Stress Testing Report Templates
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## Stress Testing Report Templates

### TID 3300 Stress Testing Report

The Stress Testing Report template is the root structure for the representation of measurements and findings of a stress testing procedure.

Type:

  Extensible

Order:

  Significant

Root:

  Yes

Table TID 3300. Stress Testing Report

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | DT (18752-6, LN, "Stress Testing Report") | 1 | M |  | Root node
2 | > | HAS CONCEPT MOD | CODE | EV (121058, DCM, "Procedure reported") | 1 | M |  | DCID 3200 “Stress Test Procedure”
3 | > | HAS CONCEPT MOD | INCLUDE | DTID 1204 “Language of Content Item and Descendants” | 1 | M |  |
4 | > | HAS OBS CONTEXT | INCLUDE | DTID 1002 “Observer Context” | 1-n | M |  |
5 | > | CONTAINS | CONTAINER | EV (121109, DCM, "Indications for Procedure") | 1 | U |  |
6 | >> | CONTAINS | CODE | EV (121071, DCM, "Finding") | 1-n | U |  | DCID 3201 “Indications for Stress Test”
7 | >> | CONTAINS | TEXT | EV (121071, DCM, "Finding") | 1 | U |  |
8 | > | CONTAINS | INCLUDE | DTID 3602 “Cardiovascular Patient Characteristics” | 1 | M |  |
9 | > | CONTAINS | INCLUDE | DTID 3802 “Cardiovascular Patient History” | 1 | U |  |
10 | > | CONTAINS | INCLUDE | DTID 3301 “Stress Test Procedure Description” | 1 | M |  |
11 | > | CONTAINS | INCLUDE | DTID 3303 “Stress Test Phase Data” | 1-n | M |  |
12 | > | CONTAINS | INCLUDE | DTID 3311 “Stress Test Summary” | 1 | U |  |
13 | > | CONTAINS | INCLUDE | DTID 3318 “Comparison to Prior Stress Exam” | 1 | U |  |
14 | > | CONTAINS | INCLUDE | DTID 3320 “Conclusions and Recommendations” | 1 | U |  |

### TID 3301 Stress Test Procedure Description

Type:

  Extensible

Order:

  Significant

Table TID 3301. Stress Test Procedure Description

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | DT (121064, DCM, "Current Procedure Descriptions") | 1 | M |  |
2 | > | CONTAINS | CODE | DT (109056, DCM, "Stress Protocol") | 1 | U |  | BCID 3261 “Stress Protocols”
3 | > | CONTAINS | TEXT | DT (109056, DCM, "Stress Protocol") | 1 | U |  |
4 | > | CONTAINS | CODE | DT (10:11345, MDC, "Lead System") | 1 | U |  | BCID 3263 “Electrode Placement Values”
5 | > | CONTAINS | CODE | DT (A-17200, SRT, "Exerciser Device") | 1 | U |  | BCID 3203 “Exerciser Device”
6 | > | CONTAINS | CODE | DT (G-C11C, SRT, "Pharmacological Stress Agent") | 1 | MC | IFF Pharmacological Stress used | BCID 3204 “Stress Agents”
7 | > | CONTAINS | CONTAINER | EV (122700, DCM, "Indications for Pharmacological Stress") | 1 | MC | IFF Pharmacological Stress used |
8 | >> | CONTAINS | CODE | EV (121071, DCM, "Finding") | 1-n | U |  | DCID 3205 “Indications for Pharmacological Stress Test”
9 | > | CONTAINS | CODE | DT (P0-0099A, SRT, "Imaging procedure") | 1 | MC | IFF imaging used in procedure | DCID 3206 “Non-invasive Cardiac Imaging Procedures”
10 | > | CONTAINS | CODE | DT (125203, DCM, "Acquisition Protocol") | 1 | UC | IFF Nuclear imaging | DCID 3110 “Nuclear Cardiology Protocols”
11 | > | CONTAINS | CODE | DT (125203, DCM, "Acquisition Protocol") | 1 | UC | IFF PET imaging | DCID 3106 “PET Cardiology Protocols”
12 | > | CONTAINS | TEXT | DT (121141, DCM, "Image Type") | 1 | UC | IFF Nuclear or PET imaging | STATIC, DYNAMIC, or GATED. See note.
13 | > | CONTAINS | CODE | DT (RID11248, RADLEX, "Cardiac Gating") | 1 | U |  | DCID 3104 “Cardiac Synchronization Technique”
14 | > | CONTAINS | CODE | DT (125203, DCM, "Acquisition Protocol") | 1 | UC | IFF Contrast echocardiography | DT (P5-B3008, SRT, "Contrast echocardiography")
15 | > | CONTAINS | CODE | DT (113743, DCM, "Patient Orientation") | 1 | U |  | DCID 19 “Patient Orientation”
16 | >> | HAS CONCEPT MOD | CODE | EV (113744, DCM, "Patient Orientation Modifier") | 1 | U |  | DCID 20 “Patient Orientation Modifier”
17 | > | CONTAINS | TEXT | DT (121065, DCM, "Procedure Description") | 1 | U |  |
18 | > | CONTAINS | DATETIME | DT (122701, DCM, "Procedure Time Base") | 1 | U |  | See note.

