeminy/couplets
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities
  Anteroseptal infarct of indeterminate age
COMMENTS:
  This tracing illustrates the electrocardiographic changes commonly observed during insertion of a pulmonary arterial catheter.
  As the catheter moves through the right ventricle, multifocal ventricular ectopy appears, occasionally in a bigeminal pattern or in pairs.
  Premature atrial contractions and a junctional escape beat are evident as the catheter traverses the pulmonary artery.
HEMODYNAMIC DATA:
  ART: 160/64
  PAP: 41/24   	PCW: 15 (@ 38 min, 42 min, 43 min, 51 min)
  RAP: 16
WAVEFORM PATTERNS:
  This tracing illustrates the hemodynamic patterns observed during insertion of a pulmonary arterial catheter.
  As the catheter is advanced through the right atrium, right ventricle and pulmonary artery into the pulmonary capillary wedge position, distinctive hemodynamic patterns are evident.
TECHNICAL COMMENTS:
  Insertion of pulmonary arterial catheter @ 0-10 min
  CVP damped @ 52 min - 55 min
RESPIRATORY DATA:
RATE:   13/22 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING:
  On @ 11 min
[top]  

Record: mgh019


PATIENT DATA:
AGE/SEX:
  79 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Smoking
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 90 bpm
RHYTHM DISTURBANCES:
  Multifocal ventricular ectopy
ECG INTERPRETATION:
  Non-specific sn wave changes
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 88
  PAP: 28/12   	PCW: 8 (@ 23 min, 44 min, 52 min)
  RAP: 6   	CO:   3.4
RESPIRATORY DATA:
RATE:   2/11 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh020


PATIENT DATA:
AGE/SEX:
  60 year old female
DIAGNOSIS/SURGERY:
  Axillo-popliteal bypass graft
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  Dopamine @ 150 mcg/min
COMMENTS:
  Arrhythmias on mgh137 with potassium therapy on mgh020
  Stop/FFW @ 23 min
  Bed changed @ 43 min - 53 min
  Suctioning @ 54 min - 56 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Junctional rhythm with right bundle branch block @ 96 bpm
RHYTHM DISTURBANCES:
  Runs of junctional tachycardia
  Atrial ectopy
ECG INTERPRETATION:
  Low voltage
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Wandering baseline
HEMODYNAMIC DATA:
  ART: 110/70   	MEAN: 75
  PAP: 36/20   	PCW: 14 (@ 5 min, 6 min, 66 min)
  RAP: 11   	CO:   2.2
WAVEFORM PATTERNS:
  The abrupt conversion of junctional rhythm to junctional tachycardia creates ringing in the pulmonary arterial tracing and elevation of arterial diastolic pressure.
  These changes subside with resumption of a slower rhythm. Central vascular pressures exhibit the pattern of respiratory variation of controlled ventilation.
TECHNICAL COMMENTS:
  PA zero @ 9 min
RESPIRATORY DATA:
RATE:   7 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh021


PATIENT DATA:
AGE/SEX:
  75 year old male
DIAGNOSIS/SURGERY:
  Upper GI bleeding
PERTINENT HISTORY:
  Coronary disease
  Peripheral vascular disease
PHARMACOLOGIC SUPPORT:
  Pitressin @ 12 mcg/min
  TNG @ 30 mcg/min, then 100 mcg/min
  Dopamine @ 320 mcg/min (then OFF @ 31 min)
GENERAL COMMENTS:
  Recording ends @ 44 min with final annotation sequence
  Re-started @ 44 min - 51 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 92 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy with bigeminal pattern
  Supraventricular tachycardia
  Multifocal ventricular ectopy, occasional fusion beats
ECG INTERPRETATION:
  Question acute anterior subendocardial injury and possibly evolving infarction
TECHNICAL COMMENTS:
  Wandering baseline
  Carotid sinus massage @ 31 min
HEMODYNAMIC DATA:
  ART: 100/75   	MEAN: 85
  (femoral)
  PAP: 34/24
  RAP: 16   	CO: 3.2
WAVEFORM PATTERNS:
  Fluctuations in arterial pressure
  Respiratory variation
RESPIRATORY DATA:
RATE:   10/10 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh022


PATIENT DATA:
AGE/SEX:
  74 year old male
DIAGNOSIS/SURGERY:
  Upper GI bleed
PERTINENT HISTORY:
  Coronary disease
  Peripheral vascular disease
GENERAL COMMENTS:
  Stop/FFW @ 62 min - 63 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 85 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy, occasional blocked conduction
  Multifocal ventricular ectopy with ventricular bigeminy, couplets and idioventricular rhythm (@ 0-13 min)
ECG INTERPRETATION:
  Acute anterior subendocardial injury, question evolving infarction
HEMODYNAMIC DATA:
  ART: 120/70   	MEAN: 93
  (femoral)
  PAP: 36/20   	PCW: 16 (@ 35 min, 49 min, 65 min)
  RAP: 8   	CO:   5.3
WAVEFORM PATTERNS:
  "Catheter whip"
  Respiratory variation
  Arrhythmias produce A-V asynchrony in the right atrial pressure trace
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
CO2 RECORDING:
  An impedance signal on @ 51 min
[top]  

Record: mgh023


PATIENT DATA:
AGE/SEX:
  78 year old male
DIAGNOSIS/SURGERY:
  Cerebral hemorrhage
PERTINENT HISTORY:
  Coronary disease
GENERAL COMMENTS:
  Stop/FFW @ 35 min - 68 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial flutter with variable block @ 60 bpm, occasional aberrant conduction
RHYTHM DISTURBANCES:
  Conversion to atrial fibrillation, occasional aberrant conduction
  Ventricular ectopy, occasional bigeminy
ECG INTERPRETATION:
  Antero-septal infarct
  Antero-apical ischemia
  Nonspecific T wave abnormalities
TECHNICAL COMMENTS:
  Wandering baseline in Leads I and II near end of trace
HEMODYNAMIC DATA:
  ART: 150/50
  PAP: 49/26   	PCW: 21 (not recorded)
  RAP: 14
WAVEFORM PATTERNS:
  Pulmonary hypertension
  "Catheter whip" in pulmonary arterial trace
RESPIRATORY DATA:
RATE:   12/12 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh024


PATIENT DATA:
AGE/SEX:
  55 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
  Renal bypass graft
PERTINENT HISTORY:
  Coronary disease
  Renovascular hypertension
  Smoker
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Junctional tachycardia with intraventricular conduction defect @ 103 bpm
ECG INTERPRETATION:
  Poor R wave progression, possibly secondary to intraventricular conduction defect
  Possible old inferior infarct
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 168/102 NIBP   	MEAN: 113
  PAP: 24/12   	PCW:   12 (@ 13 min, 24 min, 45 min, 63 min)
  RAP: 6   	CO: 9
WAVEFORM PATTERNS:
  Cannon waves with junctional tachycardia
TECHNICAL COMMENTS:
  Arterial tracing not recorded; non-invasive blood pressure device in operation
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh025


PATIENT DATA:
AGE/SEX:
  69 year old male
DIAGNOSIS/SURGERY:
  Resection of bilateral iliac aneurysms
PERTINENT HISTORY:
  Coronary disease
PHARMACOLOGIC SUPPORT:
  TNG @ 100 mcg/min
GENERAL COMMENTS:
  Stop/FFW @ 26 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial flutter with intra-ventricular conduction defect @ 54 bpm
RHYTHM DISTURBANCES:
ECG INTERPRETATION:
  Left atrial hypertrophy
  Non-specific sn wave changes
  Poor precordial R wave progression
  ? Old anteroseptal infarct
  Possible old inferior infarct
TECHNICAL COMMENTS:
  Muscle tremor, agitated, out of bed
  ?Change in lead configuration
  LL and V electrode changed @ 26 min
HEMODYNAMIC DATA:
  ART: 180/40   	MEAN: 82
  PAP: 40/11 to 56/24   	PCW: 11 (@ 13 min, 38 min, 43 min, 57 min)
  RAP: 8
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
  Respiratory variation
RESPIRATORY DATA:
RATE:   7/16 changed to 5/16 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING:
  On @ 26 min
[top]  

Record: mgh026


PATIENT DATA:
AGE/SEX:
  74 year old female
DIAGNOSIS/SURGERY:
  Aorto-bifemoral bypass graft
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ 50 mcg/min, then 100 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with right bundle branch block @ 100 bpm
RHYTHM DISTURBANCES:
  Multifocal ventricular ectopy with occasional bigeminy, couplets, and fusion beats (0-256)
  ? Supraventricular tachycardia @ 24 min
ECG INTERPRETATION:
  Non-specific sn wave changes
  Possible old anterolateral scar
TECHNICAL COMMENTS:
  RA electrode disconnected/re-positioned @ 18 min
HEMODYNAMIC DATA:
  ART: 160/60   	MEAN: 88
  PAP: 40/16   	PCW: 16 (@ 27 min, 28 min, 65 min)
  RAP: 8   	CO:   5.6
WAVEFORM PATTERNS:
  PA line repositioned @ 17 min, 29 min
TECHNICAL COMMENTS:
  Zero/col/pop-test sequence @ 41 min - 50 min
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh027


PATIENT DATA:
AGE/SEX:
  73 year old male
DIAGNOSIS/SURGERY:
  Carotid endartarectomy
PERTINENT HISTORY:
  Diffuse coronary disease
  Cardiomyopathy
  COPD
GENERAL COMMENTS:
  Movement artifact throughout
  Extreme artifact @ 10 min - 12 min
  Asleep @ 25 min - 37 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 88 bpm
ECG INTERPRETATION:
  Diffuse transmural infarct
  Inferior wall ischemia
  Non-specific sn wave changes
  Left ventricular hypertrophy
HEMODYNAMIC DATA:
  ART: 140/60 	MEAN: 72
  PAP: 46/20
  RAP: 14
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh028


PATIENT DATA:
AGE/SEX:
  49 year old female
DIAGNOSIS/SURGERY:
  Unstable post-infarction angina
PERTINENT HISTORY:
  Mitral regurgitation
GENERAL COMMENTS:
  Recording of PA and PCW during V pacing @ 0-4 min
  Stop/FFW @ 4 min - 5 min
  Record @ 5 min - 6 min
  Stop/FFW @ 6 min - 7 min
  Chest pain resolving @ 0 - 7 min
  Set-up sequence @ 45 min - 52 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Ventricular pacing @ 70 bpm
RHYTHM DISTURBANCES:
  First degree heart block
  Transient acceleration of underlying sinus rhythm with RBBB near end of recording
PACEMAKER DATA:
  Permanent ventricular demand pacemaker (WI)
  Medtronic 8423 pulse generator
  Pulse width .496 msec
  Sensitivity 2.5 mv
  Refractory period 324 msec
ECG INTERPRETATION:
  Antero-septal infarct
  Inferior infarct
  Left anterior hemiblock
  Left axis deviation
TECHNICAL COMMENTS:
  Pace channel on @ 23 min
  ECG cal after 52 min
  Frequent movement artifact
HEMODYNAMIC DATA:
  ART: 92/60
  PAP: 44/22   	PCW: 20 (@ 359 min)
WAVEFORM PATTERNS:
  The pulmonary arterial channel illustrates the following configurations in sequence @ 0-4 min:
  1) PCW cannon waves due to A-V asynchrony,
  2) slight normalization of cannon waves (when P preceds QRS), with evidence of V waves in PCW due to mitral regurgitation,
  3) cannon waves,
  4) V waves during NSR, and
  5) pulmonary arterial configuration.
  The arterial trace exhibits minor changes in configuration during normal sinus rhythm when atrio-ventricular synchrony is restored.
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh029


PATIENT DATA:
AGE/SEX:
  84 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  COPD
PHARMACOLOGIC SUPPORT:
  Dopamine @ 800 mcg/min,then 200 mcg/min, then 800 mcg/min
  Levophed @ 2 mcg/min, then 3 mcg/min, then 2 mcg/min, then 10 mcg/min
  Accidental Levophed bolus near end of tape
GENERAL COMMENTS:
  Suctioning @ 35 min - 40 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 100 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  Unifocal ventricular ectopy
  Run of supraventricular tachycardia @ 61 min
ECG INTERPRETATION:
  Evolving anterior infarct
TECHNICAL COMMENTS:
  LL electrode off @ 41 min - 43 min
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 85
  PAP: 44/24   	PCW: 20 (@ 8 min, 56 min, 57 min, 60 min)
  RAP: 18
WAVEFORM PATTERNS:
  Arterial hypotension near end of tape is followed by acute hypertension culminating in pulsus alternans.
   The course of pulmonary hypertension parallels that of systemic arterial hypertension.
   "Catheter whip" is pronounced in the pulmonary arterial tracing.
TECHNICAL COMMENTS:
Poor frequency response CVP (12.5 Hz)
Borderline frequency response PAP (16.5 H2z
RESPIRATORY DATA:
RATE:   10 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING:
  On @ 11 min, off @ 50 min
[top]  

Record: mgh030


PATIENT DATA:
AGE/SEX:
  67 year old male
DIAGNOSIS/SURGERY:
  Esophagogastrectomy
  Sepsis
PERTINENT HISTORY:
  Smoker
  Aspiration
PHARMACOLOGIC SUPPORT:
  Dopamine @ 240 mcg/min
  Levophed @ 4.8 mcg/min
GENERAL COMMENTS:
  Bedmaking @ 49 min
  Stop/FFW @ 37 min and 64 min - 65 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with right bundle branch block @ 84 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy with occasional aberrant conduction
  Atrial fibrillation
  Atrial flutter with 2: 1 conduction @ 33 min
  Unifocal ventricular ectopy
ECG INTERPRETATION:
  Left anterior hemiblock
  Left axis deviation
  Non-specific sn wave changes
HEMODYNAMIC DATA:
  ART: 124/58 (pedal)
  PAP: 50/25   	PCW: 15 (@ 12 min, 47 min, 69 min)
  RAP: 14
WAVEFORM PATTERNS:
  Pulmonary hypertension
TECHNICAL COMMENTS:
  Zero @ 11 min
  PAP/CVP on same transducer
RESPIRATORY DATA:
RATE:   18/18 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh031


PATIENT DATA:
AGE/SEX:
  81 year old male
DIAGNOSIS/SURGERY:
  Total hip replacement
  Pneumonia
PERTINENT HISTORY:
  Coronary disease
  Aortic stenosis and mitral regurgitation
PHARMACOLOGIC SUPPORT:
  TNG @ 60 mcg/min
GENERAL COMMENTS:
  Stop/FFW @ 2 min - 3 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 114 bpm
RHYTHM DISTURBANCES:
  Multifocal ventricular ectopy, occasional quadrageminy, fusion beats
ECG INTERPRETATION:
  Inferior infarct
  Left atrial enlargement
  Anteroseptal scar
TECHNICAL COMMENTS:
  Movement artifact
HEMODYNAMIC DATA:
  ART: 100/60   	MEAN: 69
  PAP: 40/20
  RAP: 16
RESPIRATORY DATA:
RATE:   30 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh032


PATIENT DATA:
AGE/SEX:
  78 year old female
DIAGNOSIS/SURGERY:
  Superior mesenteric embolectomy
  Small bowel resection
PERTINENT HISTORY:
  Mitral stenosis
GENERAL COMMENTS:
  Suctioning @ 52 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 91 bpm
ECG INTERPRETATION:
  Anteroseptal infarct
  Left atrial enlargement
  Left ventricular hypertrophy
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 100/40   	MEAN: 55
  (axillary)
  PAP: 36/16
  RAP: 6
TECHNICAL COMMENTS:
  Cardiac output measurement @ 22 min; line movement
RESPIRATORY DATA:
RATE:   7/7 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh033


PATIENT DATA:
AGE/SEX:
  77 year old male
DIAGNOSIS/SURGERY:
  Colectomy
PERTINENT HISTORY:
  Coronary disease
PHARMACOLOGIC SUPPORT:
  TNG @ 20 mcg/min
GENERAL COMMENTS:
  Stop/FFW @ 69 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with first degree A-V block and left bundle branch block @ 93 bpm
ECG INTERPRETATION:
  Nonspecific ST segment and T wave changes
TECHNICAL COMMENTS:
  Wandering baseline in Leads I, II, and V
HEMODYNAMIC DATA:
  ART: 100/60   	MEAN: 68
  PAP: 44/24   	PCW: 24 (@ 13 min, 14 min, 44 min, 47 min)
  RAP: 7   	CO: 4.8
WAVEFORM INTERPRETATION:
  Volume change @ 44 min
  PA configuration change (? damped, against wall)
  Repositioning of PA catheter @ 50 min
  Normal traces restored @ 53 min
  V wave
RESPIRATORY DATA:
RATE:   16 born
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh034


PATIENT DATA:
AGE/SEX:
  66 year old male
DIAGNOSIS/SURGERY:
  Transurethral prostrate resection
PERTINENT HISTORY:
  Coronary disease
  Mitral regurgitation
  Ventricular septal defect
  Ventricular aneurysm
  Smoker
GENERAL COMMENTS:
  Bed change @ 47 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus bradycardia @ 58 bpm
ECG INTERPRETATION:
  Non-specific sn wave changes
  Old inferior infarct
  Left atrial enlargement
TECHNICAL COMMENTS:
  Muscle tremor
HEMODYNAMIC DATA:
  ART: 140/70   	MEAN: 88
  PAP: 48/20   	PCW: 18 (@ 52 min, 54 min, 64 min)
  RAP: 6   	CO: 7.8
WAVEFORM PATTERNS:
  V wave
  Overwedge @ 54 min
  "Catheter whip" in PA trace
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh035


PATIENT DATA:
AGE/SEX:
  68 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ 100 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus bradycardia @ 42 bpm
ECG INTERPRETATION:
  Left atrial enlargement
  Left ventricular hypertrophy
HEMODYNAMIC DATA:
  ART: 200/100   	MEAN: 125
  PAP: 32/16   	PCW: 14 (@ 10 min, 14 min, 67 min)
  RAP:   8   	CO:   3.7
WAVEFORM PATTERNS:
  Hypertension
RESPIRATORY DATA:
RATE:   5/8 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh036


PATIENT DATA:
AGE/SEX:
  66 year old female
DIAGNOSIS/SURGERY:
  Renal artery bypass graft
PERTINENT HISTORY:
  Mild mitral regurgitation
  Aortic regurgitation and stenosis
  Coronary disease
  Hypertension
  Smoker
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with left bundle branch block @ 76 bpm
ECG INTERPRETATION:
  Inferior infarct
  Anterior infarct
  R waves consistent with left ventricular hypertrophy and strain
TECHNICAL COMMENTS:
  Muscle tremor, wandering baseline and movement artifact
HEMODYNAMIC DATA:
  ART: 160/59   	MEAN: 83
  PAP: 48/20   	PCW: 18 (@ 14 min, 15 min, 22 min, 23 min, 37 min)
  CO: 6.3
WAVEFORM PATTERNS:
  V waves due to mitral regurgitation in the pulmonary capillary wedge tracing
  Corresponding spikes in the pulmonary arterial tracing.
RESPIRATORY DATA:
RATE:   2/6 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh037


PATIENT DATA:
AGE/SEX:
  71 year old female
DIAGNOSIS/SURGERY:
  Renal artery bypass graft
PERTINENT HISTORY:
  Mild mitral regurgitation
  Coronary disease
PHARMACOLOGIC SUPPORT:
  TNG @ 60 mcg/min
  Labetolol @ .06 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 73 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy, occasionally with aberrant or blocked conduction
  Junctional escape beats
ECG INTERPRETATION:
  Left ventricular hypertrophy
  Old anterior infarct
  Left axis deviation
  Nonspecific ST segment and T wave abnormalities
  Slurred upstroke, resembles Wolff-Parkinson-White pattern syndrome
HEMODYNAMIC DATA:
  ART: 150/60
  PAP: 36/16   	PCW: 16 (@ 20 min, 21 min, 58 min)
  RAP: 7   	CO: 5.9
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh038


PATIENT DATA:
AGE/SEX:
  66 year old female
DIAGNOSIS/SURGERY:
  Renal artery bypass graft
PERTINENT HISTORY:
  Mild mitral regurgitation
  Aortic regurgitation and stenosis
  Coronary disease
  Hypertension
  Smoker
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with left bundle branch block @ 76 bpm
RHYTHM DISTURBANCES:
  3-beat run of supra-ventricular tachycardia @ 25 min
  Supraventricular ectopy, occasional aberrant conduction
  Multifocal ventricular ectopy
ECG INTERPRETATION:
  Inferior infarct
  Anterior infarct
  R waves consistent with left ventricular hypertrophy and strain
HEMODYNAMIC DATA:
  ART: 140/40   	MEAN: 76
  PAP: 42/20   	PCW: 16 (@ 13 min, 26 min, 52 min, 53 min)
  CVP: 8   	CO:   6.3
WAVEFORM PATTERNS:
  V waves due to mitral regurgitation in the pulmonary capillary wedge tracing
  Corresponding spikes in the pulmonary arterial tracing.
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh039


PATIENT DATA:
AGE/SEX:
  66 year old female
DIAGNOSIS/SURGERY:
  Renal artery bypass graft
PERTINENT HISTORY:
  Mild mitral regurgitation
  Aortic regurgitation and stenosis
  Coronary disease
  Hypertension
  Smoker
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with left bundle branch block @ 76 bpm
RHYTHM DISTURBANCES:
  Supraventricular ectopy, occasional aberrant conduction
  Multifocal ventricular ectopy
ECG INTERPRETATION:
  Inferior infarct
  Anterior infarct
  R waves consistent with left ventricular hypertrophy and strain
HEMODYNAMIC DATA:
  ART: 140/40   	MEAN: 76
  PAP: 42/20   	PCW: 16
  CVP: 8   	CO:   6.3
WAVEFORM PATTERNS:
  V waves due to mitral regurgitation in the pulmonary capillary wedge tracing
  Corresponding spikes in the pulmonary arterial tracing.
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh040


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	BYPASS
	OFF BYPASS
[top]  

Record: mgh041


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
1 min	ZERP/CA; CH8/9/11
3 min	VENOUS CANNULALTION
6 min	BYPASS
11 min		VENTRICULAR FIBRILLATION
[top]  

Record: mgh042


PATIENT DATA:
AGE/SEX:
  1 year old female
DIAGNOSIS:
  Ventricular septal defect
  Coarctation of the aorta
PROCEDURE:
  Pediatric Cath/RHC/LHC
ECG DATA:
LEADS:
  I (telemetry), II, V4 (on ch5)
RHYTHM:
  Sinus tachycardia
RHYTHM CHANGES:
  Multifocal ventricular ectopy with fusion beats, couplets, and runs of tachycardia
  Episodes of atrial tachycardia
ECG INTERPRETATION:
  Biventricular hypertrophy
  ST depression in V4 due to RV conduction defect
TECHNICAL COMMENTS:
  ECG on Channel 5 initially set-up for Lead III, lead selection changed to V4 for recording
HEMODYNAMIC DATA:
  ART: 100/?
  PA: 35/14 (20)
  CVP: 2
  LAP: 8
  VENTRICULAR SHUNT: 3: 1
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-10 sec	CAL TO ECG
10-14 sec	ZERO CH 10/CAL OF 200 CH 10
1 min	ZERO CH9/CAL OF 200 CH9
1 min	STOP TAPE
1 min	ZERO CH8/CAL OF 200 CH8
2 min	EKG ON
3 min	CAL TO ECG TELEMETRY
5 min	CAL TO ECG   LEAD I, II, V4
8 min	STOP/FFW
8 min	TAPE ON
	CATHETER IN IVC
		TRACE OFF
11 min	CATHETER IN RV   RV
11 min	CHANGE ATTENUATION
		RUNS OF VT
12 min	CATHETER IN PA   PA
	SCALE 0-100
12 min	SCALE 0-40
13 min	PULLBACK RV
13 min		BLOCK AND IRRITABILITY
14 min	RV BODY
	SCALE 0-40
14 min	SCALE 0-100
14 min	PULLBACK TO RA   RA
18 min	ACROSS FORAMEN TO LA   LA
18 min	LV   LV
25 min	ECG TELEMETERY OFF
	PRESSURE SCALE TO 200
29 min	LV GRAM
[top]  

Record: mgh043


PATIENT DATA:
AGE/SEX:
  66 year old male
DIAGNOSIS:
  Coronary artery disease
PROCEDURE:
  Angioplasty
COMMENTS:
  Intra-aortic balloon in place
ECG DATA:
LEADS:
  I (telemetry), A VF, V3
RHYTHM:
  Sinus Bradycardia with first degree heart block
RHYTHM CHANGES:
  Sinus tachycardia
  Atrial ectopy and runs of tachycardia
  Episode of A-V dissociation
  Ventricular ectopy with couplet
PACEMAKER INFORMATION:
  Temporary WI pacer
ECG INTERPRETATION:
  Acute ST wave changes
  Inferior wall infarct
TECHNICAL COMMENTS:
  AVF on Channel 4, V3 on Channel 5
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0   TAPE ON
16 min		AO/RADIAL ARTERY
22 min	IABP OFF
23 min	IABPON
56 min	GUIDE WIRE THRU LESION
66 min	VPACE   BRADYCARDIA/HYPOTENSION
	BALLOON ON/levophed ON-OFF
		TACHYCARDIC
[top]  

Record: mgh044


PATIENT DATA:
AGE/SEX:
  64 year old male
DIAGNOSIS:
  Paroxysmal ventricular tachycardia
PROCEDURE:
  Pace map
ECG DATA:
LEADS:
  I (telemetry) II, III
RHYTHM:
  Normal sinus rhythm with left bundle branch block
RHYTHM CHANGES:
  Ventricular ectopy with runs of tachycardia requiring defibrillation
ECG INTERPRETATION:
  Possible old anterior wall infarct
HEMODYNAMIC DATA:
  ART: 98/68
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-16 sec	CAL TO ECG (s)
18-27 sec	STOP/FFW
	INSERT PACING CATHETER
1 min	?PACE ON-OFF   PACE
3 min	?PACE
4 min	ON-OFF
4 min	STIMULATE VT   VT
5 min	INTERRUPT VT WITH PACING
12 min		ART
12 min	ZERO/CAL
23 min	CATHETER RE-POSITIONING   RUNS OF VENTRICULAR
	IRRITABILITY   (BIGEMINY /COUPLETS/MULTIFOCAL)
29 min	PACE   PACE
	PACE OFF
30 min	REPEAT
32 min	REPEAT
40 min	?PACE   3 BEAT RUN
40 min	STIMULATE VT   VT
41 min	INTERRUPT VT
47 min	STIMULATE VT   VT
50 min	DEFIBILLATE @ 100 joules
[top]  

Record: mgh045


PATIENT DATA:
AGE/SEX:
  9 month old female
DIAGNOSIS:
  Ventricular septal defect repair
  PA band and coarctation repair
PROCEDURE:
  Pediatric Cath
ECG DATA:
LEADS:
  I (telemetry), II, III
RHYTHM:
  Normal sinus rhythm with right bundle branch block
RHYTHM CHANGES:
  Atrial ectopy and run of atrial tachycardia
  Multifocal ventricular ectopy with couplets and runs of ventricular tachycardia
  Mobitz II with 2: 1 and 3: 1 conduction
ECG INTERPRETATION:
  Marked right axis deviation
  Non-specific ST segment changes
  HEMODYNAMIC DATA:(pre-cath)
  ART: (72)
  CVP: 6
  GRADIENT: 50 mm gradient across aortic valve
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
2 sec	ZERO
4-11 sec	CAL OF 200 CH9
11-20 sec	ZERO
20-22 sec	TAPE OFF
1 min	ECG CALS
1 min	TAPE OFF
1 min	TAPE ON
2 min	SUBCLAVIAN INJECTION
5 min		RA
6 min	RV OUTFLOW 0-40 SCALE   RV
7 min	0-100 SCALE
7 min	0-200 SCALE
8 min		ARRHYTHMIAS
9 min	LEFT PA 0-40 SCALE   PA
9 min	LEFT PA TO MAIN PA
9 min	0-100 SCALE   MEAN PA
10 min	PULLBACK
13 min	0-200 SCALE
13 min	RV BODY   RV
19 min	DESCENDING AORTA 0-200   AO
19 min	ZERO/CAL
19 min	DESCENDING AORTA 0-100   MEAN ART = 72
20 min	LV PRESSURE 0-100   LV
21 min	LVEDP 0-40
21 min	0-200 SCALE
21 min	PULLBACK TO AORTA   AO
21 min	LV   LV
	0-200 SCALE
	PATIENT RE-POSITIONED
32 min	LV GRAM
34 min		2: 1 BLOCK (Atropine)
35 min		3:1 BLOCK
36 min	CATHETER OUT   RATE UP
42 min	LV   LV
43 min	LV INJECTION
	LV PRESSURE
44 min	ZERO/CAL
44 min	LV PULLBACK 0-200 SCALE
44 min	MEAN ACROSS COARCTATION
	DESCENDING AORTA   AO
	RIGHT HEART CATHETER INSERTED   RA
48 min	RV   RV
	RE-POSITION PT
55 min	RV
	RA PRESSURE   RA
64 min	STOP
[top]  

