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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549


FORM 10-Q


[X] Quarterly Report Pursuant to Section 13 or 15(d) of the Securities Exchange
Act of 1934 For the quarterly period ended November 30, 2003

[ ] Transition Report Pursuant to Section 13 or 15(d) of the Securities Exchange
Act of 1934 For the transition period from _______________ to ______________

Commission File Number: 0-18105

VASOMEDICAL, INC.
- --------------------------------------------------------------------------------

(Exact name of registrant as specified in its charter)

Delaware 11-2871434
- --------------------------------------------------------------------------------
(State or other jurisdiction of (IRS Employer Identification Number)
incorporation or organization)

180 Linden Ave., Westbury, New York 11590
- --------------------------------------------------------------------------------
(Address of principal executive offices)

Registrant's Telephone Number (516) 997-4600

Number of Shares Outstanding of Common Stock,
$.001 Par Value, at January 9, 2004 57,827,690


Indicate by check mark whether the registrant (1) has filed all reports
required to be filed by Section 13 or 15 (d) of the Exchange Act of 1934 during
the preceding 12 months (or for such shorter period that the registrant was
required to file such reports), and (2) has been subject to such filing
requirements for the past 90 days. Yes [X] No [ ]
--- --
1



Vasomedical, Inc. and Subsidiaries



INDEX



PART I - FINANCIAL INFORMATION

Item 1 - Financial Statements (unaudited) Page
----
Consolidated Condensed Balance Sheets as of
November 30, 2003 and May 31, 2003 3

Consolidated Condensed Statements of Earnings for the
Six and Three Months Ended November 30, 2003 and 2002 4

Consolidated Condensed Statement of Changes in Stockholders'
Equity for the Period from June 1, 2003 to November
30, 2003 5

Consolidated Condensed Statements of Cash Flows for the
Six Months Ended November 30, 2003 and 2002 6

Notes to Consolidated Condensed Financial Statements 7

Item 2 - Management's Discussion and Analysis of Financial Condition
and Results of Operations 16

Item 3 Qualitative and Quantitative Disclosures About Market Risk 27

Item 4 Procedures and Controls 27

PART II - OTHER INFORMATION 28

2



Vasomedical, Inc. and Subsidiaries

CONSOLIDATED CONDENSED BALANCE SHEETS



November 30, May 31,
2003 2003
----------------- -----------------
ASSETS (unaudited) (audited)

CURRENT ASSETS
Cash and cash equivalents $7,554,220 $5,222,847
Accounts receivable, net of an allowance for doubtful accounts of
$763,888 at November 30, 2003 and $768,629 at May 31, 2003 4,514,363 7,377,118
Inventories 3,062,260 3,439,567
Deferred income taxes -- 303,000
Financing receivables, net 149,387 264,090
Other current assets 494,723 268,231
----------------- -----------------
Total current assets 15,774,953 16,874,853

PROPERTY AND EQUIPMENT, net of accumulated depreciation of $2,584,511 at
November 30, 2003 and $ 2,338,366 at May 31, 2003 2,686,638 3,233,158
FINANCING RECEIVABLES, net -- 679,296
DEFERRED INCOME TAXES 14,582,000 14,279,000
OTHER ASSETS 298,440 261,243
----------------- -----------------
$33,342,031 $35,327,550
================= =================

LIABILITIES AND STOCKHOLDERS' EQUITY
CURRENT LIABILITIES
Accounts payable and accrued expenses $3,218,925 $2,667,861
Current maturities of long-term debt and notes payable 112,658 108,462
Sales tax payable 342,913 461,704
Deferred revenues 1,334,983 789,118
Accrued warranty and customer support expenses 358,000 575,000
Accrued professional fees 107,654 207,793
Accrued commissions 382,561 586,823
----------------- -----------------
Total current liabilities 5,857,694 5,396,761

LONG-TERM DEBT 1,121,179 1,177,804
ACCRUED WARRANTY COSTS 143,000 213,000
DEFERRED REVENUES 949,183 920,433
OTHER LIABILITIES 300,250 300,250

