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NAME OF PROCEDURE: Left heart catheterization with ventriculography, selective coronary angiography.

INDICATIONS: Acute coronary syndrome.

TECHNIQUE OF PROCEDURE: Standard Judkins, right groin. Catheters used were a 6 French pigtail, 6 French JL4, 6 French JR4.

ANTICOAGULATION: The patient was on heparin at the time.

COMPLICATIONS: None.

I reviewed with the patient the pros, cons, alternatives, risks of catheterization and sedation including myocardial infarction, stroke, death, damage to nerve, artery or vein in the leg, perforation of a cardiac chamber, dissection of an artery requiring countershock, infection, bleeding, ATN allergy, need for cardiac surgery. All questions were answered, and the patient desired to proceed.

HEMODYNAMIC DATA: Aortic pressure was in the physiologic range. No significant gradient across the aortic valve.

ANGIOGRAPHIC DATA
1. Ventriculogram: The left ventricle is of normal size and shape, normal wall motion, normal ejection fraction.
2. Right coronary artery: Dominant. There was insignificant disease in the system.
3. Left coronary: Left main, left anterior descending and circumflex systems showed no significant disease.

CONCLUSIONS
1. Normal left ventricular systolic function.
2. Insignificant coronary disease.

PLAN: Based upon this study, medical therapy is warranted. Six-French Angio-Seal was used in the groin.

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