Record: mgh046


PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
0-14 sec	ECG CAL
8 min	PACING (CHECK THRESHOLD)   PACE
11 min	INSERT WIRE
		MF-VENT
	ECTOPY /COUPLETS/VT
12 min	PACE     PACE:PVCS/NO CAPTURE
13 min	PACE OFF
14 min	PACE
14 min		VENTRICULAR TACHYCARDIA
15 min		SINUS
15 min		ARTERIAL
16 min	ZERO
22 min	ARTERIAL ON   ART = 200/80
35 min	PACE STIMULATION
36 min	REPEAT
38 min	REPEAT
39 min	INSERT WIRE LV
43 min	PACE STIMULATION
44 min	REPEAT
	REPEAT
47 min	INDUCE	VT	VT
47 min	ATTEMPT TO TERMINATE
47 min	REPEAT
	REPEAT
	LV PACEMAP
53 min	STIMULATE
54 min	INDUCE VT     VT
55 min	STIMULATE
	INDUCE   VT   VT
56 min	STIMULATE
57 min	INDUCE	VT	VT
59 min	INDUCE	VT	VT
59 min	PACE     PACE
61 min	PACE     PACE
61 min	INDUCE	VT	VT
66 min	ZERO
66 min	CAL
[top]  

Record: mgh047


PATIENT DATA:
AGE/SEX:
  1 year old male
DIAGNOSIS:
  Tetralogy of Fallot
PROCEDURE:
  Right /Left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, V?
RHYTHM:
  Sinus tachycardia @ 120 bpm
RHYTHM CHANGES:
  Atrial ectopy with occasional aberrant conduction
  Run of atrial tachycardia
  Ventricular ectopy with bigeminy, couplet, run of tachycardia
TECHNICAL COMMENTS:
  Clipping of V lead; V lead on CH5
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-4 sec	ECG CALS
10-15 sec	REPEAT ECG CAL
28-29 sec	REPEAT TELEMETRY CAL
2 min	ZERO/CAL OF 20
2 min	STOP /FFW ION
3 min	ZERO
	INSERT RIGHT HEART CATHETER
5 min	LEFT ATRIUM   LA
	CHG CH5 LEVEL
7 min	LEFT VENTRICLE   LV
	PULLBACK TO LEFT ATRIUM   LA
9 min	SCALE 40
9 min	LEFT ATRIUM TO RIGHT ATRIUM   LA/RA
9 min	RIGHT ATRIUM
38 min	PT RE-POSITIONED X2
40 min	RV GRAM   RV
42 min		VENTRICULAR IRRITABILITY
45 min		CHANGE IN CONDUCTION
55 min		INCREASED BUNDLE BRANCH BLOCK
		IRRITABILITY; BLOCK
57 min	ASCENDING AO   AO
59 min		AO PRESSURE
60 min		AO OFF
	RE-ZERO
60 min		AO ON
70 min	AORTOGRAM
72 min	PULLBACK
72 min	RIGHT ATRIUM   RA
73 min	ECG CAL
83 min	END     
[top]  

Record: mgh048


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-18 sec		RUN VENTRICULAR
		TACHYCARDIA
1 min	LV /FEMORAL ARTERY   LV/ART
	RE-POSITION PT   VENTRICULAR IRRITABILITY
10 min		RUNS OF VT
10 min	LV GRAM   LV/VENTRICULAR BIGEMINY
23 min	MOVE TO STRETCHER
26 min	ECG OFF
32 min	CAL OF 200
32 min	ZERO
33 min	STOP
[top]  

Record: mgh049


PATIENT DATA:
AGE/SEX:
  8 year old male
DIAGNOSIS:
  Transposed right ventricle
  Left Ventricle with Ebsteins tricuspid valve (?tricuspid regurgitation)
  Ventricular septal defect
  Infundibular and valvular stenosis
PROCEDURE:
  Right heart cath/Left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, V?
RHYTHM:
  Sinus tachycardia
RHYTHM CHANGES:
  Atrial tachycardia
  Multi-focal ventricular ectopy, bigeminy, couplets, with runs of tachycardia
ECG INTERPRETATION:
  Intraventricular conduction defect
  STT wave abnormalities consistent with LV strain
TECHNICAL COMMENTS:
  V lead on CHS
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-7 sec	ECG STD
7-11 sec	TELEMETRY STD
11-20 sec	FFW/ON
12 min	ZERO CH9
12 min	CAL OF 200 CH9
	CATHETER INSERTION
12 min	DESCENDING AORTA   AO
13 min	LEFT VENTRICLE   LV
	SCALE 200
13 min	SCALE 40
14 min	PULLBACK TO AORTA   AO
	MEAN/PHASIC
14 min	LEFT VENTRICLE   LV
16 min	PULMONARY VEINS   PV
	SCALE 40
22 min	ANGIO TEST
23 min	LEFT VENTRICLE   LV
	RIGHT VENTRICLE   RV
24 min	SCALE 40
24 min	SCALE 100
24 min	SCALE 200
26 min	PULMONARY ARTERY   PA
	SCALE 40
27 min	PULLBACK PA TO LV   PA/LV
	SCALE 40
27 min	SCALE 100
28 min	INFUNDIBULUM
28 min	BODY
30 min	ZERO CH9
31 min	CAL CH9
31 min	PULLBACK
	SCALE 100
37 min		VENTRICULAR IRRITABILITY
	RE-POSITION PT
46 min	ANGIOGRAM
		TACHYCARDIA
	PULLBACK ATRIUM   ATRIUM
52 min	ANGIO
59 min	CORONARY CATHETER IN
65 min	CORONARY ANGIOGRAM
69 min	REPEAT
69 min	REPEAT
	PRESSURE ON (DAMPED)   DAMPING
70 min	REPEAT COR
		VENTRICULAR IRRITABILITY
70 min	END
[top]  

Record: mgh050


PATIENT DATA:
AGE/SEX:
  10 month old male
DIAGNOSIS:
  ASD/PDA/pulmonary disease
PROCEDURE:
  Right heart cath/Left heart cath
ECG DATA:
LEADS:
  I (telemetry), III, V4
RHYTHM:
  Atrial tachycardia
RHYTHM CHANGES:
  Atrial tachycardia, occasional aberrant conduction
  Multifocal ventricular ectopy with bigeminy, couplets, and runs of tachycardia
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-18 sec	ECG STD
18-22 sec	FFW/STOP/ON
4 min		SUPRA VENTRICULAR
	TACHYCARDIA
6 min	ZERO/CAL
	CATHETER INSERTION
7 min	RIGHT ATRIUM   RA
	SCALE 40
7 min	MEAN RIGHT ATRIUM
8 min	RIGHT VENTRICLE   RV
	SCALE 40
8 min	PULMONARY ARTERY   PA
	SCALE 100
8 min	MEAN PA
12 min	RIGHT VENTRICLE   RV
	SCALE 100
13 min	RIGHT ATRIUM   RA
	SCALE 100
14 min	SCALE 40
16 min	LEFT ATRIUM   LA
17 min	PULMONARY VEIN   PV
18 min	LEFT UPPER PULMONARY VEIN
19 min		SUPRA VENTRICULAR
	TACHYCARDIA
20 min	LEFT VENTRICLE   LV
	SCALE 100
20 min	SCALE 40
		COUPLETS/RUN OF VT
	LEFT ATRIUM   LA
22 min	LEFT ATRIUM MEAN
22 min	RIGHT ATRIUM   RA
25 min	RIGHT ATRIUM
27 min	RIGHT VENTRICLE   RV
29 min	PULMONARY ARTERY   PA
30 min	SUPERIOR VENA CAVA
		MULTI FOCAL VPCS/RUNS OF VT
33 min	LEFT VENTRICLE   LV
34 min		VT vs. SVT with ABERRANCY
35 min	LEFT VENTRICLE TO LEFT ATRIUM   LV/LA
	LEFT ATRIUM TO RIGHT ATRIUM   LA/RA/RV
35 min	TO RIGHT VENTRICLE
49 min	PA GRAM   PA
61 min	RV GRAM
		RUN OFVT
	RIGHT VENTRICLE   RV
62 min	RIGHT ATRIUM
[top]  

Record: mgh051


PATIENT DATA:
AGE/SEX: 75 year old male
DIAGNOSIS/SURGERY:
  Aortic and mitral valve replacements for valvular stenosis
  Coronary artery bypass graft
PHARMACOLOGIC SUPPORT:
  Dopamine @ 250 mcg/min
  TNG @ 83 mcg/min
  Levophed @ .75 mcg/min
GENERAL COMMENTS:
  Stop/FFW 14 min - 15 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation with 1: 1 intraventricular conduction defect and ventricular demand pacing
PACEMAKER DATA:
  Temporary ventricular demand pacing (WI)
  Epicardial wires
  Medtronic A-V sequential pacer
  MA 13
ECG INTERPRETATION:
  Low voltage
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 106/36
  PAP: 36/18
  RAP: 11   	Cl: 2.4
TECHNICAL COMMENTS:
  PAP/CVP/LAP on same transducer
  PAP recordings @ 16 min - 19 min and 26 min
  CVP recordings @ 19 min - 22 min and 33 min
  LAP recordings @ 24 min - 25 min and 33 min
  No pop-test on combined pressure channel
RESPIRATORY DATA:
RATE:   B/B changed to 6 bpm @ 23 min
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh052


PATIENT DATA:
AGE/SEX:
  60 year old male
DIAGNOSIS/SURGERY:
  Coronary artery bypass grafts
PERTINENT HISTORY:
  Apical aneurysm
PHARMACOLOGIC SUPPORT: .
  Dopamine @ 180 mcg/min
  Levophed @ 5 mcg/min
  TNG @ 41 mcg/min
GENERAL COMMENTS:
  Motion artifact with suctioning @ 42 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with left bundle branch block @ 108 bpm
RHYTHM DISTURBANCES:
  Premature atrial contractions
  Unifocal ventricular ectopy
ECG INTERPRETATION:
  Non-specific sn wave changes
  Old antero-septal infarct
  Old inferior infarct
TECHNICAL COMMENTS:
  Chest lead = V4
HEMODYNAMIC DATA:
  ART: 100/43   	MEAN: 80
  PAP: 31/15
  RAP: 13   	CO: 6.1
INTRA-AORTIC BALLOON DATA:
  Aries console
  1: 1 balloon ratio
WAVEFORM INTERPRETATION:
  Aortic lumen and radial IABP traces
  Equivalent systolic and augmented diastolic peaks
  Example of late inflation
RESPIRATORY DATA:
RATE:   5/5 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh053


PATIENT DATA:
AGE/SEX:
  60 year old male
DIAGNOSIS/SURGERY:
  Acute antero-lateral infarct
PHARMACOLOGIC SUPPORT:
  TNG @ 100 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 84 bpm
ECG INTERPRETATION:
  Poor R wave progression consistent with anterior infarct of indeterminate age
  ST segment and T wave abnormalities consistent with evolving anterolateral infarct
HEMODYNAMIC DATA:
  ART: 135/58   	MEAN: 89
INTRA-AORTIC BALLOON DATA:
  40 cc
  Aries console
  1: 1 ratio
WAVEFORM INTERPRETATION:
  Radial and aortic lumen IABP traces
  Timing adjustment @ 13 min - 18 min
  Systolic peak greater than augmented diastolic
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh054


PATIENT DATA:
AGE/SEX:
  62 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of thoracoabdominal aneurysm
  Bifurcation graft to common iliac artery
  Bleeding diathesis
PERTINENT HISTORY:
  G-suit (MASD applied with pressure of 40 mm Hg
  Hypothermic @ 3 min
  Massive transfusions and pressor support
PHARMACOLOGIC SUPPORT:
  Levophed @ 17.5 mcg/min, then 20 mcg/min
  Pitressin @ 0.1 mcg/min
  Amicar @ 1 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 76 bpm
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities with U waves consistent with electrolyte imbalance
  (? low potassium)
HEMODYNAMIC DATA:
  ART: 100/75   	MEAN: 93
  (femoral)
  PAP: 70/48
  RAP: 36   	CO: 4.64
WAVEFORM PATTERNS:
  Hypotension
  Pulmonary hypertension
  Respiratory variation
TECHNICAL COMMENTS:
  No final zero/cal for PA/CVP lines
  ECG cal still not working
RESPIRATORY DATA:
RATE:   16/16 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh055


PATIENT DATA:
AGE/SEX:
  63 year old female
DIAGNOSIS/SURGERY:
  Coronary artery bypass graft
PERTINENT HISTORY:
  VF arrest s/p MI
  Hypertension
PHARMACOLOGIC SUPPORT:
  Nipride @ 41 mcg/min
  TNG @ 41 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with left bundle branch block @ 105 bpm
ECG INTERPRETATION:
  Anterior infarct
HEMODYNAMIC DATA:
  ART: 101/42   	MEAN: 80
  PAP: 37/10   	PCW: 20
  RAP: 10   	LAP: 19   	CO: 2.5
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Aries console
  1 : 1 balloon ratiO
WAVEFORM PATTERNS:
  Radial and aortic lumen IABP traces
  V wave in LA trace
TECHNICAL COMMENTS:
  PA/CVP/LA on same transducer
  PA and RAP traces not recorded
  LA zero @ 10 min
  Sequence of traces @ 12 min - 21 min
  IABP off @ 17 min
  No poptests to PA/CVP/LA
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh056


PATIENT DATA:
AGE/SEX:
  70 year old male
DIAGNOSIS/SURGERY:
  Ventricular septal defect post MI
  Sepsis
PERTINENT HISTORY:
  Coronary Disease
  Smoking
PHARMACOLOGIC SUPPORT:
  Dopamine @ 300 mcg/min
  Inocor @ 583 mcg/min
GENERAL COMMENTS:
  Suctioning/ambu @ 16 min - 31 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 86 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
ECG INTERPRETATION:
  Non-specific sn wave changes
  Prolonged QT interval
  Old inferior infarct
HEMODYNAMIC DATA:
  ART: 84/66   	MEAN: 66
  RAP: 13
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Kontron console
  1: 1 balloon ratio
WAVEFORM PATTERNS:
  Aortic lumen and radial arterial IABP traces
TECHNICAL COMMENTS:
  PA/CVP on same transducer
  Poor quality PA/CVP tracings (air trapping in system)
RESPIRATORY DATA:
RATE:   7/20 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING:
  Ambu thru sensor @ 18 min
  CO2 off @ 45 min
[top]  

Record: mgh057


PATIENT DATA:
AGE/SEX:
  57 year old male
DIAGNOSIS/SURGERY:
  Coronary artery bypass graft
PHARMACOLOGIC SUPPORT:
  TNG @ 36 mcg/min, then off
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial pacing @ 96 bpm (AOO)
PACEMAKER INFO:
  Temporary atrial fixed rate pacing
  Epicardial wires
  Medtronic S837 pulse generator
  MA 14.96
ECG INTERPRETATION:
  Inferior and anterior infarcts
  Low voltage
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Intermittent 6O-cycle interference
HEMODYNAMIC DATA:
  ART: 114/56   	MEAN: 88
  PAP: 38/16
  RAP: 14   	LAP: 16   	CO: 3.4
INTRA-AORTIC BALLOON DATA:
  40 cc ballon
  Kontron console
  1:1 balloon ratio
WAVEFORM PATTERNS:
  Aortic lumen and radial arterial IABP trace
TECHNICAL COMMENTS:
  Aortic lumen damping, flushed
  PA recording @ 19 min - 23 min
RESPIRATORY DATA:
RATE:   7/7 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh058


PATIENT DATA:
AGE/SEX:
  78 year old male
DIAGNOSIS/SURGERY:
  Coronary artery bypass grafts
PHARMACOLOGIC SUPPORT:
  Dopamine @ 208 mcg/min
  TNG @ 41 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 3 min
RHYTHM DISTURBANCES:
  Sinus tachycardia
  Atrial ectopy
ECG INTERPRETATION:
  Minor nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 100/47   	MEAN: 80
  PAP: 49/15   	PCW: 13
  RAP: 14   	LAP: 13   	Cl: 2.3
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Kontron console
  1: 1 balloon ratio
WAVEFORM PATTERNS:
  Respiratory variation
  Radial and aortic lumen IABP traces
TECHNICAL COMMENTS:
  LAP recording @ 28 min
  Zero @ 35 min
  No final zero-cal-pop-test sequence
RESPIRATORY DATA:
RATE:   3/12 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh059


PATIENT DATA:
AGE/SEX:
  25 year old male
DIAGNOSIS/SURGERY:
  Spinal fusion
PERTINENT HISTORY:
  Quadriplegic
  Scoliosis
GENERAL COMMENTS:
  Suctioning @ SO min - 60 min
  Phrenic nerve stimulation for nighttime breathing
  PPV blower for day ventilation
  Movement artifact due to patient re-positioning
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 84 bpm
HEMODYNAMIC DATA:
  ART: 100/50
  RAP: 10
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  CVP dressing changed @ 62 min
RESPIRATORY DATA:
RATE:   5/5 bpm
MODE OF VENTILATION:
  Diaphragmatic pacer
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh060


PATIENT DATA:
AGE/SEX:
  25 year old male
DIAGNOSIS/SURGERY:
  Spinal fusion
PERTINENT HISTORY:
  Quadriplegic
  Scoliosis
GENERAL COMMENTS:
  Application of iron lung @ 5 min
  Out of lung @ 1 min
  Phrenic nerve stimulation for nighttime breathing
  PPV blower for day ventilation
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 84 bpm
HEMODYNAMIC DATA:
  ART: 100/50
  RAP: 10
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   5/5 bpm
MODE OF VENTILATION:
  Iron Lung
CO2 RECORDING
[top]  

Record: mgh061


PATIENT DATA:
AGE/SEX:
  58 year old male
DIAGNOSIS/SURGERY:
  Coronary artery bypass grafting
PERTINENT HISTORY:
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ mcg/min
COMMENT:
  Chest physical therapy @ 94 bpm
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 94 bpm
ECG INTERPRETATION:
  Left atrial enlargement
  Old anteroseptal infarct
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 120/50   	MEAN: 85
  PAP: 30/9
  RAP: 14   	LAP: 14   	CO: 5.4
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Kontron console
  1: 1 balloon ratio
WAVEFORM PATTERNS:
  Radial artery and aortic lumen IABP tracings
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh062


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Aortic valve replacement
PERTINENT HISTORY:
  COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Ventricular demand pacing @ 85 born for atrial fibrillation with complete heart block
PACEMAKER DATA:
  Permanent pacer
  Medtronic 4011-58 leads
  Medtronic 5985 generator
  MAS
RHYTHM DISTURBANCES:
  Rare ventricular ectopy
ECG INTERPRETATION:
  Anterior infarct
  Left ventricular hypertrophy
HEMODYNAMIC DATA:
  ART: 126/70
RESPIRATORY DATA:
RATE:   36 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh063


PATIENT DATA:
AGE/SEX:
  73 year old female
DIAGNOSIS/SURGERY:
  Mitral valve replacement
  Coronary disease
PERTINENT HISTORY:
  COPD
PHARMACOLOGIC SUPPORT:
  Dopamine @ 150 mcg/min
  Dobutamine @ 466 mcg/min
  TNG @ 60mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrioventricular pacing @ 89 bpm
PACEMAKER DATA:
  Temporary artioventricular fixed rate pacing (000)
  Epicardial wires
  Medtronic 5837 (MA 14.9 for atria and ventricles)
RHYTHM DISTURBANCES:
  Loss of atrial capture
ECG INTERPRETATION:
  Inferior infarct
  Non-specific sn wave changes
  Left atrial enlargement
TECHNICAL COMMENTS:
  Muscle tremor
  Electrical interference
HEMODYNAMIC DATA:
  ART: 134/31   	MEAN: 84
  PAP: 35/13
  RAP: 16   	LAP: 16   CI: l.9
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Kontron console
  1 : 1 balloon ratio
WAVEFORM PATTERNS:
  IABP waveform
  Respiratory variation
TECHNICAL COMMENTS:
  Poor frequency response on CVP (13 Hz)
  CVP on @ 16 min and off @ 34 min; Zero @ 18 min
  PA and LA on same transducer; LAP on @ 22 min - 24 min
RESPIRATORY DATA:
RATE:   7/7 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh064


PATIENT DATA:
AGE/SEX:
  50 year old female
DIAGNOSIS/SURGERY:
  Coronary bypass graft
PERTINENT HISTORY:
  Mitral valve prolapse
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 117 bpm
ECG INTERPRETATION:
  Posterior subendocardial infarct
  Minor nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 124/56   	MEAN: 84
  PAP: 29/11
  RAP: 2   CI:4.2
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Kontron console
  1 :4 balloon ratio
WAVEFORM PATTERNS:
  Radial artery and aortic lumen IABP traces
TECHNICAL COMMENTS:
  PA frequency response low (16.7 Hz)
RESPIRATORY DATA:
RATE:   12 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh065


PATIENT DATA:
AGE/SEX:
  63 year old female
DIAGNOSIS/SURGERY:
  Redo mitral valve replacement
PERTINENT HISTORY:
  Coronary disease (post CAB6)
  Hypertension
  Smoker
PHARMACOLOGIC SUPPORT:
  Dopamine @ 250 mcg/mln
  TNG @ 60 mcg/min
GENERAL COMMENTS:
  Stop/FFW @ 53 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with left bundle branch block @ 98 bpm
RHYTHM DISTURBANCES:
  Sinus pause @ 47 min
  Burst of atrial pacing @ 59 min
ECG INTERPRETATION:
  Non-specific ST segment and T wave changes
TECHNICAL COMMENTS:
  No pace channel activation
HEMODYNAMIC DATA:
  ART: 114/68
  PAP: 40/15
  RAP: 9   	LAP: 15   	CO: 5.3
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
TECHNICAL COMMENTS:
  PA/CVP/LAP on same transducer
  LA @ 15 min - 19 min
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh066


PATIENT DATA:
AGE/SEX:
  49 year old female
DIAGNOSIS/SURGERY:
  Unstable post-infarction angina
PERTINENT HISTORY:
  Mitral regurgitation
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Ventricular pacing @ 70 born. re-programmed to 60 (@ 0 min - 20 min)
RHYTHM DISTURBANCES:
  First degree heart block
  Transient acceleration of underlying sinus rhythm with RBBB near end of recording
PACEMAKER DATA:
  Implanted WI pacemaker
  Medtronic 8423
  Pulse width .496 msec; sensitivity 2.5 mv
  Refractory period 324 msec
ECG INTERPRETATION:
  Antero-septal infarct
  Inferior infarct
  Left anterior hemiblock
  Left axis deviation
GENERAL COMMENTS:
  Carotid sinus massage x2 @ 20 min and 22 min
  Re-programming pacemaker from rate of 70 to 60 @ 0 min - 20 min
HEMODYNAMIC DATA:
  ART: 92/60
  PAP: 44/22   	PCW: 20 (@ .6 min,S min, 7 min)
WAVEFORM PATTERNS:
  V wave in PCW
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh067


PATIENT DATA:
AGE/SEX:
  64 year old female
DIAGNOSIS/SURGERY:
  Redo coronary artery bypass graft
GENERAL COMMENTS:
  Stop/FFW @ 12 min and 51 min - 52 min
  Coughing @ 61 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial pacing with incomplete right bundle branch block @ 87 bpm
RHYTHM DISTURBANCES:
  Competition
PACEMAKER DATA:
  Temporary atrial fixed rate pacing (AOO)
  Epicardial wires
  Medtronic 5330 pulse generator
  MA 15
ECG INTERPRETATION:
  Left atrial hypertrophy
  Old inferior infarct
  ST segment and T wave abnormalities consistent with lateral ischemia digitalis effect
TECHNICAL COMMENTS:
  Wandering baseline
  Electrodes changed @ 44 min
HEMODYNAMIC DATA:
  ART: 170/44   	MEAN: 84
  PAP: 52/23   	PCW: 19 (not recorded)
  RAP: 15   	LAP: 17   CI: 3.2
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Aries console
  1 :4 balloon ratio
WAVEFORM PATTERNS:
  Radial and aortic lumen traces
  Balloon console intermittently sensing atrial pacing spike as R wave from 0 min to 12 min interfering with timing.
  Good timing restored from 12 min
  Timing adjusted from 58 min - 60 min
  Timing poor from 60 min to 61 min
TECHNICAL COMMENTS:
  PA/CVP/LAP on same transducer.
  No final pop-tests
  ECG and BP curve output from console recorded on CH8 and CH12, respectively, from 36 min - 51 min
  BP curve is substituted for aortic lumen tracing on AUX channel 10 due to saturation of CH8 @ 55 min
  (Signal is still clipped on CH8)
RESPIRATORY DATA:
RATE:   5/27 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh068


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Cholecystectomy
PERTINENT HISTORY:
  Chronic CHF
  COPD
GENERAL COMMENTS:
  Chest physical therapy @ 11 min and 21 min - 25 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial flutter @ 61 bpm with ventricular demand pacing for sick sinus syndrome
RHYTHM DISTURBANCES:
  Mobitz II
PACEMAKER INFO:
  Specifics unavailable
  Permanent ventricular demand pacemaker (WI)
ECG INTERPRETATION:
  Poor R wave progression consistent with old anteroseptal infarct
  Chronic obstructive pulmonary disease
  Nonspecific ST segment and T wave changes
TECHNICAL COMMENTS:
  Monitor pace channel off and on x2 @ 14 min - 15 min
  Muscle tremor
HEMODYNAMIC DATA:
  ART: 140/50   	MEAN: 71
TECHNICAL COMMENTS:
  Best tracings @ 33 min - 43 min
  Arterial line tracing of 2nd patient recorded @ 51 min - 54 min
  Arterial line damped @ 62 min
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh069


PATIENT DATA:
AGE/SEX:
  81 year old male
DIAGNOSIS/SURGERY:
  Resection of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  Aortic stenosis
  Cardiomyopathy
PHARMACOLOGIC SUPPORT:
  Dopamine @ 250 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 100 bpm with ventricular demand pacemaker
RHYTHM DISTURBANCES:
  Ventricular pacing overdrive for ventricular ectopy
PACEMAKER INFO:
  Specifics unavailable
HEMODYNAMIC DATA:
  ART: 90/40   	MEAN: 48
  PAP: 36/20   	PCW: 14 (@ 13 min, 26 min, 30 min, 43 min)
  RAP: 8   	CO:   5.9
TECHNICAL COMMENTS:
  Zero @ 14 min
  CVP on @ 17 min - 33 min
RESPIRATORY DATA:
RATE:   10/10 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh070


PATIENT DATA:
AGE/SEX:
  81 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  Aortic stenosis
  Cardiomyopathy
PHARMACOLOGIC SUPPORT:
  Digoxin @ 32 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  A trial fibrillation @ 120 bpm
RHYTHM DISTURBANCES:
  Ventricular pacing overdrive for ventricular ectopy
PACEMAKER INFO:
  Specifics unavailable
TECHNICAL COMMENTS:
  RA electrode off @ 54 min
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 68
  PAP: 54/24   	PCW: 22 (@ 10 min, 13 min, 27 min)
  RAP: 12
WAVEFORM PATTERNS:
  Atrial contours changing? V waves
  Pulmonary hypertension
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh071


