SUMMARY NOTES IN THE RECORD s30741 (Duration: 23:49:59.984) Starting time, recording date: 13:11:00 09/08/1999 Lead 0: E-S Lead 1: A-S Lead 2: A-I Age: 54 Sex: F Comments: This is the same patient as s30742. There are numerous regions of transient ST depression noted in all three leads. Episodes are associated with increased heart rate. In fact, there is a period of almost three hours with increased heart rate associated with ST depression in all three leads near the beginning of the record. (The global reference actually shows slight ST elevation.) Symptoms during Holter recording: No data Diagnoses: Coronary artery disease Asthma Hypertension Stroke Congestive heart failure Treatment: Medications: Zocor Atenolol Ketorolac Proventil Balloon Angioplasty: No Coronary Artery bypass Grafting: No History: Angina, asthma, congestive heart failure, hypertension, stroke, coronary artery disease. Hypertension: Yes Left ventricular hypertrophy: No Cardiomyopathy: No Valve disease: No Electrolyte abnormalities: No Hypercapnia, anemia, hypotension, hyperventilation: No Atrioventricular nodal conduction delay: No data Intraventricular conduction block: No data Previous Myocardial Infarction: Yes, in 1996 and 1997 Previous tests: ECG stress test: Yes Date: April, 1999 Findings: Normal with inadequate heart rate, but with chest pain Thallium/Stress echo: No data Left ventricular function: No data Echocardiogram: No data Coronary Arteriography: No data Baseline ECG: No data Holter Recording: Date: 09/08/1999 Recorder: Zymed ST ANNOTATIONS A. Criteria of 30 seconds and 75 microVolts (s30741.sta) Lead 0: Ischemic episodes: 17 Duration: 5:38:52 23.70% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 11 Duration: 4:08:54 17.41% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 18 Duration: 5:35:26 23.46% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 46 Duration: 15:23:12 21.52% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 20 Duration: 6:28:10 27.14% Rate-related episodes: 0 Duration: 0:00 0.00% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 20 Duration: 6:28:10 27.14% Unreadable intervals: 0 Duration: 0:00 0.00% B. Criteria of 30 seconds and 100 microVolts (s30741.stb) Lead 0: Ischemic episodes: 5 Duration: 3:31:38 14.80% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 3 Duration: 2:45:14 11.55% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 9 Duration: 4:12:22 17.65% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 17 Duration: 10:29:14 14.67% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 9 Duration: 4:18:36 18.08% Rate-related episodes: 0 Duration: 0:00 0.00% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 9 Duration: 4:18:36 18.08% Unreadable intervals: 0 Duration: 0:00 0.00% C. Criteria of 60 seconds and 100 microVolts (s30741.stc) Lead 0: Ischemic episodes: 2 Duration: 2:54:02 12.17% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 1: Ischemic episodes: 1 Duration: 2:19:34 9.76% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Lead 2: Ischemic episodes: 6 Duration: 3:47:12 15.89% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Total: Ischemic episodes: 9 Duration: 9:00:48 12.61% Rate-related episodes: 0 Duration: 0:00 0.00% Axis shifts: 0 Conduction-change shifts: 0 Noisy events: 0 Unreadable intervals: 0 Duration: 0:00 0.00% Combined: Ischemic episodes: 6 Duration: 3:49:46 16.07% Rate-related episodes: 0 Duration: 0:00 0.00% Unreadable intervals: 0 Duration: 0:00 0.00% Combined [ischemic or rate-related]: ST segment episodes: 6 Duration: 3:49:46 16.07% Unreadable intervals: 0 Duration: 0:00 0.00% QRS ATRUTH ANNOTATIONS (s30741.atr) Total number of beats 123461 Normal beats 123461