RSUP. Dr. Hasan Sadikin No.

Registry : /Echo/04/2024
INSTALASI PELAYANAN JANTUNG No.Med-Rec :
Unit Diagnostik Non Invasive Date : 02/04/2024
Jl. Pasteur No. 38 Bandung T.B : cm
Telp. 022-2034953 s/d 2034955 Psw.3341 B.B : kg
Machine : Epiq
PEDIATRIC ECHOCARDIOGRAPHY REPORT

NAME : By. Ny. Meilani SEX : Female AGE : 4/20/2024

ADDRESS :
PHONE :
REFF. DOCTOR : Dr. Putria Rayani Apandi, SpA ( K ), M.Kes
OPERATOR : Dr. Putria Rayani Apandi, SpA ( K ), M.Kes
CLINICAL DIAGNOSTIC : PDA

RESTING ECHOCARDIOGRAPHY
LVPWs mm LV ET : Aortic root : mm
LVIDs mm MV CLOSURE TO OPENING : Sinus valsava : mm
IVSs mm LV MPI : Sinotubular junction : mm
LVPWd mm RVET : Aortic ascendens : mm
LVIDd mm TV CLOSURE TO OPENING : Aorta regurgitation :
IVSd mm RV MPI :
EF % IVCT LV : E : cm
FS % IVRT LV : A : cm
LA/ao TEI INDEKS LV : E/A :
LVMI IVRT RV : DT : ms
RWT IVCT RV :
TAPSE TEI INDEKS RV :

Atrial situs solitus

Normal systemic and pulmonary venous drainage
AV-VA concordance
Dilated LA LV
Normal AV and semiluran valves
Intact IAS
Small PDA
No pericardial effusion
Confluent PA's
Left aortic arch, mild CoA, normal coronary artery
No pericardial effusion
Well contracted ventricles

Conclusion :
Small PDA
Mild CoA

Pro:
-

Dr. Putria Rayani Apandi, SpA ( K ), M.Kes

Instalasi Pelayanan Jantung Tanggal = 06 September 2008
( Sabtu )
Poli Spesialis :
Dr. Toni 2 X Rp 100,000 = Rp 200,000
∑ = 2 Pasien = Rp 200,000

EKG:
Dr. Toni 1 X Rp 40,000 = Rp 40,000
∑ = 2 Pasien = Rp 40,000

Echocardiography :
Dr. Toni 2 X Rp 65,000 = Rp 130,000
Dr. Rizki 1 X Rp 300,000 = Rp 300,000
∑ = 3 Pasien = Rp 430,000

Jumlah Total = Rp 670,000