Content Item Descriptions

Row 12 | Image Type may be copied from the NM Image SOP Instance attribute Image Type (0008,0008) value 3, or from the PET Image SOP Instance attribute Series Type (0054,1000).
Row 18 | The Procedure Time Base is the time from which elapsed times are measured. The Study Time (0008,0030) may include the patient prep period, while this Procedure Time Base is typically established when baseline data collection begins.

### TID 3303 Stress Test Phase Data

The Stress Test Phase Data template provides a structure for measurements acquired during a single procedure phase.

Type:

  Extensible

Order:

  Significant

Table TID 3303. Stress Test Phase Data

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | DT (121070, DCM, "Findings") | 1 | M |  | See note.
2 | > | HAS ACQ CONTEXT | CODE | EV (G-7292, SRT, "Procedure phase") | 1 | MC | XOR row 3 | BCID 3207 “Stress Test Procedure Phases”
3 | > | HAS ACQ CONTEXT | CODE | EV (G-7292, SRT, "Procedure phase") | 1 | MC | IFF Nuclear Imaging; XOR row 2 | DCID 3101 “Cardiac Procedural State Values”
4 | > | HAS ACQ CONTEXT | TEXT | EV (G-7292, SRT, "Procedure phase") | 1 | U |  |
5 | > | CONTAINS | INCLUDE | DTID 3301 “Stress Test Procedure Description” | 1 | MC | IFF protocol changed from initial specification |
6 | > | HAS ACQ CONTEXT | NUM | EV (109055, DCM, "Protocol Stage") | 1 | U |  | UNITS = DT ({stage}, UCUM, "stage")
7 | > | CONTAINS | INCLUDE | DTID 3304 “Stress Test Measurement Group” | 1-n | U |  |
8 | > | CONTAINS | INCLUDE | DTID 3307 “NM/PET Perfusion Measurement Group” | 1 | MC | IFF Nuclear or PET Imaging |
9 | > | CONTAINS | INCLUDE | DTID 3309 “Stress Echo Measurement Group” | 1 | UC | IFF Echocardiography Imaging |

Content Item Descriptions

Row 1 | The Container shall have a specific Content Item Observation DateTime (0040,A032) attribute to indicate the time at which the phase began.

### TID 3304 Stress Test Measurement Group

Each instance of the Stress Test Measurement Group represents a group of data elements acquired at approximately the same instant, and conventionally rendered as row in a tabular presentation. It is typically generated during the Stress exam whenever a time interval elapses (for example, every minute of the phase), when a technician observes data worth capturing, or when measurements exceed a given range.

Type:

  Extensible

Order:

  Significant

Table TID 3304. Stress Test Measurement Group

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | DT (121070, DCM, "Findings") | 1 | M |  | See note.
2 | > | CONTAINS | NUM | DT (F-031F9, SRT, "Time since start of exam") | 1 | M |  | UNITS = DT (min, UCUM, "min")
3 | > | CONTAINS | NUM | DT (122710, DCM, "Time since start of stage") | 1 | M |  | UNITS = DT (min, UCUM, "min")
4 | > | CONTAINS | NUM | DT (122702, DCM, "Treadmill speed") | 1 | U |  | UNITS = DCID 3212 “Treadmill Speed”
5 | > | CONTAINS | NUM | DT (122703, DCM, "Treadmill gradient") | 1 | U |  | UNITS = EV (%, UCUM, "%")
6 | > | CONTAINS | NUM | DT (122704, DCM, "Ergometer power") | 1 | U |  | UNITS = EV (W, UCUM, "Watts")
7 | > | CONTAINS | NUM | DT (122709, DCM, "Activity workload") | 1 | U |  | UNITS = DT ([MET], UCUM, "METS")
8 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1 | U |  | $Measurement = DT (122706, DCM, "Rating of Perceived Exertion") $Method = BCID 3239 “Perceived Exertion Scales”
9 | > | CONTAINS | NUM | DT (122705, DCM, "Pharmacological Stress Agent Dose Rate") | 1 | MC | IFF Pharmacological Stress used | UNITS = EV (ug/kg/min, UCUM, "ug/kg/min")
10 | > | CONTAINS | INCLUDE | DTID 3106 “Drugs/Contrast Administered” | 1 | U |  | See note.
11 | > | CONTAINS | NUM | EV (8867-4, LN, "Heart Rate") | 1 | U |  | UNITS = EV ({H.B.}/min, UCUM, "BPM")
12 | > | CONTAINS | NUM | EV (F-008EC, SRT, "Systolic Blood Pressure") | 1 | U |  | UNITS = DCID 3500 “Pressure Units”
13 | > | CONTAINS | NUM | EV (F-008ED, SRT, "Diastolic Blood Pressure") | 1 | U |  | UNITS = DCID 3500 “Pressure Units”
14 | > | CONTAINS | NUM | DT (122707, DCM, "Number of Ectopic Beats") | 1 | U |  | UNITS = EV ({beats}, UCUM, "beats")
15 | >> | HAS PROPERTIES | NUM | DT (R-40861, SRT, "Period of collection") | 1 | M |  | UNITS = DT (min, UCUM, "min")
16 | >> | HAS PROPERTIES | CODE | EV (G-C504, SRT, "Associated Morphology") | 1-n | U |  | BCID 3234 “Ectopic Beat Morphology”
17 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = DT (F-03204, SRT, "ST Elevation") $Units = DT (mV, UCUM, "mV") $TargetSite = DCID 3001 “ECG Leads”
18 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = DT (F-38279, SRT, "ST Depression") $Units = DT (mV, UCUM, "mV") $TargetSite = DCID 3001 “ECG Leads”
19 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = DCID 3228 “ECG Timing Measurements” $Units = DT (ms, UCUM, "ms") $TargetSite = DCID 3001 “ECG Leads” See note.
20 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = DCID 3227 “QTc Measurements” $Units = DT (ms, UCUM, "ms") $TargetSite = DCID 3001 “ECG Leads” $Equation = DCID 3678 “Qt Correction Algorithms” See note.
21 | >> | INFERRED FROM | NUM | DT (2:16000, MDC, "RR Interval for QTc") | 1 | U |  | UNITS = DT (ms, UCUM, "ms") See note.
22 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = DCID 3229 “ECG Axis Measurements” $Units = DT (deg, UCUM, "deg") See note.
23 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1 | U |  | $Measurement = DCID 3526 “Blood Gas Saturation” $Units = EV (%, UCUM, "%")
24 | > | CONTAINS | NUM | DT (122708, DCM, "Double Product") | 1 | U |  | UNITS = DT (mm[Hg].{H.B.}/min, UCUM, "mmHg.BPM")
25 | > | CONTAINS | CODE | EV (121071, DCM, "Finding") | 1-n | U |  | DCID 3220 “Stress Symptoms”
26 | > | CONTAINS | CODE | EV (F-00033, SRT, "ECG Finding") | 1-n | U |  | DCID 3230 “ECG Findings”
27 | > | CONTAINS | TEXT | EV (121106, DCM, "Comment") | 1 | U |  |

Content Item Descriptions

Row 1 | The Container shall have a specific Content Item Observation DateTime (0040,A032) attribute to indicate the time at which the measurements were made.
Row 10 | Included TID 3106 “Drugs/Contrast Administered” allows the recording of test medications other than the Pharmacological Stress Agent identified in TID 3301 “Stress Test Procedure Description”.
Rows 17, 18 | ECG ST elevation/depression is measured in units of mV, but is conventionally reported in units of mm, based on strip recordings with scaling of 100 uV/mm. The display application should render these measurements in units meaningful to the user.
Row 19 | Note that the MDC codes for "per lead" measurements specified in CID 3228 “ECG Timing Measurements” are base codes for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300 “Measurement”. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row.
Row 20 | Note that the MDC code for "QTc interval per lead" specified in CID 3227 “QTc Measurements” is a base code for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300 “Measurement”. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row. Note that TID 300 “Measurement” enables the encoding of a non-standard correction algorithm, either as a local code, or as a TEXT Method Citation (see TID 300 “Measurement” row 12).
Row 21 | R-R interval used for QT correction algorithm
Row 22 | Recommended range for ECG axis measurements is -90° to +270°

### TID 3307 NM/PET Perfusion Measurement Group

Type:

  Extensible

Order:

  Significant

Table TID 3307. NM/PET Perfusion Measurement Group

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | DT (121070, DCM, "Findings") | 1 | M |  |
2 | > | HAS CONCEPT MOD | CODE | EV (121058, DCM, "Procedure reported") | 1 | M |  | DCID 3108 “NM/PET Procedures”
3 | > | CONTAINS | CODE | EV (F-61FDB, SRT, "Radiopharmaceutical agent") | 1 | M |  | DCID 3111 “Nuclear Cardiology Radiopharmaceuticals”
4 | > | CONTAINS | NUM | EV (123006, DCM, "Radionuclide Total Dose") | 1 | M |  | DCID 3083 “Units of Radioactivity”
5 | > | CONTAINS | DATETIME | EV (123003, DCM, "Radiopharmaceutical Start Time") | 1 | M |  |
6 | > | CONTAINS | NUM | DT (122711, DCM, "Exercise duration after stress agent injection") | 1 | U |  | UNITS = DT (min, UCUM, "min")
7 | > | CONTAINS | DATETIME | EV (122712, DCM, "Imaging Start Time") | 1 | M |  |
8 | > | CONTAINS | CODE | EV (122713, DCM, "Attenuation correction") | 1 | U |  | BCID 3112 “Attenuation Correction”
9 | >> | HAS PROPERTIES | CODE | EV (111001, DCM, "Algorithm Name") | 1 | U |  | BCID 3117 “Attenuation Correction Methods”
10 | > | CONTAINS | CODE | EV (121071, DCM, "Finding") | 1-n | U |  | BCID 3113 “Types of Perfusion Defects”
11 | >> | HAS PROPERTIES | CODE | EV (G-C0E3, SRT, "Finding Site") | 1 | M |  | BCID 3717 “Myocardial Wall Segments”
12 | >> | HAS PROPERTIES | CODE | EV (112025, DCM, "Size Descriptor") | 1 | M |  | BCID 252 “S-M-L Size Descriptor”
13 | >> | HAS PROPERTIES | CODE | EV (G-C197, SRT, "Severity") | 1 | M |  | BCID 3716 “Severity”
14 | > | CONTAINS | CODE | EV (F-02220, SRT, "Left Ventricular Function") | 1 | U |  | BCID 3119 “LV Function”
15 | >> | HAS PROPERTIES | CODE | EV (G-C197, SRT, "Severity") | 1 | U |  | BCID 3716 “Severity”
16 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1 | U |  | $Measurement = EV (10230-1, LN, "LV Ejection Fraction") $Units = EV (%, UCUM, "%") $Derivation = DT (R-41D2D, SRT, "Calculated")
17 | > | CONTAINS | CODE | EV (F-02236, SRT, "Left Ventricular Size") | 1 | U |  | BCID 3122 “Ventricular Enlargement”
18 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1 | U |  | $Measurement = EV (8821-1, LN, "Left Ventricular ED Volume") $Units = EV (ml, UCUM, "ml")
19 | > | CONTAINS | INCLUDE | DTID 300 “Measurement” | 1 | U |  | $Measurement = EV (8823-7, LN, "Left Ventricular ES Volume") $Units = EV (ml, UCUM, "ml")
20 | > | CONTAINS | INCLUDE | DTID 5204 “Wall Motion Analysis” | 1 | U |  | $Procedure = DCID 3108 “NM/PET Procedures”

### TID 3309 Stress Echo Measurement Group

Type:

  Extensible

Order:

  Significant

Table TID 3309. Stress Echo Measurement Group

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | DT (121070, DCM, "Findings") | 1 | M |  |
2 | > | HAS CONCEPT MOD | CODE | EV (121058, DCM, "Procedure reported") | 1 | M |  | DT (P5-B3000, SRT, "Echocardiography")
3 | > | CONTAINS | INCLUDE | DTID 5203 “Echo Measurement” | 1-n | U |  | $Measurement = DCID 12200 “Echocardiography Left Ventricle” $Method = CID 12227 “Echocardiography Measurement Method”
4 | >> | HAS CONCEPT MOD | CODE | EV (G-C0E3, SRT, "Finding Site") | 1 | MC | IF Row 3 measurement concept is in CID 12222 “Orifice Flow Properties” | EV (T-32600, SRT, "Left Ventricle")
5 | > | CONTAINS | INCLUDE | DTID 5203 “Echo Measurement” | 1-n | U |  | $Measurement = DCID 12211 “Echocardiography Aortic Valve” $Method = CID 12227 “Echocardiography Measurement Method”
6 | >> | HAS CONCEPT MOD | CODE | EV (G-C0E3, SRT, "Finding Site") | 1 | MC | IF Row 5 measurement concept is in CID 12222 “Orifice Flow Properties” | EV (T-35400, SRT, "Aortic Valve")
7 | > | CONTAINS | INCLUDE | DTID 5203 “Echo Measurement” | 1-n | U |  | $Measurement = DCID 12207 “Echocardiography Mitral Valve” $Method = CID 12227 “Echocardiography Measurement Method”
8 | >> | HAS CONCEPT MOD | CODE | EV (G-C0E3, SRT, "Finding Site") | 1 | MC | IF Row 7 measurement concept is in CID 12222 “Orifice Flow Properties” | EV (T-35300, SRT, "Mitral Valve")
9 | > | CONTAINS | INCLUDE | DTID 5203 “Echo Measurement” | 1-n | U |  | $Measurement = DCID 12208 “Echocardiography Tricuspid Valve” $Method = CID 12227 “Echocardiography Measurement Method”
10 | >> | HAS CONCEPT MOD | CODE | EV (G-C0E3, SRT, "Finding Site") | 1 | MC | IF Row 9 measurement concept is in CID 12222 “Orifice Flow Properties” | EV (T-35100, SRT, "Tricuspid Valve")
11 | > | CONTAINS | INCLUDE | DTID 5204 “Wall Motion Analysis” | 1 | U |  | $Procedure = DT (P5-B3121, SRT, "Echocardiography for Determining Ventricular Contraction")

Content Item Descriptions

Rows 3-10 | These invocations of TID 5203 “Echo Measurement” do not include an inherited Findings Site concept, for example as in the invocations of TID 5203 “Echo Measurement” from TID 5202 “Echo Section”. Echo measurements that do not have the associated Finding Site pre-coordinated in the measurement concept (i.e., the orifice flow measurements of CID 12222 “Orifice Flow Properties”), shall have the Finding Site explicitly post-coordinated with a Concept Modifier (Rows 4, 6, 8, and 10). This template does not include the concept of an Image Library, for example as used in TID 5200 “Echocardiography Procedure Report”. Image Content Items in the Echo Measurement template shall be included with by-value relationships, not with by-reference relationships.

### TID 3311 Stress Test Summary

Type:

  Extensible

Order:

  Significant

Table TID 3311. Stress Test Summary

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | EV (121111, DCM, "Summary") | 1 | M |  |
2 | > | CONTAINS | TEXT | EV (121111, DCM, "Summary") | 1 | U |  |
3 | > | CONTAINS | INCLUDE | DTID 3312 “Physiological Summary” | 1 | U |  |
4 | > | CONTAINS | INCLUDE | DTID 3313 “Stress ECG Summary” | 1 | U |  |
5 | > | CONTAINS | INCLUDE | DTID 3317 “Stress Imaging Summary” | 1 | U |  |
6 | > | CONTAINS | CODE | EV (121071, DCM, "Finding") | 1 | U |  | EV (D3-13025, SRT, "Exercise-induced angina") See note.
7 | >> |  | INCLUDE | DTID 1350 “Negation Modifier, Presence of Finding” | 1 | M |  |
8 | > | CONTAINS | CODE | EV (121071, DCM, "Finding") | 1-n | U |  | DCID 3220 “Stress Symptoms”
9 | > | CONTAINS | TEXT | EV (121071, DCM, "Finding") | 1 | U |  |
10 | > | CONTAINS | CODE | DT (G-0180, SRT, "Reason for stopping test") | 1 | U |  | DCID 3221 “Stress Test Termination Reasons”
11 | > | CONTAINS | NUM | DT (122715, DCM, "Pharmacological Stress Agent Dose") | 1 | U |  | DT (mg/kg, UCUM, "mg/kg")

Content Item Descriptions

Rows 6-7 | These rows allow an explicit finding of presence or absence of exercise-induced angina through the TID 1350 “Negation Modifier, Presence of Finding” Concept Modifier "Presence of property"

### TID 3312 Physiological Summary

Type:

  Extensible

Order:

  Significant

Table TID 3312. Physiological Summary

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | NUM | DT (40443-4, LN, "Resting Heart Rate") | 1 | M |  | UNITS = DT ({H.B.}/min, UCUM, "BPM")
2 |  |  | NUM | EV (F-008EC, SRT, "Systolic Blood Pressure") | 1 | M |  | UNITS = DCID 3500 “Pressure Units”
3 | > | HAS CONCEPT MOD | CODE | EV (109054, DCM, "Patient State") | 1 | M |  | DT (F-01604, SRT, "Resting State")
4 |  |  | NUM | EV (F-008ED, SRT, "Diastolic Blood Pressure") | 1 | M |  | UNITS = DCID 3500 “Pressure Units”
5 | > | HAS CONCEPT MOD | CODE | EV (109054, DCM, "Patient State") | 1 | M |  | DT (F-01604, SRT, "Resting State")
6 |  |  | NUM | DT (F-04F92, SRT, "Target HR") | 1 | M |  | UNITS = DT ({H.B.}/min, UCUM, "BPM")
7 |  |  | NUM | DT (F-04FA6, SRT, "Maximum HR Achieved") | 1 | M |  | UNITS = DT ({H.B.}/min, UCUM, "BPM")
8 |  |  | NUM | DT (F-04FA6, SRT, "Maximum HR Achieved") | 1 | M |  | UNITS = EV (%, UCUM, "%")
9 | > | HAS CONCEPT MOD | CODE | EV (121425, DCM, "Index") | 1 | M |  | DT (F-04F92, SRT, "Target HR")
10 |  |  | NUM | DT (122716, DCM, "Maximum Power Output Achieved") | 1 | U |  | UNITS = DT (W, UCUM, "Watts")
11 |  |  | NUM | DT (122717, DCM, "Peak activity workload") | 1 | U |  | UNITS = DT ([MET], UCUM, "METS")
12 |  |  | CODE | DT (F-04F9F, SRT, "HR Response") | 1 | U |  | DCID 3210 “Speed of Response”
13 |  |  | NUM | DT (F-00E11, SRT, "Maximum systolic blood pressure") | 1 | U |  | UNITS = DCID 3500 “Pressure Units”
14 |  |  | NUM | DT (F-00E21, SRT, "Maximum diastolic blood pressure") | 1 | U |  | UNITS = DCID 3500 “Pressure Units”
15 |  |  | CODE | DT (F-04F74, SRT, "BP Response") | 1 | U |  | DCID 3210 “Speed of Response”
16 |  |  | NUM | DT (122718, DCM, "Peak Double Product") | 1 | U |  | UNITS = DT (mm[Hg].{H.B.}/min, UCUM, "mmHg.BPM")
17 |  |  | NUM | DT (F-031F8, SRT, "Total Exercise duration") | 1 | U |  | UNITS = DT (min, UCUM, "min")
18 |  |  | NUM | DT (F-031F7, SRT, "Total test duration") | 1 | U |  | UNITS = DT (min, UCUM, "min")
19 |  |  | INCLUDE | DTID 300 “Measurement” | 1 | U |  | $Measurement = DT (F-04FCC, SRT, "Functional capacity") See note.
20 |  |  | TEXT | DT (F-04FCC, SRT, "Functional capacity") | 1 | U |  |
21 |  |  | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = EV (122760, DCM, "Stress test score") $Method = BCID 3238 “Stress Scoring Scales”
22 |  |  | NUM | DT (F-04FCA, SRT, "Heart rate recovery time") | 1 | U |  | UNITS = DT (s, UCUM, "s")
23 |  |  | CODE | EV (121071, DCM, "Finding") | 1-n | U |  | BCID 3213 “Stress Hemodynamic Findings”
24 |  |  | CODE | EV (F-00F4E, SRT, "Cardiovascular event risk") | 1 | U |  | BCID 3118 “Level of Risk”

Content Item Descriptions

Row 22 | Numerical scoring of a patient's functional capacity shall include the range of the scoring system in the Units of Measurement (see Section 7.2.2), and may include a coded identifier for the scoring system in the Method concept modifier of TID 300 “Measurement”.

### TID 3313 Stress ECG Summary

Type:

  Extensible

Order:

  Significant

Table TID 3313. Stress ECG Summary

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | TEXT | EV (F-00033, SRT, "ECG Finding") | 1 | U |  | Device Generated Test Summary
2 | > | HAS OBS CONTEXT | CODE | EV (121005, DCM, "Observer Type") | 1 | M |  | EV (121007, DCM, "Device")
3 | > | HAS OBS CONTEXT | INCLUDE | DTID 1004 “Device Observer Identifying Attributes” | 1 | M |  |
4 |  |  | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = EV (F-03204, SRT, "ST Elevation") $Units = DT (mV, UCUM, "mV") $Derivation = EV (G-A437, SRT, "Maximum") $TargetSite = DCID 3001 “ECG Leads”
5 |  |  | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = EV (F-38279, SRT, "ST Depression") $Units = DT (mV, UCUM, "mV") $Derivation = EV (G-A437, SRT, "Maximum") $TargetSite = DCID 3001 “ECG Leads”
6 |  |  | INCLUDE | DTID 300 “Measurement” | 1-n | U |  | $Measurement = EV (F-38287, SRT, "T wave alternans") $Units = DT (uV, UCUM, "uV") $Derivation = EV (G-A437, SRT, "Maximum") $TargetSite = DCID 3001 “ECG Leads”
7 |  |  | CODE | EV (F-38035, SRT, "ST Segment Finding") | 1 | U |  | BCID 3231 “ST Segment Findings”
8 | > | HAS PROPERTIES | CODE | EV (G-C0E3, SRT, "Finding Site") | 1-n | U |  | BCID 3232 “ST Segment Location”
9 | > | HAS PROPERTIES | CODE | EV (G-C504, SRT, "Associated Morphology") | 1 | U |  | BCID 3233 “ST Segment Morphology”
10 |  |  | NUM | DT (122707, DCM, "Number of Ectopic Beats") | 1 | U |  | UNITS = EV ({beats}, UCUM, "beats")
11 | > | HAS PROPERTIES | CODE | EV (G-C504, SRT, "Associated Morphology") | 1-n | U |  | BCID 3234 “Ectopic Beat Morphology”
12 |  |  | CODE | DT (8884-9, LN, "Cardiac Rhythm") | 1-2 | U |  | BCID 3415 “Cardiac Rhythms” See note.
13 | > | HAS CONCEPT MOD | CODE | EV (109054, DCM, "Patient State") | 1 | M |  | DCID 3102 “Rest-Stress”
14 |  |  | CODE | EV (F-00033, SRT, "ECG Finding") | 1-n | U |  | BCID 3230 “ECG Findings”
15 | > | HAS CONCEPT MOD | CODE | EV (109054, DCM, "Patient State") | 1 | U |  | BCID 3262 “ECG Patient State Values”

Content Item Descriptions

Rows 4-14 | Each observation (measurement or finding) may have a specific Content Item Observation DateTime attribute to indicate the time in the procedure at which the observation was made (e.g., time of maximum heart rate, or time of occurrence of an arrhythmia).
Row 12-13 | This Concept and the associated Concept Modifier may be instantiated twice, once for resting state measurements, once for stress.

### TID 3317 Stress Imaging Summary

Type:

  Extensible

Order:

  Significant

Table TID 3317. Stress Imaging Summary

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CODE | DT (122739, DCM, "Overall study quality") | 1 | M |  | BCID 3114 “Study Quality”
2 |  |  | CODE | DT (113010, DCM, "Quality Issue") | 1 | U |  | BCID 3115 “Stress Imaging Quality Issues”
3 |  |  | CODE | EV (121071, DCM, "Finding") | 1 | U |  | BCID 3116 “NM Extracardiac Findings”
4 |  |  | INCLUDE | DTID 300 “Measurement” | 1-2 | U |  | $Measurement = DT (F-04F76, SRT, "Perfusion defect extent") $ModType = EV (109054, DCM, "Patient State") $ModValue = DCID 3102 “Rest-Stress” $Units = EV (%, UCUM, "%") See note.
5 |  |  | INCLUDE | DTID 300 “Measurement” | 1 | U |  | $Measurement = DT (F-04FCD, SRT, "Stress ischemia extent") $Units = EV (%, UCUM, "%")
6 |  |  | INCLUDE | DTID 300 “Measurement” | 1 | U |  | $Measurement = DT (122762, DCM, "Number of diseased vessel territories") $Units = EV ({territories}, UCUM, "territories")
7 |  |  | CODE | EV (121071, DCM, "Finding") | 1 | U |  | EV (D3-13040, SRT, "Coronary artery disease")
8 | > | HAS PROPERTIES | CODE | EV (G-C0E3, SRT, "Finding Site") | 1-n | M |  | BCID 3016 “Major Coronary Arteries”
9 |  |  | CODE | EV (F-0238D, SRT, "Myocardial perfusion") | 1-2 | U |  | BCID 3120 “Perfusion Findings”
10 | > | HAS CONCEPT MOD | CODE | EV (G-C0E3, SRT, "Finding Site") | 1 | M |  | BCID 3463 “Ventricle Identification”
11 | > | HAS PROPERTIES | CODE | EV (G-C504, SRT, "Associated Morphology") | 1 | U |  | BCID 3121 “Perfusion Morphology”
12 |  |  | CODE | EV (121071, DCM, "Finding") | 1 | U |  | DT (D4-31124, SRT, "Transient cavitary dilatation")
13 | > |  | INCLUDE | DTID 1350 “Negation Modifier, Presence of Finding” | 1 | U |  |
14 |  |  | INCLUDE | DTID 300 “Measurement” | 1 | U |  | $Measurement = DT (F-04FB4, SRT, "Transient cavitary dilatation ratio") $Units = EV ({ratio}, UCUM, "ratio")
15 |  |  | INCLUDE | DTID 300 “Measurement” | 1-2 | U |  | $Measurement = EV (10230-1, LN, "LV Ejection Fraction") $ModType = EV (109054, DCM, "Patient State") $ModValue = DCID 3102 “Rest-Stress” $Units = EV (%, UCUM, "%") See note.