COMMITMENTS AND CONTINGENCIES

STOCKHOLDERS' EQUITY
Preferred stock, $.01 par value; 1,000,000 shares authorized; none
issued and outstanding -- --
Common stock, $.001 par value; 110,000,000 shares authorized;
57,827,690 and 57,822,023 shares at November 30, 2003 and May 31,
2003, respectively, issued and outstanding 57,828 57,822
Additional paid-in capital 50,628,269 50,623,316
Accumulated deficit (25,715,372) (23,361,836)
----------------- -----------------
Total stockholders' equity 24,970,725 27,319,302
----------------- -----------------
$33,342,031 $35,327,550
================= =================

The accompanying notes are an integral part of these condensed statements.

3


Vasomedical, Inc. and Subsidiaries

CONSOLIDATED CONDENSED STATEMENTS OF EARNINGS
(unaudited)



Six Months Ended Three Months Ended
November 30, November 30,
------------------------------ ------------------------------
2003 2002 2003 2002
------------- ------------- ------------- -------------

Revenues
Equipment sales $8,961,860 $10,414,340 $4,173,750 $6,209,831
Equipment rentals and services 1,367,801 769,098 729,379 433,437
------------- ------------- ------------- -------------

10,329,661 11,183,438 4,903,129 6,644,268

Cost of sales and services 3,631,923 3,963,889 1,693,249 2,004,537
------------- ------------- ------------- -------------
Gross Profit 6,697,738 7,219,549 3,209,880 4,639,731

Expenses
Selling, general and administrative 6,134,429 7,863,844 3,512,977 4,176,948
Research and development 1,953,375 2,517,626 997,830 1,326,640
Provision for doubtful accounts 985,511 3,260,708 796,330 11,834
Interest and financing costs 66,246 97,067 32,880 48,215
Interest and other income, net (108,287) (104,704) (53,195) (28,214)
------------- ------------- ------------- -------------
9,031,274 13,634,541 5,286,822 5,535,423

------------- ------------- ------------- -------------
LOSS BEFORE INCOME TAXES (2,333,536) (6,414,992) (2,076,942) (895,692)
Income tax (expense) benefit, net (20,000) 1,583,922 (10,000) 298,900
------------- ------------- ------------- -------------
NET LOSS ($2,353,536) ($4,831,070) ($2,086,942) ($596,792)
============= ============= ============= =============

Net loss per common share
- basic ($0.04) ($0.08) ($0.04) ($0.01)
============= ============= ============= =============
- diluted ($0.04) ($0.08) ($0.04) ($0.01)
============= ============= ============= =============

Weighted average common shares outstanding
- basic 57,827,265 57,567,317 57,827,690 57,658,021
============= ============= ============= =============
- diluted 57,827,265 57,567,317 57,827,690 57,658,021
============= ============= ============= =============

The accompanying notes are an integral part of these condensed statements.

4



Vasomedical, Inc. and Subsidiaries

CONSOLIDATED CONDENSED STATEMENT OF CHANGES IN STOCKHOLDERS' EQUITY
(unaudited)


Additional Total
Paid-in Accumulated Stockholders
Shares Amount Capital Deficit Equity
------------ ---------- -------------- --------------- --------------

Balance at June 1, 2003 57,822,023 $57,822 $50,623,316 ($23,361,836) $27,319,302
Exercise of stock options 5,667 6 4,953 4,959
Net loss (2,353,536) (2,353,536)
------------ ---------- -------------- --------------- --------------
Balance at November 30, 2003 57,827,690 $57,828 $50,628,269 ($25,715,372) $24,970,725
============ ========== ============== =============== ==============


The accompanying notes are an integral part of this condensed statement.

