{"text":"Acute Services Division ' . ~ NHS | \nEmergency Care and \n: Al Greater'(\u2018.!asgow \nMedical Service Directorate and Clyde \nDEPARTMENT OF CARDIOLOGY Correspondence Address; \nStobhill Hospital gilepartmeFr;t of I(.iafr\u2018dlology \n< 1) s \u2018 P asgow Royal Infirmary \nDr Goodfield\u2019s Cardiology Clinic . Castle Street \nF \n17\/05\/2013 Glasgow G4 0S \nDictated \" 17\/05\/2013 Dr F G Dunn (Secretary 211 5500) \nTyped 06\/06\/2013 Dr N E R Goodfield . (Secretary 232 1042) \nOur Ref NERG\/DMCL . Dr J Lindsay . (Secretary 211 9370) \nDr FG Dunn . Dr W Martin \nConsultant Cardiologist Consultant Medical Physicist \nKerry Jane Hogg Heart Unit Glasgow Royal Infirmary - \nSTOBHILL ACH \u2018 GLASGOW \nDear Frank \nAgnes Clelland ~ 08\/09\/1955 ~ CHI: 0809555328 ~ CRN: 10338654X \n39 Rennle Road, Kilsyth, Glasqow G65 9PQ \n1 think | picked up this woman because | was signing your letters. | was interested to see that her \ncoronaries were normal and that we had said there had been a big perfusion defect on thallium \nscanning. In fact reviewing the notes she had a thallium scan in October 2012, She had a \n. Dobutamine stress echo with good heart rate but limited blood pressure response with no ECG \nchanges. Stress thallium showed a very large anterior lateral, septal, posterior perfusion defect- \nwith preserved regional wall motion. There was partial redistribution anteriorly, distal septally, distal. \nlaterally and posteriorly but minimal change basal septally and basal laterally. The defect was \nthought to at least partly be due to attenuation artefact and was overall felt to be consistent with a \nsmall area of reversibility detected in the LAD or Cx territory. She went on to angiography following \na letter which suggested that she had a small to moderate area of reversibility although this was \nnot,what said on the thallium scan. Subsequent letter actually suggested that there was a large \ndefect in the LAD Cx territory! As a result of this she went to angiography which subsequently \nturned out to be minor atheroma in the ostium. of the right coronary artery with clean LAD and Cx. \nShe also took part in an MRI study which was suggested in the discharge summary from the \nGolden Jubilee that there was a large CMR defect, although in fact the MRI scan shows the LV is \nnot dilated, left atrial area is mildly elevated but no significant aortic or mltral regurgltatlon is noted. \nThe right ventricle was thought to be normal but first pass perfusion imaging at rest is \nunremarkable. with no inducible str\u00e9ss perfusion defect. le, she had a small thallium defect, no \ninducible MRI perfusion and relatively normal coronary arteries. \nYours sincerely \nDr N. E. R. Goodfield * \nConsultant Cardiologist \nPs: Can we review all this. \nCLELLAND, Agnes ) Page 1 of 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