Content Item Descriptions

Row 4 | This row may be instantiated twice, once for resting state measurements, once for stress.
Row 15 | The LVEF code specified in this row is defined in LOINC with method "imaging". LVEF measurement by ultrasound may also be encoded elsewhere in the Content Tree (e.g., in TID 3309 “Stress Echo Measurement Group”) with LOINC code 18043-0, which has method "ultrasound". It is recommended that such findings from the per-phase measurements be summarized here with the generic "LVEF by Imaging" concept code.

### TID 3318 Comparison to Prior Stress Exam

This template describes changes in findings from a prior stress exam. Comparison is to only one prior exam, even though the generic concept name for the template uses the plural "exams".

Type:

  Extensible

Order:

  Significant

Table TID 3318. Comparison to Prior Stress Exam

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | EV (111424, DCM, "Comparison to previous exams") | 1 | M |  |
2 | > | CONTAINS | CODE | DT (121058, DCM, "Procedure Reported") | 1 | U |  | DCID 3200 “Stress Test Procedure”
3 | >> | HAS PROPERTIES | DATETIME | EV (122146, DCM, "Procedure DateTime") | 1 | U |  |
4 | >> | HAS PROPERTIES | UIDREF | EV (121018, DCM, "Procedure Study Instance UID") | 1 | U |  |
5 | >> | HAS PROPERTIES | COMPOSITE | EV (122075, DCM, "Prior report for current patient") | 1-n | U |  |
6 | > | CONTAINS | CODE | DT (F-03D1D, SRT, "Exercise tolerance") | 1 | U |  | BCID 3236 “Tolerance Comparison Findings”
7 | > | CONTAINS | CODE | DT (F-0238D, SRT, "Myocardial Perfusion") | 1 | U |  | BCID 3235 “Perfusion Comparison Findings”
8 | >> | HAS CONCEPT MOD | CODE | EV (G-C036, SRT, "Measurement Method") | 1-n | U |  | BCID 3215 “Perfusion Finding Method”
9 | > | CONTAINS | CODE | DT (F-02225, SRT, "LV Wall motion") | 1-n | U |  | BCID 3237 “Wall Motion Comparison Findings”
10 | >> | HAS CONCEPT MOD | CODE | EV (109054, DCM, "Patient State") | 1 | M |  | DCID 3102 “Rest-Stress”
11 | > | CONTAINS | CODE | EV (111424, DCM, "Comparison to previous exams") | 1 | U |  | BCID 3217 “Comparison Finding”
12 | > | CONTAINS | NUM | DT (122768, DCM, "Difference in Ejection Fraction") | 1 | U |  | UNITS = EV (%, UCUM, "%")
13 | > | CONTAINS | NUM | DT (122769, DCM, "Difference in ED LV Volume") | 1 | U |  | UNITS = EV (ml, UCUM, "ml")
14 | > | CONTAINS | NUM | DT (122769, DCM, "Difference in ED LV Volume") | 1 | U |  | UNITS = EV (ml/m2, UCUM, "ml/m2")
15 | >> | HAS CONCEPT MOD | CODE | EV (121425, DCM, "Index") | 1 | M |  | DT (8277-6, LN, "BSA")

### TID 3320 Conclusions and Recommendations

Type:

  Extensible

Order:

  Non-Significant

Table TID 3320. Conclusions and Recommendations

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | CONTAINER | EV (121076, DCM, "Conclusions") | 1 | MC | IF Completion Flag (0040,A491) = COMPLETE |
2 | > | CONTAINS | TEXT | EV (121077, DCM, "Conclusion") | 1 | U |  |
3 | > | CONTAINS | CODE | EV (F-00033, SRT, "ECG Finding") | 1 | M |  | DCID 3208 “Summary Codes Exercise ECG”
4 | > | CONTAINS | CODE | EV (F-01969, SRT, "Imaging Finding") | 1 | M |  | DCID 3209 “Summary Codes Stress Imaging”
5 |  |  | CONTAINER | EV (121074, DCM, "Recommendations") | 1 | U |  |
6 | > | CONTAINS | TEXT | EV (121075, DCM, "Recommendation") | 1 | U |  |

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