5


Vasomedical, Inc. and Subsidiaries

CONSOLIDATED CONDENSED STATEMENTS OF CASH FLOWS
(unaudited)


Six months ended
November 30,
--------------------------------------
2003 2002
----------------- -----------------

Cash flows from operating activities
Net loss ($2,353,536) ($4,831,070)
----------------- -----------------
Adjustments to reconcile net loss to net cash provided by operating
activities
Depreciation and amortization 415,003 589,998
Provision for doubtful accounts, net of write-offs 675,258 3,001,708

Deferred income taxes -- (1,643,900)
Stock options granted for services -- 25,125
Changes in operating assets and liabilities
Accounts receivable 2,867,497 2,819,302
Financing receivables, net 113,999 112,892
Inventories 645,361 (174,093)
Other current assets (226,492) 67,793
Other assets (53,372) (41,589)
Accounts payable, accrued expenses and other current
liabilities 456,737 (198,536)
Other liabilities (41,250) 493,912
----------------- -----------------
4,852,741 5,052,612
----------------- -----------------
Net cash provided by operating activities 2,499,205 221,542
----------------- -----------------

Cash flows from investing activities
Purchase of property and equipment (120,362) (217,716)
----------------- -----------------
Net cash used in investing activities (120,362) (217,716)
----------------- -----------------

Cash flows from financing activities
Proceeds from notes -- 126,967
Payments on notes (52,429) (29,904)
Proceeds from exercise of options and warrants 4,959 225,000
----------------- -----------------
Net cash provided by (used in) financing activities (47,470) 322,063
----------------- -----------------

NET INCREASE IN CASH AND CASH EQUIVALENTS 2,331,373 325,889
Cash and cash equivalents - beginning of period 5,222,847 2,967,627
----------------- -----------------
Cash and cash equivalents - end of period $7,554,220 $3,293,516
================= =================

Non-cash investing and financing activities were as follows:
Inventories transferred to (from) property and equipment, attributable
to operating leases - net ($268,054) $312,405


The accompanying notes are an integral part of these condensed statements.

6

Vasomedical, Inc. and Subsidiaries

NOTES TO CONSOLIDATED CONDENSED FINANCIAL STATEMENTS (unaudited)
November 30, 2003

NOTE A - BASIS OF PRESENTATION

The consolidated condensed balance sheet as of November 30, 2003, and the
related consolidated condensed statements of earnings for the six and
three-month periods ended November 30, 2003 and 2002, changes in stockholders'
equity for the six-month period ended November 30, 2003, and cash flows for the
six-month periods ended November 30, 2003 and 2002, have been prepared by
Vasomedical, Inc. and Subsidiaries (the "Company") without audit. In the opinion
of management, all adjustments (which include only normal, recurring accrual
adjustments) necessary to present fairly the financial position and results of
operations as of November 30, 2003, and for all periods presented have been
made.

Certain information and footnote disclosures, normally included in
financial statements prepared in accordance with accounting principles generally
accepted in the United States of America, have been condensed or omitted. These
financial statements should be read in conjunction with the financial statements
and notes thereto included in the Annual Report on Form 10-K for the year ended
May 31, 2003. Results of operations for the periods ended November 30, 2003 and
2002 are not necessarily indicative of the operating results expected or
reported for the full year.

NOTE B IMPACT OF NEW ACCOUNTING PRONOUNCEMENTS

In April 2003, the FASB issued Statement of Financial Accounting Standards
No. 149 ("SFAS No. 149"), "Amendment of Statement 133 on Derivative Instruments
and Hedging Activities," which amends and clarifies financial accounting and
reporting for derivative instruments, including certain derivative instruments
embedded in other contracts and for hedging activities under SFAS No. 133. SFAS
No. 149 is effective for contracts entered into or modified after June 30, 2003,
except for the provisions that were cleared by the FASB in prior pronouncements.
The adoption of SFAS No. 149 has not had a material impact on the Company's
financial position and results of operations.