PATIENT DATA:
AGE/SEX:
  79 year old female
DIAGNOSIS/SURGERY:
  Fixation hip fracture
  GI bleed
PERTINENT HISTORY:
  Post mitral valve replacement
  Aortic regurgitation
PHARMACOLOGIC SUPPORT:
  Dopamine @ 80 mcg/min started @ 53 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Ventricular pacing @ 70 bpm for sick sinus syndrome with AV block
PACEMAKER INFO:
  Permanent ventricular demand pacemaker (WI)
  Medtronic Spectrax 5985
TECHNICAL COMMENTS:
  Agitated
HEMODYNAMIC DATA:
  ART: 118/45
  PAP: 90/28   	PCW: 20 (@ 3 min, 8 min, 22 min)
  RAP: 20   	CO: 3.2
WAVEFORM INTERPRETATION:
  Respiratory variation
TECHNICAL COMMENTS:
  PA/CVP on same transducer
  CVP on @ 14 min and 37 min - 41 min
  Zero/cal/pop-test sequence @ 27 min
RESPIRATORY DATA:
RATE:   22 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh072


PATIENT DATA:
AGE/SEX:
  78 year old female
DIAGNOSIS/SURGERY:
  Coronary artery bypass graft
PHARMACOLOGIC SUPPORT:
  Dopamine @ 200 mcg/min
  TNG @ 64 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial pacing @ 75 bpm for cardiac output support
RHYTHM DISTURBANCES:
  Left bundle branch block
  Atrial ectopy
  Multifocal ventricular ectopy
  First degree heart block
  Loss of atrial capture @ 36 min
  Pacing discontinued @ 37 min
PACEMAKER INFO:
  Temporary atrial fixed rate pacing (AOO)
  Epicardial wires
  Medtronic 5330 pulse generator (MA 20)
ECG INTERPRETATION:
  Inferior infarct
  Left atrial enlargement
HEMODYNAMIC DATA:
  ART: 176/28   	MEAN: 85
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Aries console
  1: 1 balloon ratio
  PAP: 27/10   	PCW: 11 (@ 20 min, 65 min)
  RAP: 11   CI: 1.6
WAVEFORM PATTERNS:
  Radial and aortic lumen IABP traces
  Timing adjusted @ 64 min
TECHNICAL COMMENTS:
  PAP/CVP/LAP on same transducer
  Left atrial tracing @ 69 min - 70 min
  CVP tracing @ 71 min
RESPIRATORY DATA:
RATE:   7/7 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh073


PATIENT DATA:
AGE/SEX:
.   61 year old male
DIAGNOSIS/SURGERY:
  Infarctectomy
  Repair of ventricular septal defect
PERTINENT HISTORY:
  Peripheral vascular disease
PHARMACOLOGIC SUPPORT:
  Dopamine @ 416 mcg/min
  Epinephrine @ 3 mcg/min
  Levophed @ 4 mcg/min
  Inocor @ 816 mcg/min
GENERAL COMMENTS:
  Chest physical therapy @ 61 min - 75 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 136 bpm
ECG INTERPRETATION:
  Possible inferior myocardial infarction
  ST segment elevation suggesting injury or pericarditis
HEMODYNAMIC DATA:
  ART: 96/46   	MEAN: 76
  PAP: 41/28
  RAP: 24   	LAP: 28
INTRA-AORTIC BALLOON DATA:
  40 cc balloon
  Aries console 1: 1 balloon ratio
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
  Radial and aortic lumen IABP traces
TECHNICAL COMMENTS:
  PA/CVP/LA on same transducer
  No final zero/cal/pop-test sequence
  CVP /LA traces recorded @ 22 min - 23 min
  Arterial blood gas/flush @ 30 min
RESPIRATORY DATA:
RATE:   10/10 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh074


PATIENT DATA:
AGE/SEX:
  75 year old male
DIAGNOSIS:
  Coronary artery bypass graft
PROCEDURE:
  Insertion of temporary pacemaker
ECG DATA:
LEADS:   II
RHYTHM:
  Atrial pacing @ 95 bpm with right bundle branch block
PACER INFO:
  Epicardial wires
  Medtronic hi-output external pacemaker
RHYTHM CHANGES:
  Rare ventricular ectopy
  Brief episode of aystole off pacer
ECG INTERPRETATION:
  Possible old inferior infarct
HEMODYNAMIC DATA:
  ART: 200/95
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
	0-20 sec   ZERO
	1 min   CAL OF 100
	1 min   TAPE OFF/ON
	15 min   PACER OFF
	CRE-ADJUST NIPRIDE TO 6)
	34 min   STOP/FFW
	CHANGE LEVEL FOR ECG CHANNEL
	39 min   POWER OFF
	ABG drawn
	INSERTION OF V PACE WIRE   PVC/Couplet
	47 min   Atrial pacer rate to 60   atrial pacing
	50 min   A trial pacer rate to 85
	CHANGED to 60
	51 min   V pace capture @ 10 MA
	PACER turned off
	Atrial pace on
	53 min   Repeat pace sequence
	56 min   Decrease A pace rate 95 to 60
	V pacing; increase V pace MA   ventricular pacing
	65 min   STOP/FFW
	68 min   STOP/FFW
		Atrial capture near end
[top]  

Record: mgh075


PATIENT DATA:
AGE/SEX:
  52 year old male
DIAGNOSIS:
  Cardiomyopathy
ECG DATA:
LEADS:
  I, II, III, VI
RHYTHM:
  Dual chamber pacing (DDD)
COMMENTS:
  ECG recording only
[top]  

Record: mgh076


PATIENT DATA:
AGE/SEX:
  52 year old male
DIAGNOSIS/SURGERY:
  Pancreatic abscess
  Exploratory laparotomy
  Adult respiratory distress syndrome
  Sepsis
GENERAL COMMENTS:
  Chest physical therapy @ 63 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 117 bpm
RHYTHM DISTURBANCES:
  Rare unifocal ventricular ectopy
ECG INTERPRETATION:
  Probable old infero-posterior myocardial infarction
  Short PR intervol consistent with tachycardia, or pre-excitation
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Persistent interference in ECG signals; extreme patient agitation
  Clearest tracing @ 23 min - 24 min, 38 min - 43 min
HEMODYNAMIC DATA:
  ART: 150/70   	MEAN: 96
  RAP: 12
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  Repeat zero @ 9 min - 10 min
  Damping of traces
RESPIRATORY DATA:
RATE:   6/28 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation.
CO2 RECORDING:
  Datex sidestream sensor
[top]  

Record: mgh077


PATIENT DATA:
AGE/SEX:
  19 year old male
DIAGNOSIS/SURGERY:
  Head trauma
  Craniotomy
  Laparotomy
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 106 bpm
ECG INTERPRETATION:
  sn wave change
HEMODYNAMIC DATA:
  ART: 140/90
  ICP:
WAVEFORM INTERPRETATION:
  Arterial tracing characteristic of neuro trauma
  Respiratory variation
TECHNICAL COMMENTS:
  Intra-cranial pressure on CVP CH 11
RESPIRATORY DATA:
RATE:   14/14 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh078


PATIENT DATA:
AGE/SEX:
  75 year old female
DIAGNOSIS/SURGERY:
  Exploratory laparotomy
  Cholecystectomy
  Common duct exploration
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 80 bpm
RHYTHM DISTURBANCES:
  Unifocal ventricular ectopy
ECG INTERPRETATION:
  Low voltage consistent with chronic obstructive pulmonary disease or pericardial effusion
  Nonspecific ST segment and T wave abnormalities
  ?Old anterolateral infarct
HEMODYNAMIC DATA:
  ART: 90/60
  PAP: 27/17 	PCW: 11 (@ 15 min,42 min, 58 min, 63 min)
  RAP: 10   CI:2
TECHNICAL COMMENTS:
  PA and CVP on same transducer
  PA off @ 35 min
  Movement @ 43 min - 51 min
  CVP recording @ 65 min and 73 min - 76 min
RESPIRATORY DATA:
RATE:   10/12 changed to 10/16 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh079


PATIENT DATA:
AGE/SEX:
  20 year old male
DIAGNOSIS/SURGERY:
  Head trauma/bilateral ventriculostomy
  Exploratory laparotomy
PHARMACOLOGIC SUPPORT:
  Pitressin .05 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 72 bpm
HEMODYNAMIC DATA:
  ART: 110/70   	MEAN: 92
  CVP: 6   CP:4
  RAP: 6
TECHNICAL COMMENTS:
  Zero to ICP @ 10 min
  L-sided ICP @ 12 min
  R-sided ICP @ 15 min
  Change head dressing @ 24 min
  CVP @ 36 min
  ICP off @ 37 min
  CVP on @ 43 min
  ICP on aux CH 10
RESPIRATORY DATA:
RATE:   10/10 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh080


PATIENT DATA:
AGE/SEX:
  70 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
  Colectomy /colostomy
PERTINENT HISTORY:
  Low systemic vascular resistance due to dysfunction from spinal cord lesion
PHARMACOLOGIC SUPPORT:
  Neosynephrine @ 16 mcg/min
GENERAL COMMENTS:
  Kinetic bed in use
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with right bundle branch block @ 76 bpm
ECG INTERPRETATION:
  Left axis deviation
  Possible lateral infarct, age undetermined
  Non-specific sn wave changes
  Left atrial hypertrophy
HEMODYNAMIC DATA:
  ART: 120/70
  RAP: 20
RESPIRATORY DATA:
RATE:   10/10 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh081


PATIENT DATA:
AGE/SEX:
  70 year old male
DIAGNOSIS/SURGERY:
  Esophageal carcinoma
  Small bowel-esophageal bypass
PERTINENT HISTORY:
  COPD
PHARMACOLOGIC SUPPORT:
  Levophed @ 15 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 106 bpm
ECG INTERPRETATION:
  Non-specific sn wave changes
  Prolonged QT interval or TU fusion, consider myocardial disease, electrolyte imbalance, or drug effects
HEMODYNAMIC DATA:
  ART: 112/80
  PAP: 28/18   	PCW: 14 (@ 9 min, 25 min, 30 min, 33 min)
  RAP: 12   	CO: 6.25
RESPIRATORY DATA:
RATE:   11/26 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh082


PATIENT DATA:
AGE/SEX:
  43 year old female
DIAGNOSIS/SURGERY:
  Crohns disease
  Bacterial endocarditis
  Cerebrovascular accident
  Pneumonia? ARDS
PERTINENT HISTORY:
  Mitral and tricusupid regurgitation secondary to staph endocarditis
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 118 bpm
ECG INTERPRETATION:
  Low voltage
  Left atrial enlargement
  Nonspecific st segment and T wave abnormalities
  Poor R wave progression consistent with clockwise rotation
HEMODYNAMIC DATA:
  ART: 110/70   	MEAN: 82
  RAP: 12
WAVEFORM PATTERNS:
  "Catheter Whip" in PA trace
TECHNICAL COMMENTS:
  CVP zero @ 22 min
  Changing CVP dressing @ 35 min - 41 min
RESPIRATORY DATA:
RATE:   4/38 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh083


PATIENT DATA:
AGE/SEX:
  17 year old female
DIAGNOSIS/SURGERY:
  Adult respiratory distress syndrome
PHARMACOLOGIC SUPPORT:
  Dopamine 80 mcg/min, then 240 mcg/min
  Epinephrine .6 mcg/min, then .5 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 98 bpm
ECG INTERPRETATION:
  Low voltage
  U waves consistent with lateral myocardial infarction of indeterminate  age
  Diffuse nonspecific segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 112/80
  (femoral)
  PAP: 44/26   	PCW: 16 (@ 13 min, 23 min, 51 min)
  RAP: 14   	CO: 3.48
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  PA/CVP on single transducer
  CVP recordings @ 13 min - 14 min and 20 min - 21 min
  PA re-positioned @ 25 min
RESPIRATORY DATA:
RATE:   6/6 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh084


PATIENT DATA:
AGE/SEX:
  66 year Old male
DIAGNOSIS/SURGERY:
  Upper GI bleed
  Esophageal varices
  Coagulopathy
  Porto-caval shunt
PERTINENT HISTORY:
  COPD
  Hypertension
  MI
PHARMACOLOGIC SUPPORT:
  Dopamine @ 200 mcg/min
  Levophed @ 11 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 96 bpm
ECG INTERPRETATION:
  Anterior infarct
  Infero-lateral ischemia
TECHNICAL COMMENTS:
  Wandering baseline
  ECG off @ 33 min
HEMODYNAMIC DATA:
  ART: 110/50   	MEAN: 67
  (femoral)
  PAP: 40/24   	PCW: 18
  RAP: 28   	CO:S
TECHNICAL COMMENTS:
  CVP non-functional
RESPIRATORY DATA:
RATE:   15/15 bpm
MODE OF VENTILATION:
  Controlled with rare spontaneous attempts
CO2 RECORDING
[top]  

Record: mgh085


PATIENT DATA:
AGE/SEX:
  43 year old female
DIAGNOSIS/SURGERY:
  LUL lobectomy for sarcoid bronchitis
  LLL apical segmentectomy
PHARMACOLOGIC SUPPORT:
  Aminophylline @ 6 mgm/hr
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 120 bpm
RHYTHM DISTURBANCES:
  Rare atrial ectopy
  Rare ventricular ectopy
ECG INTERPRETATION:
  Peaked T waves suggest acidosis or high potassium effect
HEMODYNAMIC DATA:
  ART: 200/90
  RAP: 25   	CO: 7.0
WAVEFORM PATTERNS:
  Hypertension
TECHNICAL COMMENTS:
  CVP recorded @ 46 min - 60 min
  Tracing damped
RESPIRATORY DATA:
RATE:   33/33 bpm
MODE OF VENTILATION:
  Controlled (spontaneous attempts initially, then sedated)
CO2 RECORDING
[top]  

Record: mgh086


PATIENT DATA:
AGE/SEX:
  66 year old female
DIAGNOSIS/SURGERY:
  Sigmoid resection and colostomy
  Sepsis
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  Dopamine @ 600 mcg/min
  Neosynephrine @ 280 mcg/mln, then discontinued
  Levophed @ 15 mcg/min, then 24 mcg/min, then 22 mcg/min
GENERAL COMMENTS:
  Stop/FFW @ 11 min - 12 min
  Recording resumed @ 61 min - 81 min after final zero/col/pop-test sequence @ 55 min - 61 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 129 bpm
ECG INTERPRETATION:
  Borderline low voltage
  Diffuse nonspecific ST segment and T wave abnormalities
  Poor R wave progression consistent with anterior myocardial infarction, poor lead placement, COPD
HEMODYNAMIC DATA:
  ART: 80/50   	MEAN: 65
  (brachial)
  PAP: 32/20   CW: 16(@ 16 min, 18 min,27 min, 43 min)
  RAP: 18   	CO: 5.4
WAVEFORM PATTERNS:
  Episode of hypotension
  Pulsus paradox
TECHNICAL COMMENTS:
  Arterial pop-test repeated @ 12 min - 13 min
RESPIRATORY DATA:
RATE:   18/18 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh087


PATIENT DATA:
AGE/SEX:
  43 year old male
DIAGNOSIS/SURGERY:
  Aorto-bifemoral bypass graft
PERTINENT HISTORY:
  Hypertension
PHARMACOLOGIC SUPPORT:
  TNG @ 160 mcg/min
GENERAL COMMENTS:
  Hypothermic @ 3 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 65 bpm
RHYTHM DISTURBANCES:
  Rare ventricular ectopy
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Muscle tremor
HEMODYNAMIC DATA:
  ART: 140/80   	MEAN: 98
  PAP: 16/8   	PCW: 8 (@ 25 min, 29 min)
  RAP: 5
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  Zero CVP @ 9 min
RESPIRATORY DATA:
RATE:   5/12 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh088


PATIENT DATA:
AGE/SEX:
  77 year old female
DIAGNOSIS/SURGERY:
  Hepato-renal bypass graft
PERTINENT HISTORY:
  Coronary disease
  Hypertension
  COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 75 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  Ventricular ectopy
HEMODYNAMIC DATA:
  ART: 160/60   	MEAN: 99
  PAP: 32/16   	PCW: 14 (@ 13 min, 15 min, 68 min)
  RAP: 10   	CO:   3.5
RESPIRATORY DATA:
RATE:   5/30 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh089


PATIENT DATA:
AGE/SEX:
  32 year old female
DIAGNOSIS/SURGERY:
  Malignant hyperthermia
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 124 bpm
TECHNICAL COMMENTS:
  Muscle tremor and shivering
HEMODYNAMIC DATA:
  ART: 100/50   	MEAN: 64
  (femoral)
  RAP: 8
WAVEFORM PATTERNS:
  Pulsus paradox
RESPIRATORY DATA:
RATE:   7/20 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh090


PATIENT DATA:
AGE/SEX:
  24 year old female
DIAGNOSIS/SURGERY:
  Multiple trauma
  Depressed occipital skull fracture
  Flail chest
  Liver resection for laceration
  Cardiac contusion
  ? ARDS
PHARMACOLOGIC SUPPORT:
  Dopamine @ 100 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 69 bpm
ECG INTERPRETATION:
  Low voltage
  Counterclockwise rotation
  QT interval prolonged for rate, consistent with drug effect metabolic abnormality, myocardial process
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 120/77
  RAP: 13   	ICP: 13
RESPIRATORY DATA:
RATE:   7/7 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh091


PATIENT DATA:
AGE/SEX:
  54 year old male
DIAGNOSIS/SURGERY:
  Multiple trauma
PERTINENT HISTORY:
  COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycadia @ 101 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
TECHNICAL COMMENTS:
  Chest lead = V5
HEMODYNAMIC DATA:
  ART: 140/70   	MEAN: 94
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
CO2 RECORDING
[top]  

Record: mgh092


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aneurysm
PERTINENT HISTORY:
  COPD
GENERAL COMMENTS:
  Hypothermic @ 93F
  Ambuing and suctioning @ 61 min - 65 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 64 bpm
RHYTHM DISTURBANCES:
  Rare atrial ectopy
  Rare ventricular ectopy
ECG INTERPRETATION:
  Non-specific sn wave changes
TECHNICAL COMMENTS:
  Shivering and movement artifact
  "V lead" message on monitor
  Chest lead = V2
HEMODYNAMIC DATA:
  ART: 100/50   	MEAN: 60
  PAP: 32/16   	PCW: 16 (@ 16 min, 29 min, 40 min)
  RAP: 10 (not recorded)
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   15 bpm
MODE OF VENTILATION:
  Spontaneous
CO2 RECORDING
[top]  

Record: mgh093


PATIENT DATA:
AGE/SEX:
  71 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of ruptured abdominal aneurysm
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ 100 mcg/min
  Dopamine @ 200 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 112 bpm
ECG INTERPRETATION:
  Possible old inferior infarct
  T wave changes consistent with anterior ischemia
HEMODYNAMIC DATA:
  ART: 110/60   	MEAN: 77
  PAP: 36/20   	PCW: 12 (@ 12 min, 46 min, 53 min)
  RAP: 14
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   8/10 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh094


PATIENT DATA:
AGE/SEX:
  61 year old male
DIAGNOSIS/SURGERY:
  Pancreatectomy
  Splenectomy
  Gastrectomy
PHARMACOLOGIC SUPPORT:
  Levophed @ 8 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 84 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
ECG INTERPRETATION:
  Low voltage
  Poor R wave progression consistent with old anteroseptal infarct or chronic obstructive pulmonary disease
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 92/44
  PAP: 30/18   	PCW: 16 (@ 5 min, 42 min, 20 min, 57 min)
  RAP: 13   	CO: 9.5
WAVEFORM PATTERNS:
  Unusual PA configuration
TECHNICAL COMMENTS:
  PA/CVP on same transducer
  CVP on @ 39 min - 41 min
RESPIRATORY DATA:
RATE:   10/10 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh095


PATIENT DATA:
AGE/SEX:
  16 year old male
DIAGNOSIS/SURGERY:
  Cerebral anoxia (drowning)
PERTINENT HISTORY:
  ARDS
PHARMACOLOGIC SUPPORT:
  Dopamine @ 266 mcg/min
GENERAL COMMENTS:
  Hypothermic @ 96F
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 114 bpm
ECG INTERPRETATION:
  Mild nonspecific ST segment and T wave changes
HEMODYNAMIC DATA:
  ART: 110/60 (axillary)
  PAP: 28/14   	PCW: 10 (@ 7 min, 33 min, 50 min)
  RAP: 7   	ICP: 14   	CO: 3.5
WAVEFORM PATTERNS:
  Biphasic, notched, arterial trace
  Arterial configuration positional
  Pulsus paradox
  Unusual PA configuration
TECHNICAL COMMENTS:
  ICP on CVP CH11
  CVP not recorded
RESPIRATORY DATA:
RATE:   12/12 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING:
  Discontinued @ 45 min
COMMENTS:
  Hiccupping       
[top]  

Record: mgh096


PATIENT DATA:
AGE/SEX:
  80 year old female
DIAGNOSIS/SURGERY:
  Aortobifemoral graft
PERTINENT HISTORY:
  Coronary disease
  ?Mitral regurgitation
  COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 88 bpm
ECG INTERPRETATION:
  Anterolateral ST and T wave abnormalities consistent with subendocardial ischemia/injury
HEMODYNAMIC DATA:
  ART: 160/80   	MEAN: 98
  PAP: 36/20   	PCW: 13 (@ 22 min, 63 min, 44 min)
  RAP: 12   	CO:   3.85
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  Repeat de-bubbling and pop-test @ 9 min - 16 min
RESPIRATORY DATA:
RATE:   4/12 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING:
  On @ 35 min
[top]  

Record: mgh097


PATIENT DATA:
AGE/SEX:
  63 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  Smoker
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with intra-ventricular conduction defect @ 82 bpm
ECG INTERPRETATION:
  Left atrial enlargement
  Old anteroseptal infarct
  Probable old anterolateral subendocardial myocardial infarction
HEMODYNAMIC DATA:
  ART: 140/60   	MEAN: 87
  PAP: 20/8   	PCW: 8 (@ 35 min, 63 min, 68 min)
  RAP: 8
RESPIRATORY DATA:
RATE:   7/19 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh098


PATIENT DATA:
AGE/SEX:
  71 year old male
DIAGNOSIS/SURGERY:
  Hemipelvectomy
PERTINENT HISTORY:
  Hypertension
  COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 81 born
RHYTHM DISTURBANCES:
  Wenckebach
ECG INTERPRETATION:
  Non-specific sn wave changes
  Markedly decreased voltage raising the possibility of pericardial fluid
TECHNICAL COMMENTS:
  Electrical interference
HEMODYNAMIC DATA:
  ART: 154/40
  RAP: 8
RESPIRATORY DATA:
RATE:   5/22 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh099


PATIENT DATA:
AGE/SEX:
  49 year old male
DIAGNOSIS/SURGERY:
  Aorto-bifemoral bypass graft
PERTINENT HISTORY:
  Coronary
PHARMACOLOGIC SUPPORT:
  TNG @ 40 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 89 bpm
ECG INTERPRETATION:
  Antero-septal infarct
  Old inferior infarct
  Nonspecific ST segment and T wave changes
HEMODYNAMIC DATA:
  ART: 130/60   	MEAN: 88
  PAP: 32/16   	PCW: 12 (@ 19 min, 36 min, 68 min)
  RAP: 9     	CO: 5.4
RESPIRATORY DATA:
RATE:   12 bpm
MODE OF VENTILATION:
  Spontaneous
CO2 RECORDING:
  On @ 18 min and discontinued @ 25 min with extubation
[top]  

Record: mgh100


PATIENT DATA:
AGE/SEX:
  20 year Old male
DIAGNOSIS/SURGERY:
  Multiple trauma
  Craniotomy
PHARMACOLOGIC SUPPORT:
  Neosynephrine @ 25 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 102 bpm
HEMODYNAMIC DATA:
  ART: 90/50   	MEAN: 66
  ICP: 11
TECHNICAL COMMENTS:
  ICP on CVP @ CH 11
RESPIRATORY DATA:
RATE:   9/9 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh101


PATIENT DATA:
AGE/SEX:
  72 year old male
DIAGNOSIS/SURGERY:
  Cervical spondylolysis
  Laminectomy
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 78 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  Unifocal ventricular ectopy
ECG INTERPRETATION:
  Left anterior hemiblock
  Left axis deviation
  Poor R wave progression, possibly due to left anterior hemiblock, clockwise rotation
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 130/50   	MEAN: 75
  PAP: 32/16   	PCW: 18 (@ 7 min, 25 min, 33 min)
  RAP: 7   	CO: 5
WAVEFORM PATTERNS:
  Large "a waves" in CVP
  "Catheter whip" in pulmonary arterial trace
  Respiratory variation
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh102


PATIENT DATA:
AGE/SEX:
  59 year Old male
DIAGNOSIS/SURGERY:
  Cerebral aneurysm
  Middle cerebral artery clipping
GENERAL COMMENTS:
  Multiple interruptions during recording
  Stop/FFW @ 12 min - 13 min
  Intermittent movement artifact
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 70 bpm
RHYTHM DISTURBANCES:
  Unifocal ventricular ectopy
ECG INTERPRETATION
  Old infero-posterior infarct
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 93
  PAP: 24/12   	PCW: 8(@ 29 min)
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  Re-zero @ counter # 13 min
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh103


PATIENT DATA:
AGE/SEX:
  71 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PHARMACOLOGIC SUPPORT:
  TNG paste
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Chaotic atrial rhythm with left bundle branch block @ 80 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy with occasional aberrant or blocked conduction
  Multifocal ventricular ectopy
ECG INTERPRETATION:
  Left atrial enlargement
  Left axis deviation
  Old anterior wall infarct
  Non-specific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  6O-cycle artifact Lead I & III
  Electrodes replaced @ 28 min - 33 min
  Chest lead = V2
HEMODYNAMIC DATA:
  ART: 120/50   	MEAN: 90
  RAP: 12
WAVEFORM PATTERNS:
  Right atrial tracing changes with Cheynes-Stokes due to effect on venous return
TECHNICAL COMMENTS:
  CVP line used intermittently for medication infusion
  Tracing recorded @ 18 min, 43 min, 51 min
  Intermittent ART line damping
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
PATTERN:
  Cheynes-Stokes
[top]  

Record: mgh104


PATIENT DATA:
AGE/SEX:
  60 year old female
DIAGNOSIS/SURGERY:
  Exploratory laporotomy
  Closure gastric perforation
  Pyloroplasty and vagotomy
  Cholecystectomy
PHARMACOLOGIC SUPPORT:
  Aminophylline @ 25 mgm/hr
GENERAL COMMENTS:
  Stop/FFW @ 2 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 87 bpm
RHYTHM DISTURBANCES:
  Premature atrial contractions, occasional blocked conduction
  Multifocal ventricular ectopy
ECG INTERPRETATION:
  Old inferior infarct
  Low voltage
  Short PR interval
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 110/60   	MEAN: 80 (axillary)
  PAP: 52/26   	PCW: 18 (@ 14 min, 15 min, 22 min, 54 min)
  RAP: 12
WAVEFORM INTERPRETATION:
  Slight pulsus paradox
  Unusual wedge configurations
  Pulmonary hypertension
TECHNICAL COMMENTS:
  CVP on @ 21 min
  PAP/PCW trace change? de 'ping @ 62 min
  PAP/PCW traces normalize @ 42 min
  PA flush @ 52 min
  Best PCW recording @ 54 min
RESPIRATORY DATA:
RATE:   6/12 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh105


PATIENT DATA:
AGE/SEX:
  86 year old male
DIAGNOSIS/SURGERY:
  GI bleed
  Choledochojejunostomy
PERTINENT HISTORY:
  Terminal condition
PHARMACOLOGIC SUPPORT:
  Dopamine @ 200 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation right bundle branch block @ 111 bpm
RHYTHM DISTURBANCES:
  Occasional aberrant conduction
  Multifocal ventricular ectopy with couplets
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities
  Possible old antero-septal infarct
HEMODYNAMIC DATA:
  ART: 60/40   	MEAN: 44
  RAP: 12
WAVEFORM INTERPRETATION:
  Arterial hypotension
TECHNICAL COMMENTS:
  CVP off @ 10 min
RESPIRATORY DATA:
RATE:   10/20 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh106


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Perforated viscus
  Colectomy
PERTINENT HISTORY:
  COPD
  Hypertension
GENERAL COMMENTS:
  Muscle tremor when awake
  Asleep @ 31 min - 40 min and 41 min - 47 min (least artifact)
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia
RHYTHM DISTURBANCES:
  Atrial ectopy with bursts of atrial tachycardia
  Occasional junctional escape beats
  Multifocal ventricular ectopy with fusion and interpolated beats, rare couplet
ECG INTERPRETATION:
  Old inferior infarct
  Counterclockwise rotation versus old "true posterior" myocardial infarction
TECHNICAL COMMENTS:
  Movement artifact due to muscle tremor, agitation
HEMODYNAMIC DATA:
  ART: 150/60   	MEAN: 91
  RAP: 9
RESPIRATORY DATA:
RATE:   4/24 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh107


