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Chest ex-rays
· characteristics of P.E. with heart displacement to the left

Pulmonary Function Test
· lung capacity below expected for age, weight and height
· only 3% increase in lung performance following use of inhaler

Dr. Eric W. Fonkalsrud MD
Chief of Pediatric Surgery, UCLA Medical Center

· provided second opinion
· determined Pectus Severity Index to be 4.64

Pediatric Pulmonary and Allergy Specialist
· prescribed asthma medication
· requested exercise induced stress test
· provided referral to surgeon specializing in surgical correction

Pulmonary Exercise Induced Stress Test [imageImage.]
· pulmonary function test completed prior to exercise
· EKG monitored stress test with heart rate up to 185 sustained for 8 minutes
· post stress pulmonary function test first without and then with inhalation aerosol
· Diagnosis:

1. the flow-volume loops abnormal suggestive of upper airway obstruction Clinical correlation advised
2. Lung volumes borderline low
3. DLCO is mildly reduced, DLCO/VA normal
" Therefore, the mild restriction is probably due to the patient's chest wall deformity."

Pediatric Surgeon specializing in Nuss and Modified Ravitch Corrections
· provided thorough explanation of condition, detailed overview of Ravitch and Nuss correction methods
· answered all inquiries, offered to provide patient references
·requested CT scan, EKG, made suggestions for pre op breathing exercises
·surgery scheduled for June 12th, 2002

Echo Cardiogram
This is one of the test required prior to P.E. corrective surgery to rule out heart problems. Sticky patches or electrodes are attached to the chest and shoulder, connected to electrodes/wires. These record the electrocardiogram (EKG or ECG) during the echocardiography test. The EKG shows the timing of various cardiac events (filling and emptying of chambers). A colorless gel is applied to the chest and the echo transducer is placed on top of it. The echo technologist makes recordings from different parts of the chest to obtain several views of the heart.
No presence or Mitral Valve Prolaps noted, Marfan Syndrome out ruled.

CT(computer tomography) Scan[imageImage.]
This is an x-ray exam that looks at the body in cross sections, in this case the chest. Contrast media (an iodine-containing solution) is injected into a vein. This shows up the blood vessels and body tissues for the scan. As the contrast media circulates, the patient may have a cool feeling in the arm followed by a warm sensation throughout the body. This may be accompanied by a metallic or salty taste sometimes accompanied by nausea. The sensation passes quickly. The procedure takes about 30 minutes including prep time.
Cross section x-rays of the chest confirmed heart obstruction.

Complete Physical Examination by Pediatrician
In addition to the above examinations, a complete physical is also completed by the patent's practitioner. It's a summary of the medical history and confirms that immunization is up to date