In May 2003, the FASB issued Statement of Financial Accounting Standards
No. 150 ("SFAS No. 150"), "Accounting for Certain Financial Instruments with
Characteristics of both Liabilities and Equity." This statement establishes
standards for how an issuer classifies and measures in its statement of
financial position certain financial instruments with characteristics of both
liabilities and equity. In accordance with the standard, financial instruments
that embody obligations for the issuer are required to be classified as
liabilities. This Statement shall be effective for financial instruments entered
into or modified after May 31, 2003, and otherwise shall be effective at the
beginning of the first interim period beginning after June 15, 2003. The
adoption of SFAS No. 150 has not had a material impact on the Company's
financial position and results of operations.

In January 2003, the FASB issued FASB Interpretation No. 46 "Consolidation
of Variable Interest Entities" ("FIN 46"). In general, a variable interest
entity is a corporation, partnership, trust, or any other legal structure used
for business purposes that either (a) does not have equity investors with voting
rights or (b) has equity investors that do not provide sufficient financial
resources for the entity to support its activities. A variable interest entity
often holds financial assets, including loans or receivables, real estate or
other property. A variable interest entity may be essentially passive or it may
engage in activities on behalf of another company. Until now, a company
generally has included another entity in its consolidated financial statements
only if it controlled the entity through voting interests. FIN 46 changes that
by requiring a variable interest entity to be consolidated by a company if that
company is subject to a majority of the risk of loss from the variable interest
entity's activities or entitled to receive a majority of the entity's residual
returns or both. FIN 46's consolidation requirements apply immediately to
variable interest entities created or acquired after January 31, 2003. The
consolidation requirements apply to older entities in the first interim period
beginning after June 15, 2003. Certain of the disclosure requirements apply in
all financial statements issued after January 31, 2003, regardless of when the
variable interest entity was established. The Company adopted FIN 46 effective
January 31, 2003. The adoption of FIN 46 did not have a material impact on the
Company's financial position or results of operations.

In November 2002, the Emerging Issues Task Force, ("EITF") reached a
consensus opinion on, "Revenue Arrangements with Multiple Deliverables", "(EITF
00-21)". That consensus provides that revenue arrangements with multiple
deliverables should be divided into separate units of accounting if certain
criteria are met. The consideration of the arrangement should be allocated to
the separate units of accounting based on their relative fair values, with
different provisions if the fair value is contingent on delivery of specified

7

Vasomedical, Inc. and Subsidiaries

NOTES TO CONSOLIDATED CONDENSED FINANCIAL STATEMENTS (unaudited)
November 30, 2003

items or performance conditions. Applicable revenue criteria should be
considered separately for each separate unit of accounting. EITF 00-21 is
effective for revenue arrangements entered into in fiscal periods beginning
after June 15, 2003. Effective September 1, 2003, the Company prospectively
adopted the provisions of EITF 00-21. Upon adoption of the provisions of EITF
00-21, the Company deferred $42,500 of revenue related to the fair value of
installation and in- service training and $253,750 of revenue related to the
warranty service for EECP system sales recognized during the second quarter of
fiscal 2004.

NOTE C STOCK-BASED COMPENSATION

The Company has four stock-based employee compensation plans. The Company
accounts for stock-based compensation using the intrinsic value method in
accordance with Accounting Principles Board Opinion No. 25, "Accounting for
Stock Issued to Employees," and related Interpretations ("APB No. 25") and has
adopted the disclosure provisions of Statement of Financial Accounting Standards
No. 148, "Accounting for Stock-Based Compensation - Transition and Disclosure,
an amendment of FASB Statement No. 123." Under APB No. 25, when the exercise
price of the Company's employee stock options equals the market price of the
underlying stock on the date of grant, no compensation expense is recognized.
Accordingly, no compensation expense has been recognized in the consolidated
financial statements in connection with employee stock option grants.

During the six-month period ended November 30, 2003, the Board of Directors
granted stock options under the 1999 Stock Option Plan (the "1999 Plan") to
three employees to purchase an aggregate of 500,000 shares of common stock, at
an exercise price of $0.92 to $1.04 per share (which represented the fair market
value of the underlying common stock at the time of the respective grants).
These options vest over a three-year period and expire ten years from the date
of grant.