PATIENT DATA:
AGE/SEX:
  77 year old female
DIAGNOSIS/SURGERY:
  Head trauma
  Aspiration pneumonia
PERTINENT HISTORY:
  COPD
  Mitral regurgitation
PHARMACOLOGIC SUPPORT:
  Neosynephrine @ 40 mcg/min
  Dopamine @ 106 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 60 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  Multifocal ventricular ectopy
  Occasional bigeminy
ECG INTERPRETATION:
  Evolving infero-lateral infarct
  Left atrial enlargement
  Minor nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  No ECG cal
  Movement artifact from muscle tremor
HEMODYNAMIC DATA:
  ART: 125/50
  PAP: 50/22   	PCW: 16 (@ 34 MIN, 41 MIN, 45 MIN)
  RAP: 15   	CO: 3.0
WAVEFORM PATTERNS:
  Pulmonary hypertension
TECHNICAL COMMENTS:
  PA pop-test poor (14.3 Hz)
RESPIRATORY DATA:
RATE:   12 to 18/38 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh108


PATIENT DATA:
AGE/SEX:
  51 year old male
DIAGNOSIS/SURGERY:
  Total repair of Tetralogy of Fallot
PERTINENT HISTORY:
  1 day post-cardiac arrest
PHARMACOLOGIC SUPPORT:
  Levophed 13 mcg/min, then 18
  Inocor @ 186 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with right bundle branch block @ 106 bpm
RHYTHM DISTURBANCES:
  Ventricular ectopy
ECG INTERPRETATION:
  Left anterior hemiblock
  Right ventricular hypertrophy
TECHNICAL COMMENTS:
  Electrical interference during ECG cal
  Poor electrode contact due to skin excoriation
HEMODYNAMIC DATA:
  ART: 104/58
  RAP: 18
WAVEFORM PATTERNS:
  Pulsus paradox
  Hypotension
  Respiratory variation
TECHNICAL COMMENTS:
  CVP zero @ 11 min and 12 min - 25 min
RESPIRATORY DATA:
RATE:   28/28 bpm
MODE OF VENTILATION:
  Controlled
TECHNICAL COMMENTS:
  Respiratory impedance signal poor
[top]  

Record: mgh109


PATIENT DATA:
AGE/SEX:
  66 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
  Femoral popliteal gift
PERTINENT HISTORY:
  Coronary disease
  Hypertension
PHARMACOLOGIC SUPPORT:
  Inocor @ 350 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 93 bpm
RHYTHM DISTURBANCES:
  Multifocal ventricular ectopy, occasional bigeminy
ECG INTERPRETATION:
  Nonspecific ST segment abnormalities
  Question old inferior infarct
HEMODYNAMIC DATA:
  ART: 140/60   	MEAN: 80
  PAP: 32/16
  RAP: 12
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  CVP on @ 27 min
RESPIRATORY DATA:
RATE:   8/20 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING:
  Off @ 58 min
[top]  

Record: mgh110


PATIENT DATA:
AGE/SEX:
  42 year old female
DIAGNOSIS/SURGERY:
  Hepatitis
  Upper GI bleedinq
  Sepsis
PHARMACOLOGIC SUPPORT:
  Dopamine @ 1000 mcg/min
  Levophed @ 10 mgm/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 80 bpm
RHYTHM DISTURBANCES:
  Multifocal ventricular ectopy
ECG INTERPRETATION:
  Low voltage
TECHNICAL COMMENTS:
  Wandering baseline; poor electrode contact due to skin excoriation
HEMODYNAMIC DATA:
  ART: 66/31   	MEAN: 39
  RAP: 14
WAVEFORM PATTERNS:
  Hypotension
TECHNICAL COMMENTS:
  Zero CVP @ 36 min
RESPIRATORY DATA:
RATE:   16/16 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh111


PATIENT DATA:
AGE/SEX:
  49 year old male
DIAGNOSIS/SURGERY:
  Colectomy
  Sepsis
PERTINENT HISTORY:
  Coronary disease
  Peripheral vascular disease
  COPD
PHARMACOLOGIC SUPPORT:
  Dopamine @ 320 mcg/min
  TNG @ 275 mcg/min
GENERAL COMMENTS:
  PA insertion @ 0 min - 15 min, TNG off resulting in worsening hemodynamics and ECG pattern
  Suctioning @ 32 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with incomplete right bundle branch block @ 84 bpm
RHYTHM DISTURBANCES:
  Rare atrial ectopy
  Supraventricular tachycardia
  Multifocal ventricular ectopy, occasional fusion beats or bigeminy
ECG INTERPRETATION:
  Left atrial enlargement
  Diffuse ST segment and T wave changes consistent with subendocardial myocardial infarction/ischemia
HEMODYNAMIC DATA:
  ART: 104/56 (pedal)
  PAP: 40/25   	PCW: (@ 10 min, 11 min, 17 min, 18 min, 56 min, 66 min)
  RAP: 14   	CO: 7.6
WAVEFORM PATTERNS:
  Rise in PCW and fall in blood pressure with pulsus alternans due to discontinuation of TNG during PA insertion
TECHNICAL COMMENTS:
  Zero @ 15 min - 16 min
  Zero/cal/pop-test sequence @ 20 min - 26 min
  PA pop-test repeated due to poor quality
RESPIRATORY DATA:
RATE:   14/14 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
COMMENTS:
  Poor impedance signal
[top]  

Record: mgh112


PATIENT DATA:
AGE/SEX:
  62 year old male
DIAGNOSIS/SURGERY:
  Removal of renal stones
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  Dopamine @ 266 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with intraventricular conduction defect @ 79 bpm
RHYTHM DISTURBANCES:
  Ventricular ectopy
ECG INTERPRETATION:
  ST segment and T wave abnormalities consistent with anterolateral subendocardial ischemia/infarction
HEMODYNAMIC DATA:
  ART: 155/75   	MEAN: 103
  PAP: 25/15   	PCW:   12 (@ 14 min, 62 min, 65 min)
  RAP: 10
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
RESPIRATORY DATA:
RATE:   5/16 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh113


PATIENT DATA:
AGE/SEX:
  70 year old male
DIAGNOSIS/SURGERY:
  Aorto-iliac bypass graft
PERTINENT HISTORY:
  Coronary disease
  Smoker
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with intra-ventricular conduction defect @ 89 bpm
RHYTHM DISTURBANCES:
  Occasional multifocal ventricular ectopy
ECG INTERPRETATION:
  Old inferior infarct
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 100/60   	MEAN: 80
  PAP: 28/12   	PCW: 6 (@ 13 min, 24 min, 48 min, 60 min)
  RAP: 5   	CO:   3.6
TECHNICAL COMMENTS:
  Poor frequency response CVP
RESPIRATORY DATA:
RATE:   6/6 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh114


PATIENT DATA:
AGE/SEX:
  72 year old male
DIAGNOSIS/SURGERY:
  Colectomy
PERTINENT HISTORY:
  Coronary disease
  Smoker
GENERAL COMMENTS:
  Monitor "discharged" @ 30 min - 31 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with left bundle branch block @ 94 bpm
RHYTHM DISTURBANCES:
  Multifocal ventricular ectopy, occasional fusion beats
ECG INTERPRETATION:
  Antero-lateral infarct
  Non-specific sn wave changes
HEMODYNAMIC DATA:
  ART: 120/50   	MEAN: 68
  PAP: 68/24   	PCW: 16 (@ 8 min, 26 min, 51 min)
  RAP: 11
WAVEFORM PATTERNS:
  Pulmonary hypertension
  Overwedge @ 51 min
TECHNICAL COMMENTS:
  Zero @ 31 min
RESPIRATORY DATA:
RATE:   24 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh115


PATIENT DATA:
AGE/SEX:
  85 year old male
DIAGNOSIS/SURGERY:
  Cholecystectomy
PERTINENT HISTORY:
  ARDS
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 107 bpm
RHYTHM DISTURBANCES:
  Unifocal ventricular ectopy
ECG INTERPRETATION:
  Left axis deviation
  Left anterior hemiblock
  Low voltage
  Poor R wave progression consistent with COPD, old ante rose pta I infarct, left anterior hemiblock
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Extremely diaphoretic, wandering baseline due to poor electrode contact
HEMODYNAMIC DATA:
  ART: 145/60
  PAP: 55/33   	PCW: 20 (@ 45 min, 64 min)
  RAP: 15
WAVEFORM PATTERNS:
  Pulmonary hypertension
  Respiratory variation
  PA catheter in RV from 0-250 floated to wedge @ 7 min and 8 min
TECHNICAL COMMENTS:
  PA/CVP on same transducer
  CVP tracing @ 36 min - 38 min
RESPIRATORY DATA:
RATE:   14/28 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING:
  On @ 21 min
[top]  

Record: mgh116


PATIENT DATA:
AGE/SEX:
  82 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  Post-aortic valve replacement
GENERAL COMMENTS:
  Hypothermic @ 95F
  Coughing, movement artifact, suctioning @ 26 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with right bundle branch block @ 65 bpm
RHYTHM DISTURBANCES:
  ?Sinus block
  Atrial ectopy
  Multifocal ventricular ectopy, occasional bigeminy
ECG INTERPRETATION:
  Left axis deviation
  Left anterior hemiblock
  Nonspecific ST segment and T wave changes
TECHNICAL COMMENTS:
  Intermittent electrical interference
HEMODYNAMIC DATA:
  ART: 110/60   	MEAN:  73
  PAP: 20/8   	PCW: 4 (@ 20 min, 36 min)
  RAP: 6   	CO:   3.25
TECHNICAL COMMENTS:
  CVP off @ 46 min - 47 min
RESPIRATORY DATA:
RATE:   8/14 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh117


PATIENT DATA:
AGE/SEX:
  88 year old male
DIAGNOSIS/SURGERY:
  Leukemia
  Acute renal failure
  Respiratory failure
PERTINENT HISTORY:
  Hypertension
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with left bundle branch block @ 112 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy, occasional aberrant conduction
  Multifocal ventricular ectopy
TECHNICAL COMMENTS:
  ECG only @ 0 min - 30 min
  LL electrode fail @ 49 min - 57 min
  Axis shift noted during electrode repositioning
  Repeat loss of electrodes @ 67 min
HEMODYNAMIC DATA:
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
  Respiratory variation
TECHNICAL COMMENTS:
  Zero @ 30 min and 33 min
GENERAL COMMENTS:
  Unable to obtain additional data
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh118


PATIENT DATA:
AGE/SEX:
  88 year Old male
DIAGNOSIS/SURGERY:
  Leukemia
  Acute renal failure
  Respiratory failure
PERTINENT HISTORY:
  Hypertension
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with left bundle branch block @ 112 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy, occasional aberrant conduction
  Multifocal ventricular ectopy
HEMODYNAMIC DATA:
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
  Respiratory variation
GENERAL COMMENTS:
  Unable to obtain additional data
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh119


PATIENT DATA:
AGE/SEX:
  88 year old male
DIAGNOSIS/SURGERY:
  Leukemia
  Acute renal failure
  Respiratory failure
PERTINENT HISTORY:
  Hypertension
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with left bundle branch block @ 112 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy, occasional aberrant conduction
  Multifocal ventricular ectopy
HEMODYNAMIC DATA:
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
  Respiratory variation
GENERAL COMMENTS:
  Unable to obtain additional data
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh120


PATIENT DATA:
AGE/SEX:
  65 year old female
DIAGNOSIS/SURGERY:
  Mitral and tricuspid valve replacements
PHARMACOLOGIC SUPPORT
  Dopamine @ 90 mcg/min
GENERAL COMMENTS:
  Bed change @ 41 min
  Suctioning @ 57 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial flutter with incomplete right bundle branch block @ 82 bpm
RHYTHM DISTURBANCES:
  Occasional aberrant conduction
  Multifocal ventricular ectopy
ECG INTERPRETATION:
  Left ventricular hypertrophy
  ST segment and T wave changes
  Possible anterior ischemia
HEMODYNAMIC DATA:
  ART: 120/44
  RAP: 18
TECHNICAL COMMENTS:
  CVP on @ 32 min - 41 min
  Pressure transducers disconnected @ 65 min
  No zero/col/pop-test sequence
RESPIRATORY DATA:
RATE:   Not documented
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh121


PATIENT DATA:
AGE/SEX:
  75 year old male
DIAGNOSIS/SURGERY:
  Multiple trauma
PERTINENT HISTORY:
  Coronary disease
PHARMACOLOGIC SUPPORT:
  Dopamine @ 200 mcg/min
GENERAL COMMENTS:
  Stop/FFW @ 70 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 104 bpm
RHYTHM DISTURBANCES:
  Unifocal ventricular ectopy
ECG INTERPRETATION:
  Probable old inferior infarct
  Nonspecific ST segment and T wave changes
HEMODYNAMIC DATA:
  ART: 120/40   	MEAN: 73
  PAP: 44/20   	PCW: 16 (@ 21 min, 30 min, 35 min)
  RAP: 16   	CO: 8.6
WAVEFORM INTERPRETATION:
  "Catheter whip" in PA trace
RESPIRATORY DATA:
RATE:   12/16 changed to 12/1.2 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING:
  On @ 37 min
[top]  

Record: mgh122


PATIENT DATA:
AGE/SEX:
  61 year old female
DIAGNOSIS/SURGERY:
  Cardiac arrest
  Post-mitral valve replacement
GENERAL COMMENTS:
  Recording begins with ECG recording only
  Cardiac massage is initiated
  ECG electrodes fall off
  Arterial tracing is turned on
  Electrodes are changed
  ECG and arterial traces are recorded during massage @ 16 min
  Massage is intermittently stopped, then resumed throughout tracing
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with intraventricular conduction delay
RHYTHM DISTURBANCES:
  Idioventricular rhythm
ECG INTERPRETATION:
  Nonspecific T wave abnormalities
RESPIRATORY DATA:
MODE OF VENTILATION:
  Controlled and ambu ventilation
[top]  

Record: mgh123


PATIENT DATA:
AGE/SEX:
  80 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  COPD
PHARMACOLOGIC SUPPORT:
  Levophed @ 13 mcg/min
  TNG @ 40 mcg/min
  Dopamine @ 267 mcg/min
GENERAL COMMENTS:
  Dressings changed @ 46 min
  Patient movement, bed changed; Stop/FFW @ 64 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 102 bpm
RHYTHM DISTURBANCES:
  A trial ectopy
  Unifocal ventricular ectopy
  First degree heart block
ECG INTERPRETATION:
  Anteroseptal infarction
  Lateral extension
  Bi-atrial hypertrophy
  Intraventricular conduction delay @ 64 min
  Nonspecific ST segment and T wave changes
TECHNICAL COMMENTS:
  RA and V lead off @ 59 min
HEMODYNAMIC DATA:
  ART: 120/40   	MEAN: 69
  PAP: 40/20   	PCW: 14
  RAP: 12   	CO:   4.6
WAVEFORM PATTERNS:
  Overwedge @ 49 min
  Pulsus paradox
  "Catheter whip" in PA trace
  Respiratory variation
TECHNICAL COMMENTS:
  Damping arterial trace @ 59 min
RESPIRATORY DATA:
RATE:   12/12 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING:
  On @ 11 min
[top]  

Record: mgh124


PATIENT DATA:
AGE/SEX:
  80 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  COPD
PHARMACOLOGIC SUPPORT:
  Levophed @ 13 mcg/min
  TNG @ 40 mcg/min
  Dopamine @ 267 mcg/min
GENERAL COMMENTS:
  Chest physical therapy @ 57 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 102 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  Unifocal ventricular ectopy
  First degree heart block
ECG INTERPRETATION:
  Anteroseptal infarction
  Lateral extension
  Bi-atrial hypertrophy
  Nonspecific ST segment and T wave changes
HEMODYNAMIC DATA:
  ART: 120/40   	MEAN: 69
  PAP: 40/20   	PCW: 14
  RAP: 12   	CO:   4.6
WAVEFORM PATTERNS:
  Pulsus paradox
  "Catheter whip" in PA trace
  Respiratory variation
RESPIRATORY DATA:
RATE:   12/12 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING:
  Off @ ?
[top]  

Record: mgh125


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Sub-total gastrectomy/duodenostomy
PERTINENT HISTORY:
  Smoking
PHARMACOLOGIC SUPPORT:
  Levophed @ 30 mcg/min
  Dopamine @ 187 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 96 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy, occasional blocked conduction, ? occasional aberrant conduction
  Junctional escape beat
  Supraventricular tachycardia
  Ventricular escape beat
  Idioventricular rhythm @ 66 min
ECG INTERPRETATION:
  Non-specific sn wave changes
  Low voltage
  Poor R wave progression consistent with old anterior scar or pericardial effusion
HEMODYNAMIC DATA:
  ART: 90/50   	MEAN: 66
  PAP: 34/16   	PCW: 16(@ 11 min, 18 min, 51 min)
  RAP: 12
WAVEFORM PATTERNS:
  Pressure change @ 66 min
  Hypotension
  Pulsus paradox
  Giant A wave in CVP trace
  "Catheter whip" in PA trace
  Respiratory variation
TECHNICAL COMMENTS:
  Arterial line on @ 14 min
  Zero @ 15 min, 17 min, 73 min
RESPIRATORY DATA:
RATE:   8/24 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh126


PATIENT DATA:
AGE/SEX:
  46 year old female
DIAGNOSIS/SURGERY:
  Pelvic mass
  Abdominal hysterectomy with removal of ovaries
PERTINENT HISTORY:
  Severe mitral stenosis
  Mild aortic regurgitation
  Moderate tricuspid regurgitation
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  A trial fibrillation @ 80 bpm
ECG INTERPRETATION:
  ST segment and T wave abnormalities consistent with digitalis effect.
HEMODYNAMIC DATA:
  ART: 100/60   	MEAN: 57
  PAP: 36/16   	PCW: 12 (@ 31 min)
  RAP: 8   CI: 2.8
WAVEFORM PATTERNS:
  Unusual arterial notching (? secondary to aortic valve dysfunction)
  Hemodynamic pattern of atrial fibrillation
TECHNICAL COMMENTS:
  Borderline frequency response for CVP/PAP
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh127


PATIENT DATA:
AGE/SEX:
  74 year old female
DIAGNOSIS/SURGERY:
  Chronic visceral ischemia
  Aorto-superior mesenteric artery/celiac bypass graft
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 73 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  Unifocal ventricular ectopy
ECG INTERPRETATION:
  Non-specific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 160/50   	MEAN: 70
  RAP: 8
WAVEFORM PATTERNS:
  Exaggerated "a waves" in CVP trace
  "V waves" in CVP trace with ventricular ectopy
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh128


PATIENT DATA:
AGE/SEX:
  84 year old male
DIAGNOSIS/SURGERY:
  Exploratory laparotomy
  Colectomy
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with left bundle branch block @ 103 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  Sick sinus syndrome
ECG INTERPRETATION:
  sn wave changes due to digitalis effect
TECHNICAL COMMENTS:
  Wandering ECG baseline
HEMODYNAMIC DATA:
  ART: 100/40   	MEAN: 52
  PAP: 40/20   	PCW: 10 (@ 17 min, 29 min, 46 min)
  RAP: 10   	CO: 3.6
WAVEFORM PATTERNS:
  Pulmonary hypertension
  "Catheter whip" in PA trace
  Respiratory variation
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous with CPAP
  Extubated @ 42 min
COMMENTS:
  Respiratory mechanics @ 38 min
  Suctioned and extubated @ 42 min
CO2 RECORDING:
  Datex sidestream sensor
  CO2 recording discontinued @ 42 min
[top]  

Record: mgh129


PATIENT DATA:
AGE/SEX:
    63 year old female
DIAGNOSIS/SURGERY:
    Gas gangrene sepsis
PHARMACOLOGIC SUPPORT:
    Dopamine @ 900 mcg/min
    Levophed @ 2 mcg/min
GENERAL COMMENTS:
    Chest physical therapy @ 8 min - 13 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
    Normal sinus rhythm with right bundle branch block @ 98 bpm
RHYTHM CHANGES:
    Conversion to atrial fibrillation with right bundle branch block @ 150 bpm @ 21 min
    Veropamil administered @ 66 min
  ECG INTERPRETATION:
    Left atrial enlargement
    Old anteroseptal infarct
    Nonspecific ST segment and T wave abnormalities
  TECHNICAL COMMENTS:
    V lead off @ 26 min - 33 min
  HEMODYNAMIC DATA:
    ART: 110/50
    PAP: 30/16   	PCW: 10 (@ 17 min, 57 min, 63 min)
    RAP: 5
  WAVEFORM PATTERNS:
    Hemodynamic pattern of atrial fibrillation
  RESPIRATORY DATA:
  RATE:   8 bpm
  MODE OF VENTILATION:
    Controlled
[top]  

Record: mgh130


PATIENT DATA:
AGE/SEX:
  73 year old male
DIAGNOSIS/SURGERY:
  Angioplasty of right external iliac artery
PERTINENT HISTORY:
  Coronary disease (unstable angina)
  Cerebral vascular disease
  Smoking
PHARMACOLOGIC SUPPORT:
  TNG @ 37 mcg/min, reduced to 30 @ 22 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation with incomplete left bundle branch block @ 78 bpm
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities consistent with digitalis effect
TECHNICAL COMMENTS:
  Chest lead = V1 (V6 on tape 37)
HEMODYNAMIC DATA:
  ART: 140/60   	MEAN: 87
  PAP: 56/32
  RAP: 10   	CO:5
WAVEFORM PATTERNS:
  Pulmonary hypertension
TECHNICAL COMMENTS:
  CVP off @ 13 min, on @ 45 min
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh131


PATIENT DATA:
AGE/SEX:
  77 year old female
DIAGNOSIS/SURGERY:
  Burns
  Acute respiratory distress syndrome
PERTINENT HISTORY:
  Trauma
PHARMACOLOGIC SUPPORT:
  Dopamine 159 mcg to 212.8 during recording
  Aminophylline @ 40 mgm/hr
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 81 bpm
RHYTHM DISTURBANCES:
  Multifocal atrial ectopy, with occasional aberrant conduction
ECG INTERPRETATION:
  Low voltage
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 101/41   	MEAN: 57
  PAP: 63/30   	PCW: 20 (@ 13 min, 39 min, 40 min)
  RAP: 25
WAVEFORM INTERPRETATION:
  Pulmonary hypertension
TECHNICAL COMMENTS:
  PA and CVP on same transducer
  Zero PA channel @ 7 min and 53 min
  CVP recording @ 54 min - 55 min and 56 min - 57 min
RESPIRATORY DATA:
RATE:   24/24 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING:
  Discontinued @ 43 min
COMMENTS:
  Respiratory impedance channel working poorly
[top]  

Record: mgh132


PATIENT DATA:
AGE/SEX:
  65 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of aortic aneurysm
  Bypass graft to superior mesenteric artery
PERTINENT HISTORY:
  Hypertension
PHARMACOLOGIC SUPPORT:
  Neosynephrine @ 20 mcg/min
GENERAL COMMENTS:
  On hemodialysis during recording
  Insertion of catheters @ 10 min- 17 min
  Unit on @ 17 min
  Suctioning @ 13 min - 17 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  A trial fibrillation @ 103 bpm
RHYTHM DISTURBANCES:
  Occasional ventricular ectopy or aberrancy
ECG INTERPRETATION:
  ST segment and T wave abnormalities consistent with digitalis effect
HEMODYNAMIC DATA:
  ART: 100/50   	MEAN: 66
    (axillary)
  PAP: 32/12   	PCW: 8 (@ 34 min, 36 min, 39 min, 44 min, 56 min)
  RAP: 10
RESPIRATORY DATA:
RATE:   8/8 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh133


PATIENT DATA:
AGE/SEX:
  69 year Old male
DIAGNOSIS/SURGERY:
  RLL lobectomy for carcinoma
PERTINENT HISTORY:
  COPD
PHARMACOLOGIC SUPPORT:
  Dopamine @ 53 mcg/min,
GENERAL COMMENTS:
  Hypothermic @ 3.2 min
  Jet ventilation
  Chest physical therapy @ 20 min, 36 min - 47 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus bradycardia @ 58 bpm
RHYTHM DISTURBANCES:
  Junctional rhythm @ 20 min - 32 min
  Rare ventricular ectopy
ECG INTERPRETATIONS:
  Marked ST abnormality
  Possible inferior subendocardial injury
HEMODYNAMIC DATA:
  ART: 150/50
  PAP: 48/18   	PCW: 13 (@ 19 min, 34 min, 49 min)
  RAP: 10
TECHNICAL COMMENTS:
  PA/CVP on same transducer
RESPIRATORY DATA:
RATE:   2/100 bpm
MODE OF VENTILATION:
  High frequency jet ventilation
CO2 RECORDING
[top]  

Record: mgh134


PATIENT DATA:
AGE/SEX:
  71 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  COPD
  Asthma
PHARMACOLOGIC SUPPORT:
  Aminophylline @ 30 mgm/hr
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with right bundle branch block @ 90 bpm
RHYTHM DISTURBANCES:
  Ventricular ectopy
  Changing P-R ? A-V Dissociation
  Junctional rhythm
ECG INTERPRETATION:
  Left anterior hemiblock
  Left axis deviation
HEMODYNAMIC DATA:
  ART: 140/80   	MEAN: 101
  PAP: 28/12   	PCW:   8 (@ 10 min, 16 min, 21 min)
  RAP: 6   	CO:   3.74
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh135


PATIENT DATA:
AGE/SEX:
  65 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of aortic aneurysm
  Bypass graft to superior mesenteric artery
PERTINENT HISTORY:
  Hypertension
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 104 bpm
ECG INTERPRETATION:
  ST segment and T wave abnormalities consistent with digitalis effect
HEMODYNAMIC DATA:
  ART: 140/60   	MEAN: 76 (brachial)
  RAP: 10
WAVEFORM PATTERNS:
  Arterial trace "spiking"
  Respiratory variation
RESPIRATORY DATA:
RATE:   5/32 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh136


PATIENT DATA:
AGE/SEX:
  55 year old male
DIAGNOSIS/SURGERY:
  Sepsis
PERTINENT HISTORY:
  Coronary disease
  Acute respiratory distress syndrome
PHARMACOLOGIC SUPPORT:
  Dopamine @ 213 mcg/min
  Epinephrine @ 2.6 mcg/min
  TNG @ 26 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 124 bpm
ECG INTERPRETATION:
  Low voltage
  Possible old anteroseptal infarct
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Intermittent 60-cycle interference
HEMODYNAMIC DATA:
  ART: 100/80
  PAP: 40/18   	PCW: 18 (@ 25 min, 32 min, 41 min)
  RAP: 16
TECHNICAL COMMENTS:
  CVP and PAP on same transducer
  CVP on @ 33 min - 39 min
RESPIRATORY DATA:
RATE:   8 bpm
MODE OF VENTILATION:
  Controlled ventilation
CO2 RECORDING:
  Off @ 36 min
TECHNICAL COMMENTS:
  Poor respiratory impedance signal
[top]  

Record: mgh137


PATIENT DATA:
AGE/SEX:
  60 year old female
DIAGNOSIS/SURGERY:
  Axillo-popliteal bypass graft
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  Dopamine @ 150 mcg/min
COMMENTS:
  Severe hyperkalemia results in a variety of progressively worsening arrhythmias
  Arrhythmias resolve with potassium therapy on mgh020
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Junctional rhythm with right bundle branch block @ 96 bpm
RHYTHM DISTURBANCES:
  Runs of junctional tachycardia @ 63 min
  Atrial ectopy
ECG INTERPRETATION:
  Low voltage
  Nonspecific St segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 110/70   	MEAN: 75
  PAP: 36/20   	PCW: 14(@ 4 min,21 min,41 min)
  RAP: 11   	CO:   3.2
WAVEFORM PATTERNS:
  Episodes of hypotension
  Fluctuations in hemodynamic pattern due to arrhythmias
TECHNICAL COMMENTS:
  Zero to CVP and PAP @ 38 min
  Final zero/cal/pop-test sequence on mgh020
RESPIRATORY DATA:
RATE:   7/7 bpm
MODE OF VENTILATION:
  Controlled ventilation
CO2 RECORDING
[top]  

