Report For Center Created Gender D.O.B Page 1 Sean Breen HeartSmart IMT plus 3/29/2012 Male 11/26/1973 B C D E

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1 Report For Center Created Gender D.O.B Page 1 Carotid Assessment A B C D E Good Satisfactory Concern Serious Highest Risk Intima-Media Thickness Additional Findings Plaque Character Percent Stenosis Comments: Carotid IMT Assessment Your risk of experiencing a heart attack or stroke is graded by zone. The zone assigned is age and gender appropriate to you. The relationship of Intima-Media Thickness (IMT) to atherosclerosis is well established. Prevention and detection of the coronary artery disease and stroke is complex. Normal or thin Carotid IMT does not completely exclude coronary artery disease; it only indicates it is less likely. The results of this test should be interpreted in conjunction with your medical history, known risk factors, other test results and symptoms. Additional Findings Please note that the findings in addition to the IMT analysis and measurement are incidental. Your physician will determine the significance in conjunction with your medical history, known risk factors, other test results and symptoms. Plaque Character Plaques or lesions develop when the atherosclerosis in the arterial wall intrudes into the lumen. Plaques may be soft, mixed or hard calcified plaques as outlined on Page 3 of the report. It is possible to have normal IMT and yet lesions may be present. Percent Stenosis Stenosis is the degree of blockage of the artery occurs when plaques intrude into the lumen and become mixed or calcified. If these plaques become large, they can reduce the flow of blood to critical areas. In general, blockages must exceed 75% before they are considered clinically significant.

2 Report For Center Created Gender D.O.B Page mm 0.585mm Intima-Media Thickness The Intimal-Medial Thickness (IMT) measurement is an accurate way of viewing the effect of atherosclerosis or hardening of the arteries is having on you. Many points along your artery wall are taken into account by our computerized analysis software. The average is then calculated from these measurements. Studies show that in about 70% of the time the disease processes similarly affect the carotid and coronary arteries. The HeartSmart IMT Report uses a graphic illustration on the front page of the report and gives the patient a "grade" of A through E based on comparing the actual IMT measurement to outcome data from a database of 40,000 patients with an average 6 year follow up based on age and gender. The grade provides a ratio of increased risk for a coronary event based on age and gender as follows: IMT Score Likelihood of Significant Disease Relative Risk of Clinical Event A Very Unlikely No increased risk B Unlikely Minimal increased risk C Possible Risk increased 1.5x D Probable Risk increased 1.5x to 2.0x E Present Risk increased to 2.7x

3 Report For Center Created Gender D.O.B Page 3 BULB- NO PLAQUE OR LESIONS OBSERVED NO PHOTOS ARE INCLUDED Plaque Character Plaques or lesions develop when the atherosclerosis in the arterial wall intrudes into the lumen. Plaques may be soft, mixed or hard calcified plaques. Calcified plaques are generally stable and pose less threat to the patient. Soft or mixed plaques are more vulnerable to inflammation and rupture and can release their contents into the blood stream. This event may trigger the formation of a blood clot that can block the blood flow through the artery leading to a heart attack or stroke. It is possible to have normal IMT and have lesions present. Quality Any lesions detected during the IMT analysis and measurement are translated into a single or multiple indicator. Location Plaque or lesions are often observed in the area of the bulb or bifurcation at the point where the common carotid artery splits into the internal and external carotid arteries and blood flow becomes turbulent. Your Ultrasound Image Included in this report are the ultrasound images that were used to measure IMT and analyze the presence and character of plaque or lesions.

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6 Report For Center Created Gender D.O.B Page 6 NO PLAQUE OR LESIONS OBSERVED NO PHOTOS ARE INCLUDED

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