The following table illustrates the effect on net loss and loss per share
had the Company applied the fair value recognition provisions of Statement of
Financial Accounting Standards No. 123, "Accounting for Stock-Based
Compensation," to stock-based employee compensation.



Six Months Ended Three Months Ended
November 30, November 30,
------------------------------ ------------------------------
2003 2002 2003 2002
------------- ------------- ------------- -------------

Net loss, as reported ($2,353,536) ($4,831,070) ($2,086,942) ($596,792)
Deduct: Total stock-based employee
compensation expense determined under fair
value-based method for all awards (678,580) (433,919) (349,109) (140,915)
------------- ------------- ------------- -------------
Pro forma net loss ($3,032,116) ($5,264,989) ($2,436,051) ($737,707)
============= ============= ============= =============

Loss per share:
Basic - as reported ($0.04) ($0.08) ($0.04) ($0.01)
============= ============= ============= =============
Diluted - as reported ($0.04) ($0.08) ($0.04) ($0.01)
============= ============= ============= =============
Basic - pro forma ($0.05) ($0.09) ($0.04) ($0.01)
============= ============= ============= =============
Diluted - pro forma ($0.05) ($0.09) ($0.04) ($0.01)
============= ============= ============= =============


Pro forma compensation expense may not be indicative of future disclosures
because it does not take into effect pro forma compensation expense related to
grants before 1995. For purposes of estimating the fair value of each option on
the date of grant, the Company utilized the Black-Scholes option-pricing model.

The Black-Scholes option valuation model was developed for use in
estimating the fair value of traded options, which have no vesting restrictions
and are fully transferable. In addition, option valuation models require the
input of highly subjective assumptions including the expected stock price
volatility. Because the Company's employee stock options have characteristics
significantly different from those of traded options and because changes in the
subjective input assumptions can materially affect the fair value estimate, in
management's opinion, the existing models do not necessarily provide a reliable
single measure of the fair value of its employee stock options.

8

Vasomedical, Inc. and Subsidiaries

NOTES TO CONSOLIDATED CONDENSED FINANCIAL STATEMENTS (unaudited)
November 30, 2003

Equity instruments issued to non-employees in exchange for goods, fees and
services are accounted for under the fair value-based method of SFAS No. 123.

NOTE D EARNINGS (LOSS) PER COMMON SHARE

Basic earnings (loss) per share is based on the weighted average number of
common shares outstanding without consideration of potential common shares.
Diluted earnings (loss) per share is based on the weighted number of common and
potential common shares outstanding. The calculation takes into account the
shares that may be issued upon the exercise of stock options and warrants,
reduced by the shares that may be repurchased with the funds received from the
exercise, based on the average price during the period. Options and warrants to
purchase 6,685,086 and 5,765,000 shares of common stock were excluded from the
computation of diluted earnings per share for the three months ended November
30, 2003 and 2002, respectively, because the effect of their inclusion would be
antidilutive.

The following table sets forth the computation of basic and diluted
earnings (loss) per common share:


Six Months Ended Three Months Ended
November 30, November 30,
------------------------------ ------------------------------
2003 2002 2003 2002
------------- ------------- ------------- -------------

Numerator:
Basic and diluted net loss ($2,353,536) ($4,831,070) ($2,086,942) ($596,792)
Denominator:
Basic - weighted average common shares 57,827,265 57,567,317 57,827,690 57,658,021
Stock options -- -- -- --
Warrants -- -- -- --
------------- ------------- ------------- -------------
Diluted - weighted average common shares 57,827,265 57,567,317 57,827,690 57,658,021
============= ============= ============= =============
Basic and diluted loss per common share ($0.04) ($0.08) ($0.04) ($0.01)
============= ============= ============= =============

