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***   Stress Testing Conclusions   ***
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There was no inducible ischemia by electrocardiographic or echocardiographic criteria.
Chest discomfort was not encountered during stress.
Good exercise capacity.
A hypertensive stress response was noted (peak blood pressure of x mmHg).
An abnormal electrocardiographic response to stress was noted, but the changes seen are not diagnostic of ischemia.
This is a non-diagnostic study as target heart rate was not achieved - use caution interpreting these results.
To the extent of stress achieved, there was no inducible ischemia by electrocardiographic or echocardiographic criteria.


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***   Generic Conclusions   ***
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No significant valvular disease is noted.
Pulmonary hypertension is not suspected based upon this study.
Pulmonary hypertension is suspected based upon this study.


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***   Left Ventricle   ***
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(x% by Simpson's bi-plane method of discs).
(x% by 3D modeling).
Not all left ventricular segments were well-visualized.
Global longitudinal strain is normal at -x%.
A prominent septal knuckle is present, but without any demonstrable outflow tract gradient.
A resting left ventricular intracavitary gradient is present (peak velocity of x m/s and a corresponding peak gradient of x mmHg).
Abnormal interventricular septal motion is noted and consistent with a conduction abnormality.


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***   Right Ventricle   ***
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The right ventricle is dilated and hypokinetic.
The right ventricle is dilated, but with preserved systolic function.
Pacemaker/catheter artifact is noted within the right ventricle.


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***   Atria   ***
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The x atrium is visibly enlarged.
Pacemaker/catheter artifact is noted within the right atrium.


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***   Aortic Valve   ***
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The aortic valve is not well-visualized, but does appear to be sclerosed/calcific.
There is a gradient across the aortic valve (mean of x mmHg), but significant stenosis is unlikely based upon this study.
The aortic valve has been previously replaced with a bio-prosthetic valve that appears to be functioning well by Doppler criteria (peak velocity of x m/s, a mean gradient of x mmHg, an acceleration time of x ms and a dimensionless valve index of x).


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***   Mitral Valve   ***
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The previously repaired mitral valve appears to be functioning well by Doppler criteria (peak velocity of x m/s, a mean gradient of x mmHg and a mitral valve to left ventricular outflow tract VTI ratio of x).


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***   Aorta   ***
*****************
The aortic root and the proximal ascending aorta are normal in size, but are sclerosed/calcific.
Atherosclerotic changes of the abdominal aorta are noted.
The left main and right coronary arteries originate normally off the proximal aortic root.
The proximal ascending aorta is dilated and measures x cm approximately x cm above the aortic valve.
The proximal ascending aorta measures at the upper limit of normal per body surface area.


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***   Pulmonary Veins   ***
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Normal systolic predominant pulmonary venous inflow is noted.