Record: mgh138


PATIENT DATA:
AGE/SEX:
  62 year old male
DIAGNOSIS/SURGERY:
  Aorto-bifemoral graft
PERTINENT HISTORY:
  Coronary disease
  COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 84 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  First degree heart block
ECG INTERPRETATION:
  Borderline voltage
  Minor ST segment and T wave changes
HEMODYNAMIC DATA:
  ART: 100/50   	MEAN: 68
  PAP: 24/12   	PCW: 1O(@ 13 min, 30 min, 40 min)
  RAP: 8   	CO: 5.4
WAVEFORM PATTERNS:
  Giant A wave in CVP trace
  Respiratory variation
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh139


PATIENT DATA:
AGE/SEX:
  64 year old female
DIAGNOSIS/SURGERY:
  Renal calculus
  Retroperitoneal hematoma
PERTINENT HISTORY:
  5 years post aortic valve replacement, mitral and tricuspid valvuloplasty
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 97 bpm
RHYTHM DISTURBANCES:
  Occasional abe   't conduction
  Ventricular ecto.
ECG INTERPRETATION:
  Anterolateral ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Movement artifact
  Loss of electrodes
HEMODYNAMIC DATA:
  ART: 123/60
  PAP: 36/20   	PCW: 30 (@ 16 min, 45 min, 56 min, 65 min)
  RAP: 17
TECHNICAL COMMENTS:
  PA and CVP on same transducer
  CVP on @ 33 min - 43 min and 50 min - 52 min
RESPIRATORY DATA:
RATE:   32 changed to 20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh140


PATIENT DATA:
AGE/SEX:
  67 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of thoraco-abdominal aneurysm
PERTINENT HISTORY:
  Coronary disease
  Hypertension
  COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 100 bpm
RHYTHM DISTURBANCES:
  A tria I ectopy
ECG INTERPRETATION:
  Left ventricular hypertrophy
  Probable old inferior infarct
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 200/80   	MEAN: 105
  RAP: 10
WAVEFORM PATTERNS:
  Hypertension
  Respiratory variation
RESPIRATORY DATA:
RATE:   6/20 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh141


PATIENT DATA:
AGE/SEX:
  73 year old male
DIAGNOSIS/SURGERY:
  Resection of abdominal aortic aneurysm
PERTINENT HISTORY:
  Diffuse coronary disease
  Cardiomyopathy
  COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 75 bpm
ECG INTERPRETATION:
  Diffuse infarct
  ?Inferior ischemia
  Left ventricular hypertrophy
  Nonspecific T wave abnormalities
TECHNICAL COMMENTS:
  V lead off @ 28 min
  LL electrode off @ 31 min
HEMODYNAMIC DATA:
  ART: 110/50 	MEAN: 60
  PAP: 44/16 	PCW: 8 (@ 5 min, 6 min, 8 min, 10 min, 57 min, 63 min)
  RAP: 10
TECHNICAL COMMENTS:
  Zero PA @ 9 min
RESPIRATORY DATA:
RATE:   6/6 bpm to 10/10 @ 44 min
MODE OF VENTILATION:
  Controlled
CO2 RECORDING:
  Changes @ 44 min
[top]  

Record: mgh142


PATIENT DATA:
AGE/SEX:
  82 year old male
DIAGNOSIS/SURGERY:
  Abdominal aortic aneurysm
  Peripheral vascular disease
PERTINENT HISTORY:
  Coronary disease
  Smoker
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 124 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  ?Junctional ectopy
  Rare unifocal ventricular ectopy with fusion beat @ 34 min
ECG INTERPRETATION:
  Prominent "R" wave in leads V1-V2 consistent with counterclockwise rotation
  Cannot rule out old "true posterior" myocardial infarction
  Possible old inferior infarct
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  "V lead fail message"
HEMODYNAMIC DATA:
  ART: 140/60   	MEAN: 85
  PAP: 20/8   	PCW: 8
  RAP: 3   	CO:   5.2
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
TECHNICAL COMMENTS:
  PAP/CVP traces damped due to catheter kinking @ 54 min - 55 min
RESPIRATORY DATA:
RATE:   24 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh143


PATIENT DATA:
AGE/SEX:
  69 year old male
DIAGNOSIS/SURGERY:
  Resection of bilateral iliac aneursysms
  Respiratory distress
PERTINENT HISTORY:
  Coronary artery disease
PHARMACOLOGIC SUPPORT:
  Neosynephrine 30 mcg/min then discontinued
GENERAL COMMENTS:
  Turning @ 55 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with first degree heart block and intra-ventricular conduction defect @ 81 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy, occasional blocked conduction
  Junctional escape beat
  Rare unifocal ventricular ectopy
ECG INTERPRETATION:
  Left atrial enlargement
  Poor R wave progression consistent with old anteroseptal infarct
  Nonspecific ST segment and T wave abnormalities
  Inferolateral infarct
  Non-specific STT wave changes
TECHNICAL COMMENTS:
  Occasional muscle tremor
HEMODYNAMIC DATA:
  ART: 130/50   	MEAN: 75
  PAP: 52/24   	PCW: 22 (@ 19 min, 42 min, 46 min)
  RAP: 10   	CO:   7.3
WAVEFORM PATTERNS:
  Pulmonary hypertension
  "Catheter whip" in PA trace
RESPIRATORY DATA:
RATE:   10/32 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh144


PATIENT DATA:
AGE/SEX:
  71 year old female
DIAGNOSIS/SURGERY:
  Innominate artery bypass
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ 47 mcg/min
  Dopamine @ 200 mcg/min, then off
  Levophed
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 73 bpm
ECG INTERPRETATION:
  Low voltage
  Left axis deviation
  Anterolateral ST segment and T wave abnormalities consistent with ischemia
TECHNICAL COMMENTS:
  Wandering baseline, tremor, electrical interference
HEMODYNAMIC DATA:
  ART: 160/70   	MEAN: 92 (pedal)
  PAP: 36/16
  RAP: 15
TECHNICAL COMMENTS:
  CVP on @ 31 min
RESPIRATORY DATA:
RATE:   4/8 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh145


PATIENT DATA:
AGE/SEX:
  81 year old female
DIAGNOSIS/SURGERY:
  Aortic valve replacement
PHARMACOLOGIC SUPPORT:
  Dopamine @ 216 mcg/min
GENERAL COMMENTS:
  Chest physical therapy @ 62 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 87 bpm
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities persists
HEMODYNAMIC DATA:
  ART: 97/40
  RAP:   15
RESPIRATORY DATA:
RATE:   12/12 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING     
[top]  

Record: mgh146


PATIENT DATA:
AGE/SEX:
  87 year old female
DIAGNOSIS/SURGERY:
  Superior mesenteric
  Embolectomy
  Small bowel resection
PERTINENT HISTORY:
  Coronary disease
PHARMACOLOGIC SUPPORT:
  Dopamine @ 200 mcg/min
  Inocor @ 350 mcg/min
GENERAL COMMENTS:
  Stop/FFW @ 53 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation @ 100 born
ECG INTERPRETATION:
  Left ventricular hypertrophy
  Poor R wave progression consistent with chronic obstructive pulmonary disease, anteroseptal infarction ST segment and T wave abnormalities consistent with digitalis/ischemia
HEMODYNAMIC DATA:
  ART: 140/50   	MEAN: 70
  PAP: 40/20   	PCW: 18
  RAP: 12
RESPIRATORY DATA:
RATE:   8/8 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING:
  On @ 55 min
[top]  

Record: mgh147


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  Post-mitral valve replacement
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ 50 mcg/min, then off
  Dopamine on @ 63 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation with intra-ventricular conduction defect @ 106 bpm
ECG INTERPRETATION:
  Left atrial enlargement
  Left ventricular hypertrophy
HEMODYNAMIC DATA:
  ART: 150/60   	MEAN: 82
  PAP: 36/20   	PCW: 18
  RAP:   4   	CO:   3.4
TECHNICAL COMMENTS:
  Poor CVP frequency response (12.5 Hz)
RESPIRATORY DATA:
RATE:   8/8 bpm
MODE OF VENTILATION:
CO2 RECORDING
[top]  

Record: mgh148


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Sub-total gastrectomy/ duodenostomy
PERTINENT HISTORY:
  Smoking
PHARMACOLOGIC SUPPORT:
  Levophed @ 30 mcg/min
  Dopamine @ 187 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 96 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  Supraventricular tachycardia
ECG INTERPRETATION:
  Non-specific STT wave changes
  Low voltage and poor R wave progression consistent with old anterior scar or pericardial effusion
HEMODYNAMIC DATA:
  ART: 90/50   	MEAN: 66
  PAP: 34/16   	PCW: 16
  RAP: 12
WAVEFORM PATTERNS:
  Hypotension
  Pulsus paradox
  Giant A wave in CVP trace
  Respiratory variation
TECHNICAL COMMENTS:
  No final zero/cot/coo-test sequence
RESPIRATORY DATA:
RATE:   8/24 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh149


PATIENT DATA:
AGE/SEX:
  67 year old female
DIAGNOSIS/SURGERY:
  Mitral valve replacement
  Tricuspid annuloplasty
  Persistent tricuspid regurgitation
  Coronary artery bypass graft
PHARMACOLOGIC SUPPORT:
  Dopamine @ 150 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Atrial fibrillation with intraventricular conduction defect @ 81 bpm
RHYTHM DISTURBANCES:
  Rare multifocal ventricular ectopy
ECG INTERPRETATION:
  Nonspecific T wave abnormalities
HEMODYNAMIC DATA:
  ART: 136/60
  PAP: 96/28   	PCW: 18 (@ 28 min, 36 min, 68 min)
  RAP: 20   CI: 2.0
WAVEFORM PATTERNS:
  Pulmonary hypertension
TECHNICAL COMMENTS:
  PA on CVP CH11
  CVP on PA CH8
  Zero @ 17 min
  Zero CVP only @ 19 min
RESPIRATORY DATA:
RATE: 8/8 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh150


PATIENT DATA:
AGE/SEX:
  69 year old female
DIAGNOSIS:
  Respiratory insufficiency sip re-do CABG
ECG DATA:
LEADS:
  I,II,III,VI
RHYTHM:
  Chaotic atrial rhythm with left bundle branch block and aberrant beats
ECG INTERPRETATION:
  Non-specific STT wave changes
HEMODYNAMIC DATA:
  ART: 132/62
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
	STANDARD ICU RECORDING
	1 min ANNOTATION
	7 min STOP/FFW/START
		ELECTRODES CHANGED/MOVED TO BED
	59 min   END
[top]  

Record: mgh151

PATIENT DATA:
AGE/SEX:
	72 year old male
DIAGNOSIS/SURGERY:
	Hepatic cancer
	Hepatectomy
	Exploratory laparotomy
PHARMACOLOGIC SUPPORT:
	Aminophylline @ 30 mgm/hr,
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
	Sinus tachycardia @ 130 bpm
ECG INTERPRETATION:
	Old inferior infarct
	Old antero-septal infarct
HEMODYNAMIC DATA:
	ART: 130/60   	MEAN: 88
	PAP: 34/20   	PCW: 14 (@ 38 min)
	RAP: 9   	CO: 8
WAVEFORM PATTERNS:
	Respiratory variation
	CVP damping
TECHNICAL COMMENTS:
	Borderline frequency response for CVP,
	CVP turned of @ 46 min
RESPIRATORY DATA:
RATE:	40 bpm
MODE OF VENTILATION:
	Spontaneous
[top]  

Record: mgh152


PATIENT DATA:
AGE/SEX:
  67 year old female
DIAGNOSIS/SURGERY:
  Gangrene of the foot
  Amputation
  Sepsis
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 91 bpm
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 73
  CVP: 6
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh153


PATIENT DATA:
AGE/SEX:
  64 year old male
DIAGNOSIS/SURGERY:
  Intraventricular tumor
  Frontal craniotomy
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 72 bpm
ECG INTERPRETATION:
  Left atrial enlargement
  Left axis deviation
  Stable anterior infarct of indeterminate age
HEMODYNAMIC DATA:
  ART: 120/50   	MEAN: 68
  PAP: 68/24   	PCW: 22 (@ 18 min)
  RAP: 4
WAVEFORM PATTERNS:
  During PCW recording, tracing converts to PA trace momentarily at peak inspiration
RESPIRATORY DATA:
RATE:   10 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh154


PATIENT DATA:
AGE/SEX:
  77 year old male
DIAGNOSIS/SURGERY:
  Renal stones
  Renal exploration
  Ureteral stent
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 80 bpm
ECG INTERPRETATION:
  ?Old antero-septal scar
HEMODYNAMIC DATA:
  ART: 100/40   	MEAN: 64
  PAP: 20/8   	PCW: 4 (@ 17 min, 22 min, 48 min)
  RAP: 6
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh155


PATIENT DATA:
AGE/SEX:
  56 year old male
DIAGNOSIS/SURGERY:
  Upper gastrointestinal bleed
  Sepsis
  Aorto-bifemoral bypass graft
  Abdominal laporotomy
PERTINENT HISTORY:
  Ongoing antero-septal ischemia
PHARMACOLOGIC SUPPORT:
  Levophed @ 2.8 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 112 bpm
ECG INTERPRETATION:
  Old anterolateral infarct
  Persistent anterior ST segment elevation consistent with aneurysm
HEMODYNAMIC DATA:
  ART: 110/60   	MEAN: 77
  PAP: 36/20   	PCW: 16 (@ 13 min, 36 min, 52 min)
  RAP: 20
WAVEFORM PATTERNS:
  Arterial line intermittently damped
  Pulsus paradox
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh156


PATIENT DATA:
AGE/SEX:
  41 year old male
DIAGNOSIS/SURGERY:
  Congestive heart failure
PERTINENT HISTORY:
  Severe mitral stenosis
  Moderate mitral regurgitation
  Aortic stenosis
  s/p AVR and MVR 10 years earlier
PHARMACOLOGIC SUPPORT:
  Dopamine @ 213 mcg/min
  Epinephrine @ 2.1 mcg/min
  Isuprel @ 2.5 mcg/min
GENERAL COMMENTS:
  Hypothermic @ 91.9F
ELECTROCARDIOGRAPHIC DATA
UNDERLYING RHYTHM:
  Normal sinus rhythm with incomplete right bundle branch block @ 90 bpm
ECG INTERPRETATION:
  Rightward axis shift
  Right ventricular strain
  Left atrial enlargement
HEMODYNAMIC DATA:
  ART: 100/50 (axillary)
  PAP: 83/56   	PCW: 30 (@ 17 min, 27 min, 41 min)
  RAP: 15
WAVEFORM PATTERNS:
  V waves due to mitral regurgitation in PCW trace
  Pulmonary hypertension
  Anacrotic notch on arterial trace due to aortic stenosis
  Pulsus paradox
TECHNICAL COMMENTS:
  CVP and PAP on single transducer
  CVP data inaccurate? medications infused simultaneously
  Zero @ 9 min
  CVP recording @ 14 min - 15 min
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh157


PATIENT DATA:
AGE/SEX:
  64 year old male
DIAGNOSIS/SURGERY:
  Thoracic abdominal aortic aneurysm
  Coagulopathy
  Aortobifemoral bypass graft
  Exploratory laporotomy
PHARMACOLOGIC SUPPORT:
  Dopamine @ 400 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 124 bpm
ECG INTERPRETATION:
  Low voltage consistent with pericardial effusion, obesity, pneumothorax
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Electrodes changed once during recording
HEMODYNAMIC DATA:
  ART: 130/80   	MEAN: 109
  PAP: 60/36   	PCW: 24 (@ 9 min, 11 min, 23 min, 46 min, 46 min)
  RAP: 26
WAVEFORM PATTERNS:
  Pulsus paradox
  Pulmonary hypertension
  Respiratory variation
TECHNICAL COMMENTS:
  Electronic cals @ 61 min
  Repeat mercury cals @ 71 min
RESPIRATORY DATA:
RATE:   12 bpm
MODE OF VENTILATION:
  Controlled
COMMENTS:
  Respiratory impedance channel on @ 20 min
[top]  

Record: mgh158


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Arterial insufficiency
  Ileo-profunda graft
PHARMACOLOGIC SUPPORT:
  TNG @ 60 mcg/min, then off
  Neosynephrine @ 30 mcg/min, then off, then 40 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 109 bpm
ECG INTERPRETATION:
  Infero-apical ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 74
  PAP: 44/24
  RAP: 7
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   24 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh159


PATIENT DATA:
AGE/SEX:
  34 year old female
DIAGNOSIS/SURGERY:
  Liver transplant
PHARMACOLOGIC SUPPORT:
  Dopamine @ 100 mcg/min (discontinued temporarily during recording)
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 115 bpm
ECG INTERPRETATION:
  Minor nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  ECG cable disconnected @ 60 min
HEMODYNAMIC DATA:
  ART: 140/90
  RAP: 14
TECHNICAL COMMENTS:
  Change in arterial line configuration @ 26 min
  CVP kinked @ 40 min
RESPIRATORY DATA:
RATE:   12/22 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh160


PATIENT DATA:
AGE/SEX:
    62 year old female
DIAGNOSIS/SURGERY:
    Exploratory laporotomy
    Colectomy
    Cholecystectomy
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
    Normal sinus rhythm @ 94 bpm
ECG INTERPRETATION:
    Left axis deviation consistent with left anterior hemiblock
    Poor R wave progression consistent with old anterolateral infarct or left   anterior hemiblock
    Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
    No ECG cal signal
HEMODYNAMIC DATA:
    ART: 130/70   	MEAN: 90
    PAP: 36/20   	PCW: 10 (@ 15 min, 26 min, 51 min, 54 min)
    RAP: 5
WAVEFORM PATTERNS:
    Giant A wave
    "Catheter whip" in PA trace
RESPIRATORY DATA:
RATE:   5/12 born
MODE OF VENTILATION:
    Intermittent mandatory ventilation
COMMENTS:
    Impedance channel off
[top]  

Record: mgh161


PATIENT DATA:
AGE/SEX:
  61 year old female
DIAGNOSIS/SURGERY:
  Multiple trauma
  Cerebral injury
  Fractures of ribs and pelvis
GENERAL COMMENTS:
  Stop/FFW @ 54 min - 55 min
  Record mgh162 was recorded from the same patient
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 69 bpm
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities consistent with digitalis effect or ischemia
  Low voltage
HEMODYNAMIC DATA:
  ART: 140/80   	MEAN: 98   (femoral)
  RAP: 10   	CO:8
WAVEFORM PATTERNS:
  Simultaneous femoral and radial traces
TECHNICAL COMMENTS:
  Radial arterial trace on PA channel after 56 min
  Zero/cal/pop-test to art lines 55 min - 61 min
  Both art lines on @ 61 min
  CVP off @ 19 min - 21 min and 27 min - 55 min
RESPIRATORY DATA:
RATE:
  8/8 bpm
MODE OF VENTILATION:
  Controlled
COMMENTS:
  CO2 monitor off @ 68 min
[top]  

Record: mgh162


PATIENT DATA:
AGE/SEX:
  61 year old female
DIAGNOSIS/SURGERY:
  Multiple trauma
  Cerebral injury
  Fractures of ribs and pelvis
GENERAL COMMENTS:
  OFF 53 min
  Record mgh161 was recorded from the same patient
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 69 bpm
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities consistent with digitalis effect or ischemia
  Low voltage
TECHNICAL COMMENTS:
  ECG module changed @ 45 min - 61 min
HEMODYNAMIC DATA:
  ART: 140/80   	MEAN: 98   (femoral)
  RAP: 10   	CO:8
WAVEFORM PATTERNS:
  Simultaneous femoral and radial traces
TECHNICAL COMMENTS:
  Femoral line damped @ 25 min
  CVP off @ 43 min
  Clipping of radial trace
RESPIRATORY DATA:
RATE:
  Regains consciousness, initiating spontaneous breaths
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh163


PATIENT DATA:
AGE/SEX:
    69 year old male
DIAGNOSIS/SURGERY:
    Spleno-renal shunt
    Splenectomy
PERTINENT HISTORY:
    Coronary disease
    COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
    Normal sinus rhythm @ 95 bpm
RHYTHM DISTURBANCES:
    Unifocal ventricular ectopy
ECG INTERPRETATION:
    Posterolateral infarct
    Left atrial enlargement
    Probable right ventricular hypertrophy
    Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
    ART: 120/40   	MEAN: 65
    PAP: 20/8   	PCW: 4 (@ 12 min, 42 min, 44 min)
    RAP: 5   	CO:   6.5
TECHNICAL COMMENTS:
    Arterial set-up first
RESPIRATORY DATA:
RATE:   10 bpm
MODE OF VENTILATION:
    Spontaneous
[top]  

Record: mgh164


PATIENT DATA:
AGE/SEX:
  62 year old female
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
GENERAL COMMENTS:
  Stop/FFW @ 1 min - 2 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with right bundle branch block @ 96 bpm
ECG INTERPRETATION:
  Right axis deviation consistent with right ventricular hypertrophy or left posterior hemiblock
  Probable old anterior infarct
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 160/60   	MEAN: 93
  PAP: 40/16
  RAP: 10
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  Poor CVP frequency response (12.5 Hz)
  Repeat CVP pop-test @ 12 min
RESPIRATORY DATA:
RATE:   24 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh165


PATIENT DATA:
AGE/SEX:
  75 year old male
DIAGNOSIS/SURGERY:
  Multiple trauma
PERTINENT HISTORY:
  Coronary disease
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 83 bpm
ECG INTERPRETATION:
  Possible old inferior infarct
  QT interval prolonged
  Nonspecific ST segment and T wave abnormalities
  Possible anterior subendocardial ischemia
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 73
  PAP: 40/16   	PCW: 14 (@ 10 min, 30 min)
  RAP: 12
TECHNICAL COMMENTS:
  Arterial blood gas withdrawn @ 16 min
RESPIRATORY DATA:
RATE:   10/10 born
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh166


PATIENT DATA:
AGE/SEX:
  52 year old female
DIAGNOSIS/SURGERY:
  Multiple trauma
  Exploratory laporotomy
  Sepsis
PHARMACOLOGIC SUPPORT:
  Dopamine @ 213 mcg/min
  Levophed @ 21 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 130 bpm
HEMODYNAMIC DATA:
  ART: 120/60
  PAP: 40/20   	PCW: 17 (@ 20 min, 41 min, 63 min)
  RAP: 17
WAVEFORM INTERPRETATION:
  Pulsus paradox
TECHNICAL COMMENTS:
  Zero @ 10 min
RESPIRATORY DATA:
RATE:   16/16 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh167


PATIENT DATA:
AGE/SEX:
  67 year old male
DIAGNOSIS/SURGERY:
  Pulmonary lobectomy
PERTINENT HISTORY:
  Coronary disease
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus bradycardia @ 54 bpm
RHYTHM DISTURBANCES:
  Rare unifocal ventricular ectopy
ECG INTERPRETATION:
  Minor nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 170/80
  PAP: 40/18
  RAP: 13   	CO: 3.2
TECHNICAL COMMENTS:
  PA/CVP on same transducer
  CVP on @ 7 min - 8 min
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh168


PATIENT DATA:
AGE/SEX:
  62 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ 40 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 69 bpm
RHYTHM DISTURBANCES:
  First degree heart block
ECG INTERPRETATION:
  Generalized T wave abnormalities
HEMODYNAMIC DATA:
  ART: 140/50   	MEAN: 78
  PAP: 26/8   	PCW: 6 (@ 46 min, 66 min)
  RAP: 8
WAVEFORM PATTERNS:
  Change in arterial line configuration @ 19 min
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh169


PATIENT DATA:
AGE/SEX:
  58 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  Smoker
GENERAL COMMENTS:
  Stop/Start @ 68 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 89 bpm
ECG INTERPRETATION:
  Left axis deviation
  Left anterior hemiblock
  Left atrial enlargement
HEMODYNAMIC DATA:
  ART: 130/60   	MEAN: 80
  PAP: 36/14
  RAP: 10
RESPIRATORY DATA:
RATE:   23 bpm
MODE OF VENTILATION:
  Spontaneous
CO2 RECORDING:
  Discontinued @ 67 min
[top]  

Record: mgh170


PATIENT DATA:
AGE/SEX:
  63 year old male
DIAGNOSIS/SURGERY:
  Hepato-renal bypass graft
PERTINENT HISTORY:
  Hypertension
  Coronary disease
  Peripheral vascular disease
PHARMACOLOGIC SUPPORT:
  TNG @ 200 mcg/min
GENERAL COMMENTS:
  Short recording to capture V waves
  No set-up sequence
  Inderal administered @ 10 sec, 2 min, 6 min
  Hypothermic @ 96.9F
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 70 bpm
ECG INTERPRETATION:
  Inferolateral subendocardial injury
TECHNICAL COMMENTS:
  ECG recording started @ 2 min
HEMODYNAMIC DATA:
  ART: 200/60   	MEAN: 92
  PAP: 48/22   	PCW: 22 (@ 3 min, 12 min)
  RAP: 12   	CO:   8.2
WAVEFORM PATTERNS:
  Hypertension
  V wave
  Respiratory variation
TECHNICAL COMMENTS:
  No initial set-up sequence
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh171


PATIENT DATA:
AGE/SEX:
  60 year old male
DIAGNOSIS/SURGERY:
  Coronary artery bypass graft
PERTINENT HISTORY:
  Peripheral vascular disease
PHARMACOLOGIC SUPPORT:
  TNG @ 40 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with right bundle branch block @ 117 bpm
ECG INTERPRETATION:
  Non-specific STT wave changes
  Anteroseptal infarct
HEMODYNAMIC DATA:
  ART: 158/60
  PAP: 38/20   	PCW: 13 (@ 11 min, 12 min, 19 min, 28 min, 49 min, 69 min)
  RAP: 12
WAVEFORM PATTERNS:
  Changing pulmonary arterial and pulmonary capillary wedge waveforms
TECHNICAL COMMENTS:
  Zero to ART and PA @ 8 min
  Zeros to PA @ 18 min
  Arterial line re-positioned @ 56 min
RESPIRATORY DATA:
RATE:   9/9 changed to 8/8 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh172


PATIENT DATA:
AGE/SEX:
  66 year old female
DIAGNOSIS/SURGERY:
  Renal artery bypass graft
PERTINENT HISTORY:
  Mild mitral regurgitation
  Aortic regurgitation and stenosis
  Coronary disease
  Hypertension
  Smoker
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with left bundle branch block @ 76 bpm
ECG INTERPRETATION:
  Inferior infarct
  Anterior infarct
  R waves consistent with left ventricular hypertrophy and strain
HEMODYNAMIC DATA:
  ART: 200/70   	MEAN: 113
  PAP: 44/16   	PCW:   16 (@ 18 min, 29 min, 31 min, 52 min)
  RAP: 8   	CO:   3.5
WAVEFORM PATTERNS:
  Hypertension
TECHNICAL COMMENTS:
  Arterial blood gas @ 24 min
RESPIRATORY DATA:
RATE:   7/7 bpm
MODE OF VENTILATION:
  Controlled/intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh173


PATIENT DATA:
AGE/SEX:
  4 day old male
DIAGNOSIS/SURGERY:
  RV hypoplasia
  Pulmonary atresia/valvotomy
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 120 bpm
ECG INTERPRETATION:
  Right atrial enlargement
  Small right ventricle
  Dominant left ventricle
HEMODYNAMIC DATA:
  ART: 80/40   	MEAN: 53
RESPIRATORY DATA:
RATE:   14/14 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh174


PATIENT DATA:
AGE/SEX:
  27 year old male
DIAGNOSIS/SURGERY:
  Aortic valve replacement
  Patch closure of aorta
PHARMACOLOGIC SUPPORT:
  Nipride @ 100 mcg/min, then off. then @ 500 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia with left bundle branch block @ 104 bpm
RHYTHM DISTURBANCES:
  Rare unifocal ventricular ectopy
ECG INTERPRETATION:
  Left ventricular hypertrophy
  Left atrial enlargement
  Left axis deviation
TECHNICAL COMMENTS:HEMODYNAMIC DATA:
  Chest lead = V4
  ART: 116/48
  PAP: 28/11   	PCW: 15
  RAP:   8   CI: 2.7
WAVEFORM PATTERNS:
  Unusual biphasic arterial trace
RESPIRATORY DATA:
RATE:   8/8 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh175