NOTE E - INVENTORIES


November 30, May 31,
2003 2003
---------------- ------------------

Inventories consist of the following:
Raw materials $1,095,056 $1,374,241
Work in progress 744,719 634,890
Finished goods 1,222,485 1,430,436
---------------- ------------------
$3,062,260 $3,439,567
================ ==================

The fair value of the Company's stock-based awards was estimated assuming
no expected dividends and the following weighted-average assumptions for the six
months ended November 30:


2003
----

Expected life (years) 5
Expected volatility 84%
Risk-free interest rate 3.6%

NOTE F - FINANCING RECEIVABLES FROM MAJOR CUSTOMERS

In fiscal 2002, the Company sold its external counterpulsation systems
("EECP" units) to two major customers engaged in establishing independent
networks of EECP centers under sales-type leases aggregating revenues of
$4,187,009 in fiscal 2002. No additional equipment was sold to these customers
during fiscal 2003 or 2004.

In late August 2002, the largest customer became delinquent in its
scheduled monthly payments under its financing obligations to the Company. In
September 2002, the Company was notified by this customer of recent
circumstances that precluded their ability to remain current under their
financing obligations to the Company. Accordingly, management decided to
write-off, in full, all funds due from this customer as of August 31, 2002,
which aggregated approximately $3,000,000, including the present carrying amount

9

Vasomedical, Inc. and Subsidiaries

NOTES TO CONSOLIDATED CONDENSED FINANCIAL STATEMENTS (unaudited)
November 30, 2003

of the underlying equipment due to the uncertainty of the Company's ability to
repossess the equipment. During the second quarter of fiscal 2003, the customer
ceased operations and the Company was able to successfully recover all of the
units that it had sold under sales-type leases to the customer back into its
finished goods inventory and recorded a bad debt recovery of $479,000, which
represented the present carrying amount of the equipment. The Company redeployed
certain pieces of the equipment while other pieces were returned to the
Company's inventory for resale.

The second customer became delinquent in its scheduled monthly payments
during the fourth quarter of fiscal 2003. During the first and second quarters
of fiscal 2004 the customer attempted to remedy the situation and made payments
totaling $70,000. In December 2003, the customer ceased operations. Accordingly,
management decided to write-off all funds due from this customer as of November
30, 2003, less the anticipated recovery of equipment and the reduction of
related liabilities for sales tax, which totals $149,387 at November 30, 2003.
The write-off of $680,000 is included as a component of provision for doubtful
accounts in the accompanying Statement of Earnings. The Company is currently
negotiating with other third parties and anticipates that it may be able to
redeploy certain pieces of the equipment while other pieces will be returned to
the Company's inventory for resale. Additionally, the Company is evaluating its
ability to seek additional recovery from the customer.

The Company is no longer offering sales-type leases.

NOTE G - LONG-TERM DEBT AND LINE OF CREDIT AGREEMENT



November 30, May 31,
2003 2003
------------ -----------


Revolving credit agreement (a) -- --
Term loans (b) (c) $1,233,837 $1,286,266
Less current portion (112,658) (108,462)
---------------- ------------------
$1,121,179 $1,177,804
================ ==================


(a) In February 2002, the Company renegotiated a secured revolving credit
line with its existing bank. The credit line provided for borrowings up to
$15,000,000, based upon eligible accounts receivable, as defined therein, at the
Libor Rate plus 150 basis points (3.4% at May 31, 2002). At May 31, 2002,
approximately $3,600,000 of the line was available of which there were
outstanding borrowings of $1,000,000. Under the terms of the agreement, which
expires in February 2005, the Company is required to meet certain quarterly
covenants, including leverage ratio, liquidity, capital expenditures, minimum
net income, minimum interest coverage and minimum tangible net worth. In
addition, the line is secured by substantially all the tangible assets of the
Company. In October 2002, the credit line was further amended to provide for
borrowings up to $5,000,000 ($2,000,000, at any time that consolidated net
income for the immediately preceding three-month period is less than $1),
primarily based upon eligible accounts receivable, as defined therein, at the
Libor Rate plus 200 basis points or the published Prime Rate plus 50 basis
points. In April 2003, the agreement was further amended to allow for borrowings
absent compliance with the financial covenants as long as such eligible
borrowings are collateralized by cash. In April 2003, the Company repaid all
outstanding borrowings under the agreement instead of maintaining restricted
cash balances and there are currently no outstanding borrowings. At November 30,
2003, the Company did not meet the minimum interest coverage, tangible net worth
and minimum net earnings covenants and future compliance with each of these
covenants in the near term is not certain.

