09-09-16 10:20 FROM- Mount Sinai Heart | T-234 P0001 F-333 _Cardiovascular Imaging Center _ 1428 Madison Avenue « New York, NY #10024 Phone: i - Fo. a CT Report Name: Epstein, Jeffrey Scan Date: 09/06/2016 MRN: 7206913 Acc Number: 1497253 DOB: 01/20/1953 ReferringMD: Rony Shimony, MD Age/Gender: 63/M AttendingMD: Adam Jacobi, MD Summary CT without contrast was performed for coronary calcium, chest, abdomen and pelvis evaluation. Reconstructions were transferred to a workstation for further analysis. 1, Coronary atherosclerosis without significant stenosis. 2. The calcium score is 63 (53rd percentile adjusted for age, gender and ethnicity). 3. Normal left ventricular size and systolic function. No regional wall motion abnormalities. 4, No abdominal aortic or iliac arterial aneurysm. Scan Info General Contrast Agent Medication Administered During Scan Type: None Type: Metoprolol iV, NTG SL0.4mg Dose: 85 m/ | Metoprolol IV, Dose; 10 mg Vitals Height: 72 in Height: 182.9cm Body Weight: 190 /bs Body Weight: 86.2 kg BSA; 2.1m°2 Heart Rate:718PM Heart Rhythm: Sinus Rhythm Setup a. conten ae Bee Type: Clinical Location: Outpatient ECG Gating Technique: Prospective Study Quality: Good Referring Provider: Rony Shimony, MD Attending Radiologist: Adam jacobi , MD Attending Cardiologist: Gina LaRocca, MD Billing CPT Code(s) 71275, 74174 CTA Chest. ABD/Peivis w/wo Contrast 75574, 71275 CTA Coronary & Chest w/wo Contrast ICD-10 Code(s) Miscellaneous 213.6 Encounter for screening for cardiovascular disorders Finalized and signed by Adam Jacobi on 09/06/2016 13:57:56 (uld:180) Page 1 of 5 EFTA00282958

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08-09-16 10:20 FROM- Mount Sinai Heart 12123763190 T-234 P0002 F-333 a EFTA00282959

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09-09-16 10:20 FROM- Mount Sinai Heart | T-234 P0003 F-333 _ S& —————s—=*s Garrdiovascular Imaging Center Mount 1428 Madis: enue « New York, NY « 10024 CT Report Cardiac Coronaries Coronary Arteries bo Coronary Arterial Dominance: Right ARTERIES Distal LCX Posterolateral DIAMETER STENOSIS: 0; <25%; 25%; 25-4996; <509; 50%; 50-6996; 70-99%; 75%; 100%; UE = UNEVALUABLE PLAQUE: NC = NONCALC,; PNC = PREDOMIN, NC; PC = PREOOMIN, C; C = CALCIFIED STENT: NORMAL; <S0%; >50%; O = OCCLUDED; ? = CANNOT EXCLUDE Coronary Calcium Scoring Agatston Additional Findings ; ‘Other' refers to a small ramus intermedius artery. Chambers Finalized and signed by Adam Jacobi on 09/06/2016 13:57:56 (uid:180) Page 2 of 5 EFTA00282960

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09-09-16 10:20 FROM- Mount Sinai Heart 1-284 P0004 = F-838 aN _ _ Cardiovascular Imaging Center iat . Heart Phone: CT Report « Fax: Volumetric Analysis Volumetric Analysis [NRV] EDV (ml) {L: 81-220, R: 81-269} jo | | ESV (ml) [L: 24-106, R: 25-140] |e | | Cardiac Output (Limin) Mass (g) [L: 48-166] Stroke Volume (ml) 12 EF (%) [L: 44-71, R: 42-74] Vascular Upper Vascular EVALUATION OF THE THORACIC AORTA COMMENTS Proximal great arch vessels are widely patent. Evaluation Detalls Sinus of Valsalva Max Diameter A: 3.5 cm Sinus of Valsalva Max Diameter 8: 3.4 cm ASCENDING AORTA Dimension A: 3.6 cm Dimension B: 3.6 cm ARCH OF THE AORTA Dimension A: 2.8 cm Dimension B: 2.8 cm | MID-DESCENDING AORTA H Dimension A: 2.5 om | 1 Dimension B: 2.5 cm DISTAL DESCENDING AORTA Dimension & 2.4cm Dimension B: 2.3 cm See comments. | Lower Vascular Finalized and signed by Adam Jacobi on 09/06/2016 13:57:56 (uid:180) Page 3 of 5 EFTA00282961

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09-09-16 10:21 FROM- Mount Sinai Heart fF T-234 P0005 F-333 a) Cardiovascular Imaging Center __ Mount 1428 Madison Avenue « New — NY * 10024 —_ Phone: . Fox: eT Report EVALUATION OF THE ABDOMINAL AORTA AND PELVIS rere COMMENTS Hepatic artery arises separately from the suprarenal abdominal aorta. The celiac artery, SMA, IMA, and bilateral renal arteries are widely patent. Evaluation Details ABDOMINAL AORTA Dimension A: 1.6 cm Dimension B: 2 cm 1. |The infra renal Abdominal Aorta has focal calcium present 2. The Right Internal Iliac has mild calcium present. 3. The Left internal iliac has focal calcium present Other Findings Lung Nodules Lung Nodules?: Yes ' Pulmonary Lobe Location: Right Lower Calcified?: Yes : Size (mm): 2 Other Findings Summary CARDIOVASCULAR: The heart is normal in size. There is no pericardial effusion. The aorta and pulmonary arteries are normal in caliber. LUNGS AND PLEURA: Benign calcified granulomas in the right lower lobe. No focal consolidation or diffuse interstitial lung disease, The trachea and central airways are patent. No pleural effusion. LIVER: Normal liver size. Wedge shaped region of hyperenhancement in the right hepatic lobe is likely related to perfusion phenomenon, but incompletely evaluated on this single phase arteria| study. Normal gallbladder. No biliary duct dilatation. Finalized and signed by Adam Jacobi on 09/06/2016 13:57:56 (uid:180) Page 4 of 5 EFTA00282962

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09-09-16 10:21 FROM- Mount Sinai Heart 1-284 P0006 «= F-838 Cardiovascular Imaging Center ss Mount 1428 Madison Avenue « New York, NY « 10024 $$$... —___—-... . oe CT Report SPLEEN: No focal lesion, Normal size. PANCREAS: No focal lesion, No calcification. No ductal dilation. GI TRACT: Stool is noted in the colon. s/p partial right colonic surgery with suture material noted. No evidence of significant diverticulosis. Limited bowel evaluation without oral contrast, LYMPH NODES: No lymphadenopathy by size criteria. GU: The kidneys are normal in size bilaterally with no focal lesion and no hydronephrosis. Mildly enlarged prostate (4.5 cm tranverse diameter) with central calcifications. MUSCULOSKELETAL: No aggressive osseous lesion. Mild degenerative changes of the spine. Finalized and signed by Adam Jacobi on 09/06/2016 13:57:56 (uid:180) Page 5 of S EFTA00282963