PATIENT DATA:
AGE/SEX:
  30 year old male
DIAGNOSIS/SURGERY:
  Reconstruction of popliteal artery and vein
GENERAL COMMENTS:
  Bed changed
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 117 bpm
TECHNICAL COMMENTS:
  ECG cal @ 20 min
HEMODYNAMIC DATA:
  ART: 200/100   	MEAN: 128
  PAP: 12
WAVEFORM PATTERNS:
  Hypertension
  Respiratory variation
TECHNICAL COMMENTS:
  Transducers re-levelled @ 34 min
RESPIRATORY DATA:
RATE:   4/20 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh176


PATIENT DATA:
AGE/SEX:
  60 year old male
DIAGNOSIS/SURGERY:
  Abdominal aortic aneurysm
  Aneurysm resection/insertion bifurcation graft
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus rhythm @ 68 bpm
RHYTHM DISTURBANCES:
  Rare atrial ectopy, with normal and aberrant conduction
  Rare ventricular ectopy
ECG INTERPRETATION:
  Left atrial enlargement
  Poor R wave progression consistent with old anteroseptal infarct, COPD, clockwise rotation
  Nonspecific St segment and T wave abnormalities
TECHNICAL COMMENTS:
  Wandering baseline
HEMODYNAMIC DATA:
  ART: 160/60   	MEAN: 93
  PAP: 38/14   	PCW: (@ 13 min, 20 min, 36 min)
  RAP: 4
WAVEFORM PATTERNS:
  "Catheter whip" in PA trace
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh177


PATIENT DATA:
AGE/SEX:
  67 year old female
DIAGNOSIS/SURGERY
  Abdominal aortlc aneurysm
  Aorto-bifemoral graft
  Aorto-iliac occlusion
  Bilateral lumbar sympathectomy
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 84 bpm
RHYTHM DISTURBANCES:
  Rare multifocal ventricular ectopy
ECG INTERPRETATION:
  Nonspecific T wave abnormalities
TECHNICAL COMMENTS:
  Occasional artifact from muscle tremor
HEMODYNAMIC DATA:
  ART: 140/60   	MEAN: 84
  PAP: 28/14   	PCW: 8 (@ 24 min, 39 min, 52 min)
  RAP: 8
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh178


PATIENT DATA:
AGE/SEX:
  52 year old male
DIAGNOSIS/SURGERY:
  Left carotid artery endartarectomy
GENERAL COMMENTS:
  Transferred from bed to chair @ 14 min
  Returned to bed @ 24 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 100 bpm
ECG INTERPRETATION:
  Non-specific STT wave changes
HEMODYNAMIC DATA:
  ART: 160/60   	MEAN: 99
  PAP: 36/16   	PCW: 12 (@ 1O min, 25 min, 39 min)
  RAP: 4
WAVEFORM PATTERNS:
  Overwedge configuration x2 @ 39 min
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh179


PATIENT DATA:
AGE/SEX:
  72 year old female
DIAGNOSIS/SURGERY:
  Chronic obstructive lung disease with pneumonia
PHARMACOLOGIC SUPPORT:
  Neosynephrine @ 59 mcg/min
GENERAL COMMENTS:
  Power to monitor off @ 27 min - 28 min
  Data collection ends @ 45 min
  Final zero/cal pop test sequence @ 45 min - 50 min
  Stop/FFW @ 52 min - 53 min
  ECG recorded during chest physical therapy @ 53 min-end
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 87 bpm
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Wandering baseline
  Electrodes replaced @ 52 min
HEMODYNAMIC DATA:
  ART: 110/60 (axillary)
  PAP: 65/27 (39)   	PCW: 12 (@ 10 min, 18 min, 20 min, 52 min,= best)
  RAP: 8   	CO: 4.35
WAVEFORM PATTERNS:
  Pulmonary hypertension
  Respiratory variation
TECHNICAL COMMENTS:
  PA and CVP on same transducer
  CVP @ 16 min - 19 min
RESPIRATORY DATA:
RATE:   12/20 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh180


PATIENT DATA:
AGE/SEX:
  61 year old female
DIAGNOSIS/SURGERY:
  Abdominal aortic aneurysm resection and grafting
  Aortobifemoral bypass graft
PERTINENT HISTORY:
  Hypertension
  Smoking
PHARMACOLOGIC SUPPORT:
  Dopamine 300 mcg/min then 600 mcg/min, then discontinued
  Neosynephrine @ 20 mcg/min, then 40 mcg /min
GENERAL COMMENTS:
  Extremely agitated
  Motion artifact
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 114 bpm
ECG INTERPRETATION:
  Left atrial enlargement
  ? Left ventricular hypertrophy
TECHNICAL COMMENTS:
  Wandering baseline
  Electrode contact lost near end of recording
HEMODYNAMIC DATA:
  ART: 100/50   	MEAN: 67
  PAP: 30/16   	PCW: 14 (@ 41 min, 46 min, 62 min, 63 min)
  RAP: 12   	CO: 6.5
WAVEFORM PATTERNS:
  Unusual contour changes in CVP
  Off pressors, hypotensive @ 32 min
  Normotensive @ 36 min
  Pulsus paradox
TECHNICAL COMMENTS:
  CVP off for CO @ 32 min
RESPIRATORY DATA:
RATE:   8/24 changed to 6/24 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
COMMENTS:
  Dyscoordinate breathing
[top]  

Record: mgh181


PATIENT DATA:
AGE/SEX:
  72 year old male
DIAGNOSIS/SURGERY:
  Femoropopliteal bypass graft
  Respiratory arrest
PERTINENT HISTORY:
  Coronary disease (CABG)
  Hvpertenslon
  Carotid disease
  Smoking
  Chronic obstructive pulmonary disease
GENERAL COMMENTS:
  Agitated with muscle tremor
  In chair @ 10 min - 16 min
  Moving @ 33 min
  Stop/FFW for chest pt @ 47 min - 48 min
  Least artifact @ 58 min - 60 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with left bundle branch block @ 91 bpm
RHYTHM DISTURBANCES:
  Junctional escape rhythm
  Atrioventricular dissociation
  Unifocal ventricular ectopy with couplet
TECHNICAL COMMENTS:
  Poor quality due to artifact
HEMODYNAMIC DATA:
  ART: 140/50   	MEAN: 74
  PAP: 60/24
  RAP: 14   	CO: 4.8
WAVEFORM PATTERNS:
  Pulmonary hvpertenslon
  Respiratory variation
TECHNICAL COMMENTS:
  Zero @ 12 min - 14 min
RESPIRATORY DATA:
RATE:   6/24 bpm changed to 2/24 bpm changed to spontaneous @ 55 min
MODE OF VENTILATION:
  Intermittent mandatory ventilation changed to spontaneous
CO2 RECORDING:
  On @ 13 min
[top]  

Record: mgh182


PATIENT DATA:
AGE/SEX:
  43 year old female
DIAGNOSIS/SURGERY:
  Crohns disease
  Bacterial endocarditis
  Cerebrovascular accident
  Pneumonia? ARDS
PERTINENT HISTORY:
  Mitral and tricuspid regurgitation secondary to staph endocarditis
PHARMACOLOGIC SUPPORT:
  Dopamine 250 mcg/min, then 450 mcg/min
GENERAL COMMENTS:
  Seizure @ 16 min
  Bed-making @ 50 min - 54 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 101 bpm
ECG INTERPRETATION:
  Minor nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 120/70   	MEAN: 85
  PAP: 30/24   	PCW: 18 (@ 13 min, 39 min, 47 min)
  RAP: 18
WAVEFORM PATTERNS:
  Pulsus paradox
  Respiratory variation
RESPIRATORY DATA:
RATE:   20/20 bpm
MODE OF VENTILATION:
  Controlled
CO2 RECORDING
[top]  

Record: mgh183


PATIENT DATA:
AGE/SEX:
  42 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary artery bypass grafts
  Hypertension
GENERAL COMMENTS:
  Suctioning @ 49 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with first degree A-V block and right bundle branch block @ 65 bpm
ECG INTERPRETATION:
  ST segment and T wave abnormalities secondary to right bundle branch block
HEMODYNAMIC DATA:
  ART: 160/80   	MEAN: 111
  PAP: 22/8   	PCW: 6 (@ 16 min, 26 min, 52 min)
  RAP: 4
RESPIRATORY DATA:
RATE:   4/22 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh184


PATIENT DATA:
AGE/SEX:
  72 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of thoracoabdominal aneurysm
PERTINENT HISTORY:
  Hypertension
PHARMACOLOGIC SUPPORT:
  Dopamine @ 250 mcg/min
  Neosynephrine @ 120 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 85 bpm
RHYTHM DISTURBANCES:
  First degree heart block
TECHNICAL COMMENTS:
  Wandering baseline
HEMODYNAMIC DATA:
  ART: 120/80   	MEAN: 95
  PAP: 36/20   	PCW: 14 (@ 14 min, 28 min, 41 min)
  RAP: 10   	CO: 3.5
WAVEFORM PATTERNS:
  Pulsus paradox
  Respiratory variation
TECHNICAL COMMENTS:
  No final arterial pop-test
RESPIRATORY DATA:
RATE:   6/6 changed to 5/16 bpm
MODE OF VENTILATION:
  Controlled changed to intermittent mandatory ventilation
CO2 RECORDING
COMMENTS:
  Paralyzed left hemidiaphragm
[top]  

Record: mgh185


PATIENT DATA:
AGE/SEX:
  61 year old male
DIAGNOSIS/SURGERY:
  Amputation foot
  Respiratory arrest
PERTINENT HISTORY:
  Hypertension
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ 30 mcg/min
GENERAL COMMENTS:
  Suctioning @ 33 min - 41 min
  Stop/FFW @ 49 min - 50 min and Stop @ 62 min
  Changing bed @ 55 min - 61 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with right bundle branch block @ 78 born
ECG INTERPRETATION:
  Anterior infarct
  Left atrial enlargement
  Left anterior hemiblock
  Increased QT interval
TECHNICAL COMMENTS:
  Movement artifact
HEMODYNAMIC DATA:
  ART: 180/80   	MEAN: 131
  PAP: 52/32   	PCW: 26
  RAP: 13   	CO: 3.6
WAVEFORM PATTERNS:
  Overwedge of PCW @ 67 min
  Pulmonary hvpertenslon
RESPIRATORY DATA:
RATE:   10/15 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh186


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  COPD
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus arrhythmia @ 66 bpm
RHYTHM DISTURBANCES:
  First degree heart block
  Atrial ectopy
ECG INTERPRETATION:
  Left anterior hemiblock
  Old anteroseptal infarct
  Left axis deviation
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  Intermittent electrical interference on ECG cal and Lead III
  Wandering baseline
HEMODYNAMIC DATA:
  ART: 160/80   	MEAN: 108
  PAP: 32/16   	PCW:   16 (@ 41 min, 54 min, 66 min)
  RAP: 10
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   7/20 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh187


PATIENT DATA:
AGE/SEX:
  61 year old male
DIAGNOSIS/SURGERY:
  Thoraco-abdominal SMA bypass graft
PERTINENT HISTORY:
  COPD
GENERAL COMMENTS:
  Patient movement @ 43 min, suctioning @ 59 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with intra-ventricular conduction defect @ 96 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
ECG INTERPRETATION:
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 140/50
  RAP: 8
WAVEFORM PATTERNS:
  Respiratory variation
RESPIRATORY DATA:
RATE:   6/28 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh188


PATIENT DATA:
AGE/SEX:
  74 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of aortic aneurysm
  Insertion of aorto-bifemoral graft
PERTINENT HISTORY:
  Coronary disease
  ?COPD
PHARMACOLOGIC SUPPORT:
  TNG @ 400 mcg/min
  Neosynephrine @ 30 mcg/min
GENERAL COMMENTS:
  Chest physical therapy @ 21 min - 36 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 88 bpm
RHYTHM DISTURBANCES:
  Rare atrial ectopy
  Rare junctional ectopy
  Rare ventricular ectopy
ECG INTERPRETATION:
  Left atrial enlargement
  Non-specific STT wave changes
  Left axis deviation
  Probable old inferior infarct
HEMODYNAMIC DATA:
  ART: 120/70   	MEAN: 83
  PAP: 28/8   	PCW: 12 (@ 10 min, 39 min, 41 min, 62 min)
  RAP: 10   	CO:   6.1
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  Poor CVP frequency response (12.5 - 14 Hz)
  CVP off @ 50 min - 51 min and 53 min
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh189


PATIENT DATA:
AGE/SEX:
    29 year old male
DIAGNOSIS/SURGERY:
    Multiple trauma
    Exploratory laparotomy
    Splenectomy
    Craniotomy
GENERAL COMMENTS:
    Power off to data collection system @ 20 min
    Stop/FFW tape @ 20 min - 21 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
    Sinus tachycardia @ 140 bpm
TECHNICAL COMMENTS:
    Shivering, movement artifact
HEMODYNAMIC DATA:
    ART: 130/80 (pedal)
    RAP: 6   	ICP:3
WAVEFORM PATTERNS:
    Pulsus paradox
    Elevation of arterial pressure during shivering
TECHNICAL COMMENTS:
    ICP on AUX CH10
    CVP tracing not recorded
    Arterial pop-test 18.2 Hz
RESPIRATORY DATA:
RATE:   12/25 bpm
MODE OF VENTILATION:
    Intermittent mandatory ventilation
[top]  

Record: mgh190


PATIENT DATA:
AGE/SEX:
  70 year old male
DIAGNOSIS/SURGERY:
  Aorto-iliac bypass graft
PERTINENT HISTORY:
  Coronary disease
  Smoker
GENERAL COMMENTS:
  Developed hiccoughs @ 46 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with intra-ventricular conduction defect @ 95 bpm
RHYTHM DISTURBANCES:
  Rare ventricular ectopy
ECG INTERPRETATION:
  Old inferior infarct
  Nonspecific ST segment and T wave abnormalities
TECHNICAL COMMENTS:
  ECG discontinued @ 13 min - 14 min
HEMODYNAMIC DATA:
  ART: 140/60   	MEAN: 72
  PAP: 24/8   	PCW: 6 (@ 32 min, 40 min, 55 min)
  RAP: 3   	CO:   3.6
WAVEFORM PATTERNS:
  Respiratory variation
TECHNICAL COMMENTS:
  Poor frequency response CVP
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh191


PATIENT DATA:
AGE/SEX:
  19 year old male
DIAGNOSIS/SURGERY:
  Multiple trauma
  Exploratory laparotomy
GENERAL COMMENTS:
  Stop/FFW @ 59 min - 60 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 128 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
  Unifocal ventricular ectopy
TECHNICAL COMMENTS:
  Wandering baseline
  "V fail" message, electrode changed without result
  RA electrode off @ 50 min
HEMODYNAMIC DATA:
  ART: 120/60   	MEAN: 84
  RAP: 4
WAVEFORM PATTERNS:
  Unusual CVP trace
TECHNICAL COMMENTS:
  Poor CVP frequency response (16.6 Hz)
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh192


PATIENT DATA:
AGE/SEX:
  61 year old female
DIAGNOSIS/SURGERY:
  Sclerotherapy of esophageal varices
PERTINENT HISTORY:
  Smoker
PHARMACOLOGIC SUPPORT:
  Dopamine @ 320 mcg/min
GENERAL COMMENTS:
  Suctioning @ 16 min - 30 min
  Morphine administered @ 38 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 94 bpm
ECG INTERPRETATION:
  Counterclockwise rotation
  Nonspecific ST segment and T wave changes
TECHNICAL COMMENTS:
  ECG baseline displaced early in recording due to electrode movement
HEMODYNAMIC DATA:
  ART: 120/75 to 180/96
  PAP: 45/30 to 61/33   	PCW: 20 (@ 10 min, 33 min, 34 min)
  RAP: 18   	CO: 6.7
WAVEFORM PATTERNS:
  Overwedge tracings @ 10 min and 33 min
  Pulmonary hypertension
TECHNICAL COMMENTS:
  Arterial line set-up sequence precedes PA set-up
RESPIRATORY DATA:
RATE:   14/28 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
[top]  

Record: mgh193


PATIENT DATA:
AGE/SEX:
  62 year old female
DIAGNOSIS/SURGERY:
  Aorto-subclavian/aorto-carotid bypass
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ 26 mcg/min
  Neosynephrine @ 36.7 mcg/min
GENERAL COMMENTS:
  Suctioning and chest PT @ 7 min - 15 min
  Stop/FFW @ 65 min - 66 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 109 bpm
ECG INTERPRETATION:
  ST segment and T wave abnormalities consistent with subendocardial ischemia
  Digitalis effect
TECHNICAL COMMENTS:
  Wandering baseline
HEMODYNAMIC DATA:
  ART: 90/48
  PAP: 35/16   	PCW: 11 (@ 6 min, 17 min, 37 min)
  RAP: 10
TECHNICAL COMMENTS:
  PAP/CVP on same transducer
  Flush CVP @ 32 min
  CVP on @ 33 min - 35 min
RESPIRATORY DATA:
RATE:   12/12 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh194


PATIENT DATA:
AGE/SEX:
  59 year old female
DIAGNOSIS/SURGERY:
  Craniotomy
  Clipping of aneurysm
PERTINENT HISTORY:
  COPD
GENERAL COMMENTS:
  Bed bath and changing bed @ 24 min - 45 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 73 bpm
ECG INTERPRETATION:
  Short PR interval
  Low voltage antero-lateral T waves
TECHNICAL COMMENTS:
  Change LL electrode @ 45 min
  Movement artifact
HEMODYNAMIC DATA:
  ART: 160/70   	MEAN: 98
  PAP: 40/8
  RAP: 4
RESPIRATORY DATA:
RATE:   18 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh195


PATIENT DATA:
AGE/SEX:
  29 year old male
DIAGNOSIS/SURGERY:
  Radial retroperitoneal resection of pheochromocytoma
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 62 corn
RHYTHM DISTURBANCES:
  Atrial ectopy
ECG INTERPRETATION:
  Slight J point elevation
  Consistent with normal early repolarization
HEMODYNAMIC DATA:
  ART: 120/80   	MEAN: 91
  RAP: 9
TECHNICAL COMMENTS:
  CVP motion artifact (dressing change) @ 58 min
  Turning in bed @ 73 min
RESPIRATORY DATA:
RATE:   14 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh196


PATIENT DATA:
AGE/SEX:
  63 year old male
DIAGNOSIS/SURGERY:
  Hepato-renal bypass graft
PERTINENT HISTORY:
  Hypertension
  Coronary disease
  Peripheral vascular disease
PHARMACOLOGIC SUPPORT:
  Nipride @ 60 mcg/min
GENERAL COMMENTS:
  Turning @ 41 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 83 bpm
RHYTHM DISTURBANCES:
  Rare unifocal ventricular ectopy
ECG INTERPRETATION:
  Inferolateral subendocardial injury
HEMODYNAMIC DATA:
  ART: 180/60   	MEAN: 89
  PAP: 60/24   	PCW: 24 (@ 12 min, 14 min, 28 min, 62 min)
  RAP: 10
WAVEFORM PATTERNS:
  Pulmonary hvpertenslon
  V wave
  Overwedge @ 28 min
TECHNICAL COMMENTS:
  Zero @ 24 min - 26 min
RESPIRATORY DATA:
RATE:   16 bpm
MODE OF VENTILATION:
  Spontaneous     
[top]  

Record: mgh197


PATIENT DATA:
AGE/SEX:
  78 year old female
DIAGNOSIS/SURGERY:
  Esophagogastrectomy
PERTINENT HISTORY:
  Coronary disease
  Mitral regurgitation
  Peripheral vascular disease
GENERAL COMMENTS:
  Suctioning @ 50 min
  Out of bed in chair
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 94 bpm
RHYTHM DISTURBANCES:
  Rare atrial ectopy
ECG INTERPRETATION:
  Poor precordial R wave progression, possible old anteroseptanyopoI infarct
  Question of an old inferior infarct
  Minor nonspecific ST segment and T wave changes
TECHNICAL COMMENTS:
  Wandering baseline @ 38 min
HEMODYNAMIC DATA:
  ART: 200/70   	MEAN: 114
  PAP: 40/16   	PCW:   12 (@ 21 min 40 min)
  RAP: 20
WAVEFORM PATTERNS:
  Arterial pulsus paradox
  Changing arterial pressure
  Unusual PCW tracing
RESPIRATORY DATA:
RATE:   8/16 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING:
  On @ 15 min
[top]  

Record: mgh198


PATIENT DATA:
AGE/SEX:
  38 year old female
DIAGNOSIS/SURGERY:
  Thoracotomy
  Decortication
PERTINENT HISTORY:
  Mitral regurgitation
  Aortic regurgitation
  Pulmonary hypertension
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 119 bpm
TECHNICAL COMMENTS:
  Wandering baseline
HEMODYNAMIC DATA:
  ART: 110/60
  PAP: 35/15   	PCW: 12 (@ 9 min, 27 min, 58 min)
  RAP: 13   	CO: 4.8
WAVEFORM PATTERNS:
  Pulsus paradox
  Respiratory variation
TECHNICAL COMMENTS:
  PAP and CVP on same transducer
  CVP on @ 59 min - 62 min
RESPIRATORY DATA:
RATE:   6/24 changed to 4 bpm @ 63 min
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh199


PATIENT DATA:
AGE/SEX:
  68 year Old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
PERTINENT HISTORY:
  Coronary disease
  Smoker
PHARMACOLOGIC SUPPORT:
  TNG @ 100 mcg/min
GENERAL COMMENTS:
  Patient movement for chest X-ray @ 42 min
  Bed change @ 51 min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus bradycardia @ 42 bpm
ECG INTERPRETATION:
  Left atrial enlargement
  Left ventricular hypertrophy
  Nonspecific T wave abnormality
HEMODYNAMIC DATA:
  ART: 200/100   	MEAN: 125
  PAP: 32/16   	PCW:   14
  RAP: 8   	CO:   3.7
WAVEFORM PATTERNS:
  Hypertension
TECHNICAL COMMENTS:
  Arterial set-up precedes PA and CVP
  Zero @ 19 min
RESPIRATORY DATA:
RATE:   8/8 changed to 5/8 bpm @ 15 min
MODE OF VENTILATION:
  Controlled changed to intermittent mandatory ventilation
CO2 RECORDING
[top]  

Record: mgh200


PATIENT DATA:
AGE/SEX:
  64 year old male
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aneurysm
PERTINENT HISTORY:
  Smoker
GENERAL COMMENTS:
  Bed change @ 14 min
  Stop/FFW @ 72 min - 73 min
  Hypothermic @ 94.9F
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm with intraventricular conduction defect @ 71 bpm
RHYTHM DISTURBANCES:
  Rare multifocal ventricular ectopy
HEMODYNAMIC DATA:
  ART: 170/90   	MEAN: 126
  RAP: 8
TECHNICAL COMMENTS:
  Pressures turned off @ 46 min
RESPIRATORY DATA:
RATE:   10/10 bpm
MODE OF VENTILATION:
  Controlled
[top]  

Record: mgh201


PATIENT DATA:
AGE/SEX:
  70 year old male
DIAGNOSIS/SURGERY:
  Abdominal aortic aneurysm resection and grafting
  Aortobifemoral bypass graft
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 92 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
ECG INTERPRETATION:
  sn wave change
  Prolonged QT interval
HEMODYNAMIC DATA:
  ART: 140/78
  PAP: 44/22   	PCW: 15 (@ 5 min, 19 min, 27 min, 47 min)
  RAP: 10
WAVEFORM PATTERNS:
  Pulsus paradox
  Respiratory variation
TECHNICAL COMMENTS:
  PA and CVP on same transducer
  PA turned off and CVP on @ 22 min
  Zero @ 26 min
RESPIRATORY DATA:
RATE:   8/8 changed to 7/16 bpm
MODE OF VENTILATION:
  Controlled changed to IMV
[top]  

Record: mgh202


PATIENT DATA:
AGE/SEX:
  78 year old female
DIAGNOSIS/SURGERY:
  Resection and grafting of abdominal aortic aneurysm
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 74 bpm
ECG INTERPRETATION:
  Small inferior Q waves
  Nonspecific ST segment and T wave abnormalities
HEMODYNAMIC DATA:
  ART: 100/50   	MEAN: 69
  RAP: 3
RESPIRATORY DATA:
RATE:   20 bpm
MODE OF VENTILATION:
  Spontaneous
[top]  

Record: mgh203


PATIENT DATA:
AGE/SEX:
  41 year old female
DIAGNOSIS/SURGERY:
  Aorto-bronchial fistula
PERTINENT HISTORY:
  Marfans disease
  Aspiration
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 100 bpm
ECG INTERPRETATION:
  Nonspecific ST segment and T wave changes, probably postoperative
TECHNICAL COMMENTS:
  "V lead fail" message
HEMODYNAMIC DATA:
  ART: 130/62 (femoral)
  RAP: 15
TECHNICAL COMMENTS:
  Zero @ 17 min
RESPIRATORY DATA:
RATE:   38 bpm
MODE OF VENTILATION:
  Spontaneous
GENERAL COMMENTS:
  CPAP increased from 5 to 10 @ 35 min
[top]  

Record: mgh204


PATIENT DATA:
AGE/SEX:
  27 year old female
DIAGNOSIS:
  Mitral stenosis
PROCEDURE:
  Right heart cath/left heart cath
  (Evaluation for mitral valvulotomy)
ECG DATA:
LEADS:   II
RHYTHM:
  Normal sinus rhythm
RHYTHM CHANGES:
  Atrial ectopy and tachycardia
  Multifocal ventricular ectopy with couplets and 3-beat run of tachycardia
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
4-21 sec	ZERO
1 min	CAL OF 40 TO CH11
1 min	CAL OF 100 CH9
2 min	CAL OF 40 TO CH8
2-3 min	ZERO
3-4 min	STOP/FFW/START
4 min	INSERTION OF PA CATHETER   RA/RV /PA/PCW
6 min	INSERTION OF RADIAL LINE   ART
17 min	INSERTION OF TRANS-SEPTAL CATHETER
25 min	STOP/FFW/START
25 min	RADIAL ON/OFFART
	POSITIONING TRANS-SEPTAL CATHETER
31 min	STOP TAPE/START
34 min	TRANSEPTAL CATHETER IN POSITION
		LEFT A TRIAL TRACE
	ON
35 min
	PCW/LA
39 min	RE-INSERTION OF CATHETER
44 min		RA?LA
	INSERTION RETROGRADE CATHETER
47 min	PA TO PCW TO PA
	PA/PCW/PA
50 min		RADIAL TRACE
	ON/OFF
53 min	ZERO
54 min		LV AND 	PCW: 10 mm
	GRADIENT
57 min	PA PULLBACK   PA
59 min		RADIAL
ON
59 min	LV INJECTION   LV
	ZERO LV
60 min	TRACE ON
61 min	PULLBACK TRANSEPTAL
63 min	END
[top]  

Record: mgh205


PATIENT DATA:
AGE/SEX:
  61 year old male
DIAGNOSIS:
  Coronary artery disease
PROCEDURE:
  Right heart cath/coronary angiography/left heart cath
ECG DATA:
LEADS:
  II, III, V3 (telemetry)
RHYTHM:
  Normal sinus rhythm @ 64 bpm
RHYTHM CHANGES:
  Occasional PVCs (rare episodes of bigeminy, couplets, and multifocal ectopy) Sinus pauses
ECG INTERPRETATION:
  Old inferior wall infarct
  Left ventricular
  Hypertrophy
  STT changes
TECHNICAL COMMENTS:
  ECG changes with position
HEMODYNAMIC DATA:
  ART: 150/40
  PA:   19/7   	PCW: 5
  CVP: 1
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-11 sec	ZERO
1 min	CAL OF 200
1 min	ZERO
1 min	CAL 200
2 min	CAL OF 20
2 min	ZERO
2-3 min	ANNOTATION
3 min	START RECORDING
	INSERT PA CATHETER   RA/RV /PA/PCW
4 min		PCW (PCW=5;CVP= 1)
8 min	RIGHT CORONARY INJECTION
9 min	REPEAT
10 min	STOP/FFW
11 min	LEFT CORONARY INJECTION
13 min	REPEAT     CENTRAL AORTIC TRACE
15 min	REPEAT     BRIEF ASYSTOLIC EPISODE
20 min	REPEAT
22 min	REPEAT
26 min	REPEAT
29 min	LV CATHETER INSERTION   LVEDP = 22
34 min	LV ANGIOGRAM
35 min	CHANGE ATTENUATION   LVEDP = 25
36 min	PULL-BACK LV CATHETER
38 min	STOP/FFW
38 min	FINAL ANNOTATION
40 min	STOP
[top]  