(b) The Company purchased its headquarters and warehouse facility and
secured notes of $641,667 and $500,000, respectively, under two programs
sponsored by New York State. These notes, which bear interest at 7.8% and 6%,
respectively, are payable in monthly installments consisting of principal and
interest payments over fifteen- year terms, expiring in September 2016 and
January 2017, respectively, and are secured by the building. At November 30,
2003, $1,049,030 was outstanding in connection with these notes.

(c) In fiscal 2003, the Company financed the cost of implementation of a
management information system and secured several notes, aggregating
approximately $238,000. The notes, which bear interest at rates ranging from

10

Vasomedical, Inc. and Subsidiaries

NOTES TO CONSOLIDATED CONDENSED FINANCIAL STATEMENTS (unaudited)
November 30, 2003

7.5% through 8.7%, are payable in monthly installments consisting of principal
and interest payments over four-year terms, expiring at various times between
August and October 2006. At November 30, 2003, $184,807 was outstanding in
connection with these notes.


NOTE H DEFERRED REVENUES

The Company records revenue on extended service contracts ratably over the
term of the related warranty contracts. Effective September 1, 2003, the Company
prospectively adopted the provisions of EITF 00-21. Upon adoption of the
provisions of EITF 00-21, the Company began to defer revenue related to EECP
system sales for the fair value of installation and in-service training to the
period when the services are rendered and for warranty obligations ratably over
the service period, which is generally one year.

The changes in the Company's deferred revenues are as follows:


Six months
ended
November 30,
2003 2002
---- ----

Deferred Revenue at the beginning of the period $1,709,551 $991,204
ADDITIONS
Deferred extended service contracts 945,938 774,425
Deferred in-service training 97,500 --
Deferred warranty obligations 292,500 --
DELETIONS
Deferred extended service contracts recognized as
revenue (667,573) (320,100)
Deferred in-service training recognized as revenue (55,000) --
Deferred warranty obligations recognized as revenue
(38,750) --
---------------- ------------------
Deferred revenue at end of period 2,284,166 1,445,529
Less current portion (1,334,983) (536,746)
---------------- ------------------
$949,183 $908,783
================ ==================


NOTE I WARRANTY COSTS

Equipment sold is generally covered by a warranty period of one year.
Effective September 1, 2003, the Company adopted the provisions of EITF 00-21,
"Accounting for Revenue Arrangements with Multiple Deliverables" on a
prospective basis. Under EITF 00-21, for certain arrangements, a portion of the
overall system price attributable to the first year warranty service is deferred
and recognized as revenue over the service period. As such, the Company no
longer accrues warranty costs upon delivery but rather recognizes warranty and
related service costs as incurred. Prior to September 1, 2003, the Company
accrued a warranty reserve for estimated costs to provide warranty services when
the equipment sale is recognized. The factors affecting the Company's warranty
liability included the number of units sold and historical and anticipated rates
of claims and costs per claim. The warranty provision resulting from
transactions prior to September 1, 2003 will be reduced in future periods for
material and labor costs incurred as related product is returned during the
warranty period or when the warranty period elapses. A review of warranty
obligations is performed regularly to determine the adequacy of the reserve.
Based on the outcome of this review, revisions to the estimated warranty
liability are recorded as appropriate. Warranty reserves related to units sold
under sales-type leases are recorded as executory costs, which serve to reduce
the amount of financing receivables reported in the consolidated balance sheets.