Record: mgh206


PATIENT DATA:
AGE/SEX:
  57 year old male
DIAGNOSIS:
  RCA disease
PROCEDURE:
  post-TPA
ECG DATA:
LEADS:
  I (telemetry), II, III
RHYTHM:
  Normal sinus rhythm @ 60 bpm
ECG INTERPRETATION:
  sn changes consistent with pericarditis
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0   RECORDING ON
3 min	INTRA-AORTIC BALLOON INSERTED
17 min	STOP/FFW
17-18 min	CAL ?200
18 min	ECG CAL
18-19 min	ANNOTATE
[top]  

Record: mgh207


PATIENT DATA:
AGE/SEX:
  63 year old male
DIAGNOSIS:
  Recurrent angina post-coronary artery bypass graft
PROCEDURE:
  Right heart cath/coronary angiography/left heart cath
ECG DATA:
LEADS:
  II, III, V3 (telemetry)
RHYTHM:
  Normal sinus rhythm of 60 bpm
RHYTHM CHANGES:
  Sinus bradycardia
  Ventricular ectopy with couplets and 3-5 beat runs of tachycardia
ECG INTERPRETATION:
  Left atrial enlargement
  Left axis deviation
  Non-specific sn changes
HEMODYNAMIC DATA:
  ART: 118/76
  PA: 26/7   	PCW: 8
  CVP: 6
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
13/16 sec	ZERO/CAL200 PRESSURE CH9
1 min	ZERO/CAL200 PRESSURE CH 11
3 min	ECG CAL
6 min	ECG CAL TELEMETRY
6 min	TAPE ON
6-7 min	STOP/FFW
8 min	TAPE ON
12-14 min	SWAN-GANZ INSERTION   RA/RV /PA/PCW
	RIGHT CORONARY ARTERY INJECTION
18 min	REPEAT
18 min	REPEAT
19 min	REPEAT
21 min	REPEAT
21 min	REPEAT
22 min	REPEAT
22 min	REPEAT
23 min	REPEAT
23 min	REPEAT
	LEFT CORONARY ARTERY INJECTION
26 min	REPEAT
28 min	REPEAT
29 min	REPEAT
32 min	BYPASS GRAFT INJECTION
33 min	REPEAT
	PULLBACK TO AORTA   AO
	REPEAT
37 min	REPEAT
46 min	CHANGE CATHETER
	ATTENUATION CHANGES
47 min		RUN	OF PVCS
	LV CATH ETER INSERTION
	ATTENUATION CHANGES
49 min	LV GRAM   LV
50 min	ATTENUATION CHANGES
50 min	CATHETER PULL-BACK   AO
51 min	CATHETER TO LV   LV
51 min	CATHETER PULL-BACK   AO
53 min	CATHETER TO AO TO LV   AO/LV
	RCA GRAFT
55 min	PT RE-POSITIONED ON PILLOW
57 min	RCA INJECTION
	CO MEASUREMENT
62 min	ADJUST ZERO/CAL
	ARRHYTHMIAS
[top]  

Record: mgh208


PATIENT DATA:
AGE/SEX:
  54 year old male
DIAGNOSIS:
  Refractory ventricular fibrillation
PROCEDURE:
  Coronary angiography/left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, III
RHYTHM:
  Normal sinus rhythm @ 70 bpm .
RHYTHM CHANGES:
  Ventricular ectopy
  Runs of VT/SVT
ECG INTERPRETATION:
  T wave inversion in inferior and anterolateral leads
  Left axis deviation
HEMODYNAMIC DATA:
  ART: 130/70
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-21 sec	ECG CAL
21 sec	TAPE OFF/ON
9 min	VENTRICULAR COUPLET
17 min	ZERO/CAL OF 200
18 min	RIGHT CORONARY INJECTION
19 min	REPEAT
	SIT CHANGES
	COUGHING/VOMITING
22 min	LEFT CORONARY INJECTION
23 min	REPEAT
	SIT CHANGES
29 min	REPEAT
29 min	REPEAT
30 min	RE-ADJUST PILLOW
32 min	REPEAT
37 min	LV CATHETER IN   LVEDP = 9
39 min	LV GRAM
	ATTENUATION CHANGE
40 min		LV TO AO
[top]  

Record: mgh209


PATIENT DATA:
AGE/SEX:
  62 year old male
DIAGNOSIS:
  Coronary artery disease
PROCEDURE:
  Right heart cath/coronary angiography/left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, III
RHYTHM:
  Normal sinus rhythm @ 67 bpm
RHYTHM CHANGES:
  Sinus bradycardia
  Atrial ectopy, run of atrial tachycardia
  Junctional ectopy
  Episode of asystole followed by A pacing
ECG INTERPRETATION:
  Poor R wave progression with inferior T wave inversion and peaking? posterior ischemia
TECHNICAL COMMENTS:
  Terrible ECG quality
HEMODYNAMIC DATA:
  ART: 118/49 (69)
  PA: 29/12   	PCW: 9
  CVP: 4
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
0-14 sec	ECG CAL
14-17 sec	ECG CAL TELEMETRY
17-24 sec	REPEAT CAL
24 sec	TAPE OFF/ON
4 min	INSERTION SWAN-GANZ (CH11)   RA/RV /PA/PCW -ART
	OFF(CH10)
6 min		AO/RADIAL ARTERIAL
8 min		TEST A PACE CAPTURE
9 min	RIGHT CORONARY ARTERY INJECTION
		AO TO RCA
10 min	REPEAT
10 min	REPEAT
11 min	REPEAT     ASYSTOLE TO A PACE
15 min	REPEAT
17 min	LEFT CORONARY ARTERY INFECTION
18 min	REPEAT
19 min	REPEAT
19 min	REPEAT
20 min	RE-ADJUST PILLOW
22 min	REPEAT
22 min	REPEAT
23 min	INSERT LV CATHETER   LV
	CHANGE ATTENUATION
26 min	LV GRAM
27 min	PULL-BACK
[top]  

Record: mgh210


PATIENT DATA:
AGE/SEX:
  32 year old male
DIAGNOSIS:
  Congenital heart disease (corrected Tetralogy of Fallot)
  Coronary heart disease
PROCEDURE:
  Right heart cath/left heart cath/coronary angiography
ECG DATA:
LEADS:   I (telemetry), II, III
RHYTHM:
  Ventricular pacing
PACEMAKER INFORMATION:
  Permanent WI pacer
RHYTHM CHANGES:
  Multifocal ventricular ectopy with couplets and runs of tachycardia
ECG INTERPRETATION:
  Probable ventricular atrial conduction
HEMODYNAMIC DATA:
  ART: 100/70
  PA: 40/20 (30)   	PCW: 26
  CVP: 30
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
0-18 sec	CAL TO ECG AND TELEMETRY
18-27 sec
	STOP/FFW
1 min	ATTACH CATHETER CH8
1 min	ATTACH CATHETER CH9
6 min	CAL OF 200 CH9
6 min	CAL OF 200 CH8
6 min	ZERO
9 min	PA INSERTION     RA/RV /PA/PCW
12 min	CATHETER IN PA OUTFLOW TRACT
17 min	ZERO
		RA TRACE
		RV/PA TRACE
30 min	PA CATHETER OUT
34 min	RE-ZERO CH9
34 min	CATHETER TO DESCENDING AORTA
	AO(CH9)
35 min	RE-ZERO CH8
35 min	CATHETER TO FEMORAL ARTERY
	ART(CH8)
36 min
	LV/FEMORAL
43 min	RE-ZERO CH8
44 min	POSITION IN RV     RV
	INSERT RIGHT HEART CATHETER
	RE-ZERO
44 min		LV/RV
46 min		PA
46 min		LV
49 min	PULLBACK PA TO RV   PA/RV
49 min	PULLBACK RV TO RA   RV/RA
54 min		PCW (CH 8)
55 min		PCW
59 min	RE-ZERO CH 8
59 min	PULLBACK
77 min	TEST DOSE
78 min	RV GRAM   RV
[top]  

Record: mgh211


PATIENT DATA:
AGE/SEX:
  3 year old female
DIAGNOSIS:
  post VSD repair
PROCEDURE:
  Pediatric right heart cath
ECG DATA:
LEADS:
  I (telemetry), II, V5
RHYTHM:
  Normal sinus rhythm
RHYTHM CHANGES:
  Wenckebach
ECG INTERPRETATION:
  Incomplete right bundle branch block with left
  Anterior hemiblock
  Biventricular hypertrophy
TECHNICAL COMMENTS:
  V5 on CH 5
  V lead gain shifting
HEMODYNAMIC DATA:
  CVP: 8
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-6 sec	ECG CAL
9/10 sec	ZERO/CAL 200 CH8
1 min	ZERO/CAL 200 CH9
2 min	ZERO/CAL 200 CH 11
2 min	TAPE OFF/ON
	WENCKEBACH
	(atropine.1 X2)
7 min	ECG TELEMETRY CAL
14 min
	CHANGE IN EKG
14 min	ECG CAL
19 min	ZERO/CAL
20 min	RA   RA
20 min	RV   RV
	0-40 SCALE
20 min	0-100 SCALE
22 min
	CHANGE IN EKG
22 min	RIGHT PA   PA
	0-40 SCALE
22 min	MEAN PA
23 min	MAIN PA
	0-40 SCALE MEAN
25 min	PULLBACK PA/RV
	0-40 SCALE
26 min	RV   RV
	0-40 SCALE
33 min	STOP
[top]  

Record: mgh212


PATIENT DATA:
AGE/SEX:
  6 month old male
DIAGNOSIS:
  Evaluation for mitral stenosis
PROCEDURE:
  Left heart cath/right heart cath
ECG DATA:
LEADS:
  I (telemetry), II, V2
RHYTHM:
  Sinus tachycardia
RHYTHM CHANGES:
  Atrial ectopy and tachycardia, occasional aberrant conduction
  Junctional rhythm
  Multifocal ventricular ectopy, bigeminy, and run of ventricular tachycardia
  Second degree heart block
HEMODYNAMIC DATA:
  ART: 105/
  LA: 20   LVEDP: 5-7
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
0-6 sec	ECG CAL
6-11 sec	ECG CAL TELEMETRY
1 min	STOP /FFW ION
3 min	LEFT ATRIUM     LA
3 min	ZERO
3 min	CAL OF ?200
3 min	LEFT ATRIUM 0-40   A WAVE TO 35
	MEAN LA
	LA/VENTRICULAR
		IRRITABILITY
	LEFT ATRIUM/LEFT VENTRICLE   LA/LV
6 min	ZERO
	CAL
8 min	LEFT VENTRICLE
	100 SCALE
8 min	200 SCALE
8 min	LEFT VENTRICLE/FEMORAL ARTERY   LV/FA
	200 SCALE
9 min	AORTA SCALE 200   AO
	MEAN AORTA
9 min	ZERO
10 min	LEFT ATRIUM     LA
	MEAN LA
	PULL-BACK TO RIGHT ATRIUM   RA
	RA PHASIC
	RIGHT VENTRICLE   RV
	SCALE 40
11 min	SCALE 100
	PULMONARY CAPILLARY WEDGE   PCW
11 min	SCALE 40
11 min	MEAN PCW
	PULMONARY ARTERY   PA
12 min	SCALE 100
12 min	MEAN PA
12 min	MEAN PA SCALE 40
12 min	PHASIC PA
13 min	PULMONARY ARTERY TO RIGHT VENTRICLE   PA/RV
	SCALE 100
14 min	RIGHT VENTRICLE OUT
15 min	LEFT ATRIUM   LA
	SCALE 40
29 min	LEFT VENTRICULAR ANGIOGRAM   LV
35 min		VENTRICULAR ECTOPY
36 min	PULMONARY ARTERY   PA
	SCALE 100
40 min	PULMONARY ARTERY INJECTION
45 min		HEART BLOCK
48 min	LEFT ATRIUM   LA
51 min	LA GRAM
54 min		HEART BLOCK
56 min	LEFT SUPERIOR VENA CAVA
56 min	LEFT ATRIUM   LA
56 min		HEART BLOCK
57 min	LEFT VENTRICLE   LV
	SCALE 40
57 min	JUNCTIONAL RHYTHM
58 min	PULL-BACK
		NORMAL SINUS
		RHYTHM
[top]  

Record: mgh213


PATIENT DATA:
AGE/SEX:
  59 year old male
DIAGNOSIS:
  Unstable angina
PROCEDURE:
  Right heart cath/coronary angiography/left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, III
RHYTHM:
  Normal sinus rhythm
RHYTHM CHANGES:
  Atrial ectopy with normal and blocked conduction
  Atrial and ventricular Couplets
  Atrial pacing
ECG INTERPRETATION:
  Indeterminant axis
HEMODYNAMIC DATA: (pre-cath)
  ART: (100)
  PCW: 5
  CVP: 2
  CO: 7.58, 6.74
PROCEDURAL EVENTS:
	RHYTHM/PRESSURE CHANGES:
	SET-UP
0-14 sec	ECG CAL
14 min	ZERO
	INSERTION OF PA CATHETER
14 min	RIGHT ATRIUM   RA
14 min	RIGHT VENTRICLE   RV
14 min	PULMONARY ARTERY   PA
14 min	PULMONARY CAPILLARY WEDGE   PCW
	CHANGE SCALE
15 min	ECG CAL
16 min	AORTA   A
21 min	ATRIAL PACING   A
	PACE
23 min	RIGHT CORONARY INJECTION
25 min	REPEAT
28 min	LEFT CORONARY INJECTION
28 min	REPEAT
29 min	REPEAT
30 min	REPEAT
	PT SITS UP
33 min	REPEAT
34 min	REPEAT
38 min	ZERO
38 min	CAL OF 200
38 min	LV CATH ETER INSERTION   LV/CHEST PAIN
	CHANGE SCALE X2
43 min	LV ANGIOGRAM
46 min	REPEAT
47 min	LV PRESSURE
48 min	PULLBACK   LV/AO
[top]  

Record: mgh214


PATIENT DATA:
AGE/SEX:
  17 year old female
DIAGNOSIS:
  Mitral regurgitation
  Atrial septal defect
  Ventricular septal defect
PROCEDURE:
  Right heart cath/left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, V?
RHYTHM:
  Normal sinus rhythm with right bundle branch block
RHYTHM CHANGES:
  Atrial and ventricular ectopy with couplet, run of ventricular tachycardia
ECG INTERPRETATION:
  Left axis deviation
  Probable left ventricular hypertrophy
TECHNICAL COMMENTS:
  V lead on CH5
HEMODYNAMIC DATA:
  PA: 40/20   	PCW: 18
  CVP: 12
  CO: 5.9
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
0-8 sec	ECG CAL
8 sec	TELEMETRY CAL
12-16 sec	ECG CAL
16-26	STOP /FFW ION
6 min-8 Z	ZERO/CAL OF 200
7 min	INSERT PA CATHETER
	RA APPENDAGE   RA
13 min	RIGHT VENTRICLE   RV
	PULMONARY ARTERY   PA
	PULMONARY CAPILLARY WEDGE   PCW
	RE-ZERO
13 min	CAL
14 min	PULMONARY CAPILLARY WEDGE
	SCALE 40
14 min	MEAN PCW
14 min	PULLBACK
	PULMONARY ARTERY   PA
14 min	MEAN PA
15 min	RIGHT VENTRICLE   RV
	VENTRICULAR   ECTOPY
17 min	ZERO/CAL
18 min	RIGHT ATRIUM   RA
	SCALE 40
18 min	MID RIGHT ATRIUM
19 min	RIGHT ATRIUM
26 min	LEFT VENTRICLE	LV	CD
	SCALE 200
27 min	SCALE 40
27 min	SCALE 200
38 min	ELECTRODE OFF
40 min	LEFT VENTRICULOGRAM
40 min	LEFT VENTRICLE   LV
44 min	RE-ZERO/CAL
44 min	LEFT VENTRICLE TO AORTA   LV/AO
44 min	END
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Record: mgh215


PATIENT DATA:
AGE/SEX:
  54 year old male
DIAGNOSIS:
  Mitral stenosis
  Mitral regurgitation
PROCEDURE:
  Right heart cath/left heart cath/coronary angiography
ECG DATA:
LEADS:
  I (telemetry), II, III
RHYTHM:
  Normal sinus rhythm
RHYTHM CHANGES:
  Atrial ectopy with couplet, occasional aberrant conduction
  Multifocal ventricular ectopy with bigeminy, couplet, run of ventricular tachycardia
ECG INTERPRETATION:
  Left atrial enlargement
  Intra-ventricular conduction defect
  Non-specific SIT wave changes
TECHNICAL COMMENTS:
  EKG off @ 26 min on mgh048
HEMODYNAMIC DATA:
  PCW: 26
  CVP: 0
  CO: 5.61/4.15/5.69
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-7 sec	ECG CAL
7-18 sec	TELEMETRY CAL
20 sec	TAPE OFF/ON
5 min	LEAD III ON
18 min	ZERO/CAL
19 min	FEMORAL ARTERY ON   ART
	INSERT PA CATHETER
24 min	RIGHT ATRIUM   RA
25 min	ZERO/CAL
	RE-LEVEL
26 min	ZERO
26 min	RIGHT ATRIUM
	RIGHT VENTRICLE   RV
26 min	SCALE 40
26 min	SCALE 100
27 min	PULMONARY ARTERY   PA
	PULMONARY CAPILLARY WEDGE   PCW
27 min	SCALE 40
27 min	MEAN PCW
	SCALE 100
29 min	FEMORAL ARTERY/MEAN PA   ART/PA
	SCALE 200/100
34 min	ZERO/CAL_S
35 min	ZERO/CAL
36 min	SIMULTANEOUS ART TRACES ART 1124-33   RE-CAL CH10
	CATHETER TIP PRESSURE
40 min	RE-ZERO/CAL
40 min	SIMULTANEOUS TRACES
41 min		VENTRICULAR IRRITABILITY
42 min	CATHETER TO LV   LV
		VENTRICULAR IRRITABILITY
	LV END-DIASTOLIC PRESSURE
43 min	SCALE 40
43 min	PULMONARY ARTERY/LV   PA/LV
	SCALE 40
	SCALE 100   	PCW: 40; LVEDP: 8
	ZERO CH8 & 9
47 min	CAL CH9
47 min	ZERO CH10
48 min	RE-ZERO
	PCW/LV
	PCW/LV
	SCALE 40
	MEAN
	SCALE 100
	MEAN
49 min	PCW     PCW
49 min	PA TO MEAN PA TO PA   PA
54 min	LV/AO
	SCALE 200
54 min	PULLBACK
	INSERT CORONARY CATHETERS
60 min	MEAN PA
	SCALE 100
	SCALE 40
	SCALE 100
60 min	RE-ZERO/CAL
64 min	LEFT VENTRICLE   LV/VENTRICULAR ECTOPY
65 min	RIGHT CORONARY
66 min	LEFT CORONARY
67 min	REPEAT X2
	RE-POSITION PT
69 min	REPEAT
73 min	ZERO   CAL
	PC     PCW
74 min	SCALE 40
	MEAN PCW
[top]  

Record: mgh216


PATIENT DATA:
AGE/SEX:
  14 year old male
DIAGNOSIS:
  Mitral regurgitation secondary to endocarditis
PROCEDURE:
  Right heart cath/left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, III/V? (telemetry)
RHYTHM:
  Normal sinus rhythm
RHYTHM CHANGES:
  Atrial ectopy with occasional aberrant conduction
  Multifocal ventricular ectopy with bigeminy, couplets, runs of ventricular tachycardia
TECHNICAL COMMENTS:
  V lead on CH5
HEMODYNAMIC DATA:
  CO: 9.2
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-10 sec	ECG CAL
10-17 sec	FFW /STOP ION
	INSERT PA CATHETER
4 min	CHANGE III TO VLEAD
5 min	RIGHT ATRIUM   RA
6 min	RIGHT VENTRICLE   RV
7 min	PA MEAN   PA
	SCALE 40
7 min	PCW   PCW
	SCALE 40
8 min	PULLBACK PA   PA
9 min	LV ON   LV
	SCALE 200
9 min	SCALE 40
9 min	PCW/LV
	PCW/LV
10 min	MEAN PA/LV   PA/LV
	SCALE 100
18 min	LV ANGIO
22 min	AORTA   AO
23 min	MEAN AORTA
26 min	AORTOGRAM
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Record: mgh217


PATIENT DATA:
AGE/SEX:
  1 year old male
DIAGNOSIS:
  Congenital heart disease
PROCEDURE:
  Right heart cath/left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, III
RHYTHM:
  Sinus tachycardia
RHYTHM CHANGES:
  Atrial ectopy with normal and blocked conduction
  Atrial tachycardia
  Multifocal ventricular ectopy and tachycardia
ECG INTERPRETATION:
  Right ventricular hypertrophy
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-15 sec	ECG CAL
15-20 sec	STOP /FFW ION
20-25 sec	ZERO/CAL OF 200
1 min	STOP /FFW ION
	INSERT CATHETER
5 min	RIGHT ATRIUM   RA
	ZERO/CAL
6 min	RIGHT ATRIUM
9 min	RIGHT VENTRICLE   RV
10 min	ZERO
10 min	RIGHT VENTRICLE
	SCALE 40
10 min	SCALE 100
10 min	RIGHT ATRIUM   RA
10 min	SCALE 40
11 min	MEAN RIGHT ATRIUM
11 min	RIGHT VENTRICLE   RV
11 min	SCALE 100
	RIGHT PULMONARY ARTERY   PA
11 min	SCALE 40
11 min	MEAN PA
12 min	MAIN PULMONARY ARTERY
12 min	LEFT PULMONARY ARTERY
13 min	SCALE 100
	PULLBACK:PA-RV-RA   PA/RV/RA
	VENTRICULAR IRRITABILITY
14 min	PULMONARY VEIN   PV
15 min	LEFT ATRIUM   LA
	SCALE 100
15 min	SCALE 40
15 min	MEAN LA
	LEFT VENTRICLE   LV
16 min	SCALE 40
16 min	SCALE 100 VENTRICULAR IRRITABILITY
18 min	VENTRICULAR IRRITABILITY
	CONDUCTION CHANGES
19 min	ASCENDING AORTA   AO
	SCALE 100
	MEAN AO
27 min	AORTOGRAM
31 min	LV ANGIOGRAM
32 min	LV   DAMPED TRACING
32 min	LV   LV
33 min	ZERO/CAL
	LV
34 min	SCALE 100
34 min	SCALE 40
34 min	LEFT ATRIUM   LA
	MEAN LA
34 min	MEAN RA   RA
34 min	RA PHASIC
34 min	RIGHT VENTRICLE   RV
41 min	LV ANGIOGRAM   LV
43 min	VENA CAVA ANGIOGRAM
44 min	RIGHT ATRIUM   RA
46 min	END
[top]  

Record: mgh218


PATIENT DATA:
AGE/SEX:
  5 year old male
DIAGNOSIS:
  Tetralogy of Fallot
PROCEDURE:
  Right heart cath/left heart cath
ECG DATA:
LEADS:
  I (telemetry), AVL, III
RHYTHM:
  Normal sinus rhythm
ECG INTERPRETATION:
  Right axis deviation
  Right ventricular hypertrophy
TECHNICAL COMMENTS:
  Artifact
  No cal signal
  Telemetry intermittent
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
1 min	RECORDING
1 min	ZERO/CAL
3 min	SUPERIOR VENA CAVA ANGIOGRAM
6 min	RIGHT VENTRICLE   RV
	SCALE 40
7 min	SCALE 100
8 min	AORTA   AO
8 min	RIGHT VENTRICLE TO AORTA   RV/AO
8 min	AORTA   AO
	MEAN AO
	SCALE 100
8 min	SCALE 200
10 min	SCALE 200
10 min	RIGHT VENTRICLE   RV
	RIGHT PULMONARY ARTERY   PA
	SCALE 100
10 min	SCALE 40
11 min	LEFT PULMONARY ARTERY
12 min	SCALE 100
12 min	PULLBACK TO INFUNDIBULUM   RV
12 min	SCALE 40
12 min	RIGHT ATRIUM   RA
	50 cc BOLUS
19 min	PULMONARY VEIN   PV
v
19 min	MEAN PV
	LEFT ATRIUM   LA
20 min	MEAN LA
	LEFT VENTRICLE   LV
	SCALE 40
20 min	SCALE 100
20 min	SCALE 200
	AORTA   AO
21 min	SCALE 200
	AORTA TO LV AND BACK
	AO/LV/AO
21 min	ASCENDING AORTA
22 min	MEAN AO
27 min	TELEMETRY ON
28 min	AORTOGRAM
29 min	LV ANGIOGRAM
31 min	ZERO/CAL
32 min	LV   LV
	SCALE 40
	SCALE 100
32 min	LV TO LA   LV/LA
32 min	LA TO RA (patent foramen)   LA/RA
40 min	RV ANGIOGRAM
41 min	RV TO RA   RV/RA
41 min	END
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Record: mgh219


PATIENT DATA:
AGE/SEX:
  1 year old male
DIAGNOSIS:
  Congenital heart disease
PROCEDURE:
  Right heart cath/left heart cath
ECG DATA:
LEADS:
  I (telemetry), V?, III
RHYTHM:
  Sinus tachycardia
RHYTHM CHANGES:
  Ventricular ectopy
  Heart block
ECG INTERPRETATION:
  Right axis deviation
  Prominent R wave in leads VI-3 ,consistent with age
  Normal early repolarization
TECHNICAL COMMENTS:
  Artifact
  V lead on CH4
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
1 min	ECG CAL
1 min	FFW/STOP
	INSERTION OF CATHETER
6 min	RIGHT ATRIUM   RA
7 min	MEAN RA
10 min	LEFT VENTRICLE   LV
	SCALE 40
11 min	SCALE 100
11 min	PULMONARY ARTERY   PA
	SCALE 100
11 min	MEAN PA
12 min	RIGHT PULMONARY ARTERY
13 min	LEFT PULMONARY ARTERY
13 min	PULLBACK TO RV   RV
13 min	RIGHT VENTRICULAR BODY
13 min	RIGHT ATRIUM   RA
14 min	LEFT ATRIUM   LA
14 min	SCALE 40
14 min	LEFT VENTRICLE   LV
	SCALE 40
14 min	SCALE 100
15 min	SCALE 40
15 min	SCALE 100
15 min	SCALE 200
		VENTRICULAR IRRITABILITY
17 min	LEFT VENTRICLE   LV
18 min	SCALE 40
18 min	SCALE 100
21 min		IRRITABLE; OCCASIONAL
		BLOCK
21 min	AORTA   AO
	MEAN AO SCALE 100
26 min	AORTOGRAM
31 min	LV GRAM
33 min	ZERO/CAL
	PULLBACK
33 min	LEFT ATRIUM   LA
	SCALE 40
34 min	PULMONARY VEIN   PV
34 min	MEAN PV
37 min		BLOCK
38 min	LEFT ATRIUM   LA
	MEAN LA
38 min	MEAN RA   RA
40 min	END
[top]  

Record: mgh220


PATIENT DATA:
AGE/SEX:
  4 month old male
DIAGNOSIS:
  Congenital heart disease
PROCEDURE:
  Right heart cath/left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, III/V4
RHYTHM:
  Sinus tachycardia
RHYTHM CHANGES:
  Atrial ectopy with occasional blocked conduction
  Multifocal ventricular ectopy with couplets and runs of tachycardia
ECG INTERPRETATION:
  Abnormal right axis deviation
  RSR or QR pattern in V1 suggests right ventricular conduction delay
  Marked ST Abnormality
  Possible Inferior Subendocardial Injury
TECHNICAL COMMENTS:
  CH5 changed from Lead III to V4 (225) to III
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-7 sec	ECG CAL
7-19 sec	TELEMETRY CAL
19 sec	OFF/ON
1 min	ZERO/CAL CH8
3 min	RE-ZERO
3 min	RIGHT ATRIUM   RA MEAN = 8
	SCALE 40
		SLIGHT BLOCK
		IRRITABILITY
	RIGHT VENTRICLE   RV
5 min	SCALE 40
5 min	SCALE 100
5 min	SCALE 200
	IRRITABILITY
7 min	LEAD III TO V4
7 min	LEAD V4 TO III
8 min	PULMONARY ARTERY   PA
	SCALE 200
8 min	SCALE 100
11 min	PT CRYING
	SCALE 200
18 min	PA ANGIOGRAM
	PULMONARY ARTERY
19 min	RIGHT VENTRICLE   RV
20 min	LEFT ATRIUM   LA
20 min	SCALE 40
	IRRITABILITY/BLOCK
21 min	LEFT VENTRICLE   LV
	SCALE 40
	SCALE 100
21 min	SCALE 200
21 min	SCALE 100
29 min	LV ANGIOGRAM
30 min	RE-ZERO
	SCALE 100
	SCALE 40
	PULLBACK
30 min	LEFT ATRIUM   LA
31 min	RIGHT ATRIAL MEAN   RA
31 min	RIGHT ATRIUM
[top]  

Record: mgh221


PATIENT DATA:
AGE/SEX:
  1 year old female
DIAGNOSIS:
  Congenital heart disease
PROCEDURE:
  Right heart cath/left heart cath
ECG DATA:
LEADS:
  I (telemetry), AVF, III
RHYTHM:
  Sinus tachycardia
RHYTHM CHANGES:
  Atrial ectopy
  Multifocal ventricular ectopy with bigeminy, couplets with runs of
  Tachycardia
TECHNICAL COMMENTS:
  AVF on CH4
  No ECG cal
HEMODYNAMIC DATA:
TECHNICAL COMMENTS:
  No zero/cal data
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
	INSERTION OF CATHETER
16 sec	MID-RIGHT ATRIUM     RA
1 min	RIGHT VENTRICLE   ,   RV
1 min	PA: DISTAL TO PA BAND     PA
	SCALE 100
2 min	SCALE 40
2 min	SCALE 100
2 min	SCALE 40
	SCALE 100
4 min	MAIN PA
	PULLBACK TO OUTFLOW
	MAIN PA TO LEFT PA
6 min	LEFT PA PULLBACK
6 min	MAIN
6 min	OUTFLOW
7 min	RV OUTFLOW     RV
7 min	RV APEX
8 min	COUPLET
14 min	RV GRAM
17 min	LA     LA
	SCALE 40
18 min	LA
19 min	LV     LV
	SCALE 40
19 min	SCALE 100
19 min	SCALE 20
22 min	LV TO LA TO LV     LV/LA/LV
	LV GRAM
27 min	LV TO LA     LV/LA
31 min	LA TO RA     LA/RA
33 min	END
[top]  

Record: mgh222


PATIENT DATA:
AGE/SEX:
  5 month old female
DIAGNOSIS:
  TGA/PS/ASD
PROCEDURE:
  Right heart cath/left heart cath
TECHNICAL COMMENTS:
  Data erased accidentally
[top]  

Record: mgh223


PATIENT DATA:
AGE/SEX:
  49 year old male
DIAGNOSIS:
  Post cardiac transplantation
PROCEDURE:
  RV Bbopsy
ECG DATA:
LEADS:
  I (telemetry), III, V2
RHYTHM:
  Normal sinus rhythm
RHYTHM CHANGES:
  Multifocal ventricular ectopy with couplets and runs of tachycardia
HEMODYNAMIC DATA:
  CO: 7.1, 6.4
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
20 min	ECG CAL
23 min		RUN OF VENTRICULAR
	ECTOPY
		PVCS
	RV BIOPSY
35 min	ZERO/CAL
	INSERTION OF PA CATHETER
36 min	RIGHT ATRIUM   RA
37 min	RIGHT VENTRICLE   RV
38 min	PULMONARY CAPILLARY WEDGE   PCW
		++"CATHETER FLING"
43 min	END
[top]  

Record: mgh224


PATIENT DATA:
  Documentation incomplete
DIAGNOSIS:
  ? Aortic regurgitation
PROCEDURE:
  Cardiac catheterization
ECG DATA:
LEADS:
  I (telemetry), A VF, II
RHYTHM CHANGES:
  Normal sinus rhythm with first degree heart block and intraventricular conduction defect
  Complete heart block
  Ventricular pacing
DOCUMENTATION INCOMPLETE
[top]  

Record: mgh225


PATIENT DATA:
AGE/SEX:
  10 month male
DIAGNOSIS:
  A-V Canal
  ?Hypoplastic left ventricle
PROCEDURE:
  Right heart cath/left heart cath
ECG DATA:
LEADS:
  I (telemetry), III, V4
DOCUMENTATION INCOMPLETE
[top]  

Record: mgh226


PATIENT DATA:
AGE/SEX:
  71 year old male
DIAGNOSIS/SURGERY:
  Thoracic aneurysm
  Pancreatic abscess
  Sepsis
  Respiratory insufficiency
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Normal sinus rhythm @ 92 bpm
RHYTHM DISTURBANCES:
  Occasional unifocal ventricular ectopy
ECG INTERPRETATION:
  Non-specific ST segment and T abnormalities
HEMODYNAMIC DATA:
  ART: 105/50
  PAP: 33/20   	PCW: 13 (@ 13 min, 17 min, 42 min, 63 min, 66 min)
  RAP: 13   	CO: 11.2 (AM); 9.15 (PM)
WAVEFORM PATTERNS:
  Unusual arterial tracing post-obliteration with cuff pressure
  Pulsus paradox
TECHNICAL COMMENTS:
  CVP and PAP on single transducer
  Poor CVP tracing quality @ 25 min - 35 min
  CVP tracing repeated @ 37 min - 40 min
RESPIRATORY DATA:
RATE:   8/28 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation   
[top]  

Record: mgh227


PATIENT DATA:
AGE/SEX:
  76 year old male
DIAGNOSIS/SURGERY:
  Sub-total gastrectomy/duodenostomy
PERTINENT HISTORY:
  Smoking
PHARMACOLOGIC SUPPORT:
  Levophed @ 40 mcg/min
  Dopamine @ 187 mcg/min
ELECTROCARDIOGRAPHIC DATA:
UNDERLYING RHYTHM:
  Sinus tachycardia @ 119 bpm
RHYTHM DISTURBANCES:
  Atrial ectopy
ECG INTERPRETATION:
  Non-specific SIT wave changes
HEMODYNAMIC DATA:
  ART: 80/40   	MEAN: 55
  PAP: 36/26   	PCW: 12 (@ 9 min, 30 min, 62 min, 63 min)
  RAP: 8
WAVEFORM PATTERNS:
  Hypotension
  Pulsus paradox
  Giant A wave in CVP trace
  Respiratory variation
RESPIRATORY DATA:
RATE:   8/28 bpm
MODE OF VENTILATION:
  Intermittent mandatory ventilation
CO2 RECORDING     
[top]  

Record: mgh228


PATIENT DATA:
AGE/SEX:
  63 year old male
DIAGNOSIS:
  Coronary artery disease
PROCEDURE:
  Coronary artery bypass graft
ECG DATA:
LEADS:
  II, V5 or V6
RHYTHM:
  Normal sinus rhythm with incomplete left bundle branch block
RHYTHM CHANGES: (mgh228 and mgh040)
  Sinus bradycardia
  Atrial ectopy, tachycardia, flutter, fibrillation
  Junctional rhythm
  Occasional aberrant conduction
  Ventricular escape beats
  Multifocal ventricular ectopy with couplets, runs of tachycardia
  Ventricular fibrillation
  Idioventricular rhythm
TECHNICAL COMMENTS:
  Electrocautery interference
  V lead off momentarily
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
1 min	ZERO/CAL
	INSERTION OF PA CATHETER   RA/RV /PA/PCW
15 min	INDUCTION OF ANESTHESIA   HYPOTENSION
		PRESSURE FLUCTUATION
	NEOSYNEPHRINE ADMINISTERED
		ARRHYTHMIAS
21 min	INTUBATION
23 min	DRAPE/PREP
46 min	INCISIONS
	ELECTROCAUTERY
51 min	STERNOTOMY     
[top]  

Record: mgh229


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	BYPASS
	OFF BYPASS     
[top]  

Record: mgh230


PATIENT DATA:
AGE/SEX:
  43 year old female
DIAGNOSIS:
  Mitral stenosis
PROCEDURE:
  Mitral valvulotomy
ECG DATA:
RHYTHM:
  Sinus tachycardia
TECHNICAL COMMENTS:
  ECG data on DR CH2 by mistake therefore data lost
HEMODYNAMIC DATA:
  ART: 140/70
  CO:   5.3, 4.4
PROCEDURAL EVENTS:       RHYTHM/PRESSURE CHANGES:
	SET-UP
2 min	ZERO/CAL
	CAL OF 200 CH8/CH10
	CAL OF 20 CH9/CH11
2 min	ZERO ALL CHANNELS
3 min	ZERO
3-6 min	INSERTION OF LA CATHETER
6-7 min	STOP/FFW/START
7-8 min	LEFT ATRIUM     LA=45
8 min	CAL OF 200 CH9
9 min	CAL OF 20 CH8
10 min	PULMONARY ARTERY   PA
	PHASIC
10 min	LEFT ATRIUM     LA
	PHASIC
39 min	ZERO CH10
40 min	LEFT VENTRICLE     LV
		VENTRICULAR ECTOPY; RUNS OF VT
	PASSING WIRE
50 min	ILIAC
50 min	STOP/FFW/START
53 min	STOP/FFW/START
53 min	INSERTING DILATING CATHETER (25mm)
56 min	DILATE
57 min	DILATE
		PCW MEAN
		PCW REDUCED
59 min	DILATE
62 min	DILATE
62-63 min	STOP/FFW/START
	WITHDRAW/EXCHANGE CATHETER (15mm)
63 min	DILATIONS X2
63 min	DILATE
63 min	DILATE
64 min	DILATE
64 min	DILATE
65 min	DILATE         
66 min	DILATE
66 min	DILATE
66 min	DILATE
67 min		PCW
67 min	STOP/FFW/START
	WITHDRAW/EXCHANGE CATHETER
67 min	DILATE
68 min	DILATE
69 min	DILATE
69 min	DILATE
69 min	DILATE
70 min	DILATE
70 min	DILATE
71 min	DILATE
71 min	STOP/FFW/START
	WITHDRAW/EXCHANGE CATHETER
71 min	DUAL BALLOON DILATION
72 min	DILATE
73 min	DILATE
73 min	DILATE
74 min	DILATE
74 min	STOP/FFW/START
74 min	CATHETER OUT   PAP 2265 LEFT ATRIAL CATHETER IN
75 min	LEFT ATRIUM   LA 2312 LA/LV
78 min		PA/PCW
79 min	RIGHT ATRIUM   RA
	(CONTINUED ON mgh235)     
[top]  

Record: mgh231


PATIENT DATA:
AGE/SEX:
  73 year old female
DIAGNOSIS:
  Unstable angina
PROCEDURE:
  Coronary artery bypass graft
ECG DATA:
LEADS:
  II, V6
RHYTHM:
  Sinus tachycardia
ECG INTERPRETATION:
  STI abnormalities, ?anterolateral subendocardial ischemia/infarct, LV strain or post-cardiotomy
TECHNICAL COMMENTS:
  V electrode off before 800, re-positioned @ 26 min
HEMODYNAMIC DATA:
  ART: 110/50
  PA: 25/10   	PCW: 6
  CVP: 6
  CO:   4.2
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
0-1 min	ZERO/CAL
5 min	INDUCTION     SLIGHT REDUCTION IN
		PRESSURE
6 min	CO INJECTION
	DRAPING
26 min	CHANGE V ELECTRODE
43 min	INCISIONS/ELECTROCAUTERY
51 min	STERNAL INCISION
73 min	AORTIC CANNULATION
75 min	STOP         
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Record: mgh232


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES
	SET-UP
0-20 sec	ZERO CH8/9/11
57 min	ZERI/CAL CH9/ll
71 min	STOP     
[top]  

Record: mgh233


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-1 sec	ZERO ALL CHANNELS
23 min	STOP/FFW/STOP
23-24 min	ZERO CH8/9
	COMING OFF BYPASS
	PACING WIRES IN
47 min	MANUAL VENTILATION
49 min	ATRIAL PACING   PACING:LACK OF
		CAPTURE
49 min		LA ON/PAP OFF
51 min		CVPON
52 min		PAP MEAN TO PCW
		PHASIC PAP
54 min		CO VIA CVP 3.7
54 min	PACER OFF/ON   PACE
55 min		AORTIC ROOT X2
58 min		PCW
63 min	CHANGE PACERS   PACE   
[top]  

Record: mgh234


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
1-2 min	ZEROS     
[top]  

Record: mgh235


PATIENT DATA:
AGE/SEX:
  43 year old female
DIAGNOSIS:
  Mitral stenosis
PROCEDURE:
  Mitral valvulotomy
ECG DATA:
RHYTHM:
  Sinus tachycardia
TECHNICAL COMMENTS:
  ECG data on DR CH2 by mistake therefore data lost
  (CONTINUATION OF mgh230)
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-20 sec	ZERO
7 min	ADMINISTER VOLUME
	VAGAL EPIDODE (atropine/
	dopamine/levophed)
15 min		PCW
		ART
20 min	LV GRAM   LV
37-38 min	ZERO/CAL CH9
38 min	ZERO/CAL CH 11
38 min	CAL CH8
39 min	CAL CH10
40 min	ECG CAL
41 min	END     
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Record: mgh236


PATIENT DATA:
AGE/SEX:
  56 year old male
DIAGNOSIS:
  Paroxysmal ventricular tachycardia
PROCEDURE:
  Ablation
ECG DATA:
LEADS:
  I (telemetry), II, III
RHYTHM:
  Normal sinus rhythm with right bundle branch block
RHYTHM CHANGES:
  Idioventricular rhythm
  Ventricular ectopy with couplet and 3-beat run of tachycardia
ECG INTERPRETATION:
  Old antero-septal infarct with apical aneurysm
  Old infero-posterior infarct
  Left atrial enlargement
  T wave abnormalities
HEMODYNAMIC DATA:
  LVEDP: 6-8
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
0-15 sec	ANNOTATION
15-22 sec	STOP/FFW
	SET-UP
22-26 sec	ZERO
1 min	CAL OF 200
1 min	STOP/FFW
1 min		ART
8 min	STOP/FFW
		DAMPING ARTERIAL
		LINE
		VENTRICULAR ECTOPY
13 min	STOP/FFW
13 min	CATHETER IN LV   LV PRESSURE FROM TIP
	PACE MAP SEQUENCE
23 min	PACE
33 min	PACE
34 min	PACE
39 min	RE-POSITION CATHETER
	ADJUST PACER DELAYS/OUTPUT
44 min	STIMULATE V   VT
45 min	TERMINATE VT
47 min	STOP/FFW
47 min	REPEAT STIMULATION
48 min	STOP/FFW
54 min	INDUCTION OF ANESTHESIA
59 min	ABLATION   Idioventricular Rhythm
		Sinus
60 min	Flush LV catheter
61 min	V Pace     Pace: No capture @ 61 min
63 min	ABLATION   Idioventricular Rhythm
		Sinus
65 min	V Pace     PACE: No capture
67 min	STOP       
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Record: mgh237


PATIENT DATA:
AGE/SEX:
  83 year old male
DIAGNOSIS:
  Aortic stenosis
PROCEDURE:
  Aortic valvulotomy
ECG DATA:
LEADS:   II
RHYTHM:
  Normal sinus rhythm @ 70 bpm
RHYTHM CHANGES:
  Atrial ectopy with run of atrial tachycardia
  Multifocal ventricular ectopy with bigeminy, couplet, runs of ventricular tachycardia
ECG INTERPRETATION:
  Postero-basilar infarct
HEMODYNAMIC DATA:
  ART: 95/60
  PA: 20/? (14)   	PCW: 4
  CVP: 0   RV: 20/0
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
0-20 sec	ZERO
1 min	CAL OF 100
2 min	TAPE OFF/ON     2 PRESSURE
	CHANNELS ON
	INSERT TRANSEPTAL CATHETER
7 min		?RA TO LA
9-10 min	STOP/FFW
10-11 min	RA TO RV TO PA TO PCW
12 min		LA
13 min		ART
	CHANGE LV ATTENUATION
16 min		LV/ART
		LV OFF
26 min		LA/LV
27 min		LV
28 min	CATHETER TO LA     LA
28 min	CATHETER TO LV     LV
29 min		LV OFF
30 min		AO
30 min		AO/RAD
31 min	RE-ZERO
31 min		LV/AO
31 min		AO OFF
		RADIAL ART
39 min	STOP/FFW
	ATTEMPTS AT DILATION
39 min
39 min
40 min	8 MM BALLOON
40-41 min
45-46 min
46 min         
47-48 min
48-49 min	PRESSURE MAINTAINED 20 MM
55-56 min
56 min		RUN OF PVCS @ 57 min
57 min
58 min	FLUSH CA TH ETER
58 min	RE-ZERO
60 min		LV TO LA/AO
61 min		LA TO LV
61 min		LV/AO
62 min	AO TO LV PULL-BACK
	LV TO LA PULL-BACK
63 min		LA/LV
64 min		RAD ART/LV
65 min		LA
65 min		RADIAL
68'min	ANNOTATE     
[top]  

Record: mgh238


PATIENT DATA:
AGE/SEX:
  63 year old male
DIAGNOSIS:
  Coronary artery disease
PROCEDURE:
  Coronary artery bypass graft
ECG DATA:
LEADS:
  II,V4
RHYTHM:
  Normal Sinus Rhythm @ 80 bpm
RHYTHM CHANGES: (mgh239 and mgh240)
  Atrial ectopy and tachycardia
  Multifocal ventricular ectopy with bigeminy, couplets, runs of tachycardia
  Ventricular fibrillation
  Idioventricular rhythm
  Atrial pacing with competition
ECG INTERPRETATION:
  Anterior T wave changes
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
8-13 sec	ZERO/CAL OF 40 CH8
16-23 sec	ZERO/CAL OF 40 CH 11
1 min	ZERO/CAL OF 200 CH9
1 min		PRESSURES ON
5-6 min	CHANGE LEVEL CH6
7-11 min	CHANGE ZERO CH 11
13 min	INDUCTION
17 min	INTUBATION
40 min	PREP/DRAPE
36 min		ART LINE ON
	INTERMITTENTLY
38 min	EKG CAL
43 min	INCISIONS
82 min	END     
[top]  

Record: mgh239


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
31 min	CHANGE PAP/CVP SCALE
32-33 min	ZERO/CAL OF 40 CH8
33 min	ZERO/CAL OF 40 CH 11
33 min	ZERO/CAL OF 200 CH8
36 min		pew
36 min	SCAN EKG CHANNELS
40 min		PCW
48 min		PCW
43 min	CANNULATION
	PROXIMAL ANASTOMOSES
66 min	BYPASS     
[top]  

Record: mgh240


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
1 min	ZERO CH11
2 min	. ZERO CH8
2 min	ZERO CH9
	WARMING
5 min	ATRIAL PACING   ATRIAL PACING: LOSS OF CAPTURE
7 min	COMING OFF BYPASS   ATRIAL PACING
9 min		LEFT A TRIAL TRACE PHASIC/MEAN
11 min		LV VENT /LA/PV
13 min		MEAN LA
16 min		PCW TO MEAN PA
43 min	CHEST CLOSING   SHIFT ECG AXIS
50 min	CLOSED
70 min	DRAPES OFF
	MOVED TO BED     
[top]  

Record: mgh241


AGE/SEX:
  61 year old male
DIAGNOSIS:
  Coronary artery disease
  Congestive heart failure
  Mild mitral regurgitation
PROCEDURE:
  LV aneurysmectomy
ECG DATA:
LEADS:
  II,V4
RHYTHM:
  Ventricular pacing @ 100 bpm
PACEMAKER DATA:
  Permanent = Atomic ventricular pacer
  Pre-bypass = Swan-Ganz temporary pacer
  Post-bypass = temporary epicardial pacing
RHYTHM CHANGES: (Tapes 209, 210, and 211)
  Ventricular ectopy
  Asystolic episode
  Single and dual chamber pacing (competition)
  Ventricular fibrillation
  Dual chamber pacing
ECG INTERPRETATION:
  Antero-lateral infarct
  STI wave change post-bypass
HEMODYNAMIC DATA:
  ART: 132/60
  PA:   50/ (37)   	PCW: 25
  CVP: 15
  CO:   2.6 (1st); 4.0 (30 min later)
  NOTE: Cannon or V waves with V Pacing
PROCEDURAL EVENTS:       RHYTHM/PRESSURE CHANGES:
	SET-UP
0-11 sec	ECG CAL
14/17 sec	ZERO/CAL OF 200 CH9
1 min	STOP/FFW/START
2 min	CHANGE CH4 LEVEL
2 min	ZERO/CAL OF 40 CH 11
2-3 min	ZERO/CAL OF 40 CH8
14 min	SWAN-GANZ INSERTION
23 min	RIGHT VENTRICLE     RV
23 min	PULMONARY ARTERY   PA
23 min	PCW       PCW
24 min	ANNOTATION
25 min	ZERO/CAL OF 40 CH 11
26 min	ZERO/CAL OF 40 CH8
26 min	ZERO/CAL OF 200 CH9
		CHANGE IN ARTERIAL CONTOUR:
		Nipride/Volume/increased cardiac output
28 min	CHANGE IN ZERO CH 11
28 min	CHANGE IN ZERO CH 11     
[top]  

Record: mgh242


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
	OPENING STERNUM
46 min	PARTIAL BYPASS
48 min	FULL BYPASS/COOLING   ASYSTOLE
50 min	ZERO/CAL OF 40 CH 11
50 min	ZERO/CAL OF 40 CH8
51 min	ZERO/CAL OF 200 CH9
51-52 min	STOP/FFW/START
52 min	OFF BYPASS A-V PACING     
[top]  

Record: mgh243


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP   LOSS OF CAPTURE WITH A-V
	PACING
		TO V PACE
21 min	? MITRAL REGURGITATION
47 min		ART = 160/75; PAP = 38/18;
		PCW = 13
		LAP = 13
48 min	PULLBACK CATHETER
49 min	ZERO CH8
49 min	ZERO CH11
49 min	ZERO CH9     
[top]  

Record: mgh244


PATIENT DATA:
AGE/SEX:
  7 year old male
DIAGNOSIS:
  PA conduit stenosis post closure VSD
  Insertion of aortic valve prosthetic (Bjork-Shiley) and PA conduit with valve (CE)
PROCEDURE:
  Right heart cath/Left heart cath
ECG DATA:
LEADS:
  I (telemetry), II, V?3 (telemetry)
RHYTHM:
  Normal sinus rhythm with right bundle branch block
RHYTHM CHANGES:
  Atrial ectopy
  Ventricular ectopy with couplet
ECG INTERPRETATION:
  Right axis deviation
  Right ventricular hypertrophy
TECHNICAL COMMENTS:
  V lead on channel 5
  V lead clipped on cath lab monitor and consequently on tape
HEMODYNAMIC DATA:
  CVP: 10
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-5 sec	ECG CAL
5-10 sec	CAL TO ECG TELEMETRY
10-20 sec	STOP/FFW
1 min	CAL OF 200 TO CH8
1 min	ZERO CH8
1 min	STOP/FFW
1 min	TAPE ON
	INSERT CATHETER FEMORAL VEIN
4 min	RA   RA
5 min	RV   RV
	0-40 SCALE
	0-100 SCALE
5 min	0-200 SCALE
	0-100 SCALE
6 min	PA
6 min	0-40 SCALE
6 min	0-100 SCALE
7 min	PULLBACK FROM PA   PA/RV
7 min	TO RV
8 min	PULLBACK CONDUIT TO RV BODY
10 min	TO LA THRU FORAMEN   LA
	0-40 SCALE
		ECTOPY
12 min	RV   RV
18 min	LV GRAM
	LV   LV
22 min	0-100 SCALE     
[top]  

Record: mgh245


PROCEDURE:
  Insertion of Swan-Ganz catheter (under fluoroscopic guidance)
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	PA INSERTION   RA/RV /PA/PCW
27 min	ZERO/CAL 200 CH9
27 min		PA DAMPED
	FLUSH PA
28 min	RECORD PA   PA
29 min	ADVANCE TO PCW   PCW
53 min	ZERO /CAL 200     
[top]  

Record: mgh246


PATIENT DATA:
AGE/SEX:
  21 year old male
DIAGNOSIS:
  Cardiac transplantation
PROCEDURE:
  RV biopsy
ECG DATA:
LEADS:
  I (telemetry)
RHYTHM:
  Normal sinus rhythm @ 90 bpm
RHYTHM CHANGES:
  Ventricular ectopy with couplets
HEMODYNAMIC DATA: (pre-cath)
  ART: 145/75
  PA: 40/20   	PCW: 10
  CVP: 5
PHARMACOLOGIC SUPPORT:
  Nipride/Dopamine/Isuprel
PROCEDURAL EVENTS:     RHYTHM/PRESSURE CHANGES:
	SET-UP
0-5 sec	ECG CAL
5-7 sec	TELEMETRY ECG CAL
18 sec	STOP/FFW
19 sec	TAPE ON
24-27 sec	ZERO/CAL OF 200 CH8
1-3 min	ART ON
3 min	STOP/REWIND TO 100/RESTART
	INSERT BIOPSY CATHETER
12 min	ZERO CH 11
12 min	PAON     PA
13 min	RA     RA
13 min	RV     RV
13 min	PA     PA
	PCW     PCW
18 min	STOP       
[top]  

Record: mgh247


PATIENT DATA:
AGE/SEX:
  73 year old female
DIAGNOSIS:
  Paroxysmal ventricular tachycardia
PROCEDURE:
  Right heart cath/coronary angiography/left heart cath
  Pace map
ECG DATA:
LEADS:
  I (telemetry), II, III
RHYTHM:
  Normal sinus rhythm with intraventricular conduction defect
RHYTHM CHANGES:
  Multifocal ventricular ectopy with runs of tachycardia and couplets
  (Ventricular pacing stimulation and interruption of VT on mgh046)
ECG INTERPRETATION:
  Old inferior infarct
  Non-specific SIT wave abnormalities
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-14 sec	ECG CAL
2-3 min	ADJUST ZERO/GAIN
7 min	ZERO
8-9 min	CALS OF 200
3-26 min	INSERTION OF PA CATHETER
26 min	RA   RA
32 min	ART   ART
35-38 min	ELECTRODES OFF
41 min	LEFT CORONARY INJECTION
42 min	REPEAT
42 min	REPEAT
43 min	REPEAT
47 min	REPEAT
52 min	LEFT VENTRICULAR CATHETER   LV
		VENTRICULAR IRRITABILITY
55 min	LV ANGIOGRAM
		VENTRICULAR IRRITABILITY
55 min	PULLBACK     
[top]  

Record: mgh248


PATIENT DATA:
AGE/SEX:
  83 year old male
DIAGNOSIS:
  Abdominal aortic aneurysm
PROCEDURE:
  Resection and grafting of aneurysm
ECG DATA:
LEADS:
  I, II, III,V5
RHYTHM:
  Normal sinus rhythm with right bundle branch block
ECG INTERPRETATION:
  Left atrial enlargement
HEMODYNAMIC DATA:
  ART: 150/60
  PA: 28/6   	PCW: 6
  CVP: 6
  CO: 3.38
PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
0-10 sec	ZERO
10-15 sec	ECG CAL
2 min	CHANGE LEVEL
	INDUCTION
	INCISION/ELECTROCAUTERY
31 min	RE-POSITION ELECTRODES
43 min	ECG CAL
48 min+50	ZERO/CAL OF 100 CH9/20 CH8/11 1564 CHG?
80 min	CLAMP AORTA   
[top]  

Record: mgh249


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
7 min		PCW
25 min	MOVE CLAMP/PRE-CLOT GRAFT
36 min	REMOVE CLOT
48 min	FLOW TO LEFT LEG
49 min	FLOW TO RIGHT LEG
79 min	ZERO     
[top]  

Record: mgh250


PROCEDURAL EVENTS:   RHYTHM/PRESSURE CHANGES:
	SET-UP
		HYPERTENSION; TNG
		ADMINISTERED
31 min	END     
[top]