The changes in the Company's product warranty liability are as follows:

11

Vasomedical, Inc. and Subsidiaries

NOTES TO CONSOLIDATED CONDENSED FINANCIAL STATEMENTS (unaudited)
November 30, 2003


Six months
ended
November 30,
2003 2002
---- ----

Warranty liability at the beginning of the period $788,000 $991,000
Expense for new warranties issued 164,000 336,000
Warranty amortization (451,000) (458,000)
---------------- ------------------
Warranty liability at end of period $501,000 $869,000
================ ==================


NOTE J - INCOME TAXES

During the six-months ended November 30, 2003, the Company recorded a
provision for state income taxes of $20,000. This is in contrast to an income
tax benefit of $1,583,922 reported during the six-months ended November 30,
2002.

As of November 30, 2003, the Company had recorded deferred tax assets of
$14,582,000 (net of a ($1,357,000) valuation allowance) related to the
anticipated recovery of tax loss carryforwards. The amount of the deferred tax
assets considered realizable could be reduced in the future if estimates of
future taxable income during the carryforward period are reduced. Ultimate
realization of the deferred tax assets is dependent upon the Company generating
sufficient taxable income prior to the expiration of the tax loss carryforwards.
In accordance with the Statement of Financial Accounting Standard No. 109
"Accounting for Income Taxes" ("SFAS 109"), management concluded at the end of
fiscal 2003, based upon the weight of available evidence at that time, that it
was more likely than not that all of the deferred tax assets would be realized.
It was management's belief that realization of the deferred tax asset was not
dependent on material improvements over the average of fiscal 2000 through
fiscal 2002 levels of pre-tax income, and that the Company is positioned for
long-term growth despite the results achieved in fiscal 2003, much of which was
unexpected and non-recurring. Management is currently evaluating the impact of
the average 34% reduction in Medicare reimbursement rates for EECP treatments in
2004 that was recently announced by The Centers for Medicare and Medicaid
Services ("CMS"), a Federal agency within the U.S. Department of Health and
Human Services responsible for the administration of the Medicare and Medicaid
programs, plus other factors currently influencing market conditions including
the impact of increased competition, declining sales prices and lower volume on
the Company's estimates of future taxable income. Due to the uncertainty
associated with estimates of future taxable income during the carryforward
period and the net value of the recorded deferred tax asset relative to the
Company's historical taxable income, management has decided to provide a
valuation allowance for all potential deferred tax assets generated during
fiscal 2004. The recorded deferred tax asset and increase to the valuation
allowance during the six-month period ended November 30, 2003 was $735,000.

The following factors are anticipated to positively impact the future of
the Company's business activities and initiatives:

A. A large and increasing worldwide patient population with
cardiovascular disease demanding new choices of therapy, leading to
increased reimbursement coverage in the United States and other
countries. The estimated US patient population for angina patients is
approximately 6.2 million and approximately 5 million patients for
heart failure.
B. Approval of Medicare coverage and other third-party payer policies
specific to the congestive heart failure indication. The results of
the Company's ongoing PEECH trial are likely a pre-requisite for
significant coverage policies. The Company anticipates that the
results from the PEECH trial will be favorable (based upon a published
feasibility study and other analyses). The results should be available
for submission to CMS in late 2004 and a coverage decision is
anticipated in mid 2005. The combination of favorable PEECH trial
results and Medicare reimbursement would likely be a significant
catalyst for significant Company growth.
C. Potential extension of Medicare coverage to include all classes of
angina (beyond the present Class III/IV indication for refractory
angina, for which the Company estimates the annual patient population
in the US alone is 150,000).
D. A cardiology community with a mandate to offer patients new disease
management solutions providing effective clinical and economic
outcomes. The Company has cultivated relationships with many of the
leading institutions and cardiologists (as evidenced in its roster of
PEECH study sites).

12

Vasomedical, Inc. and Subsidiaries

NOTES TO CONSOLIDATED CONDENSED FINANCIAL STATEMENTS (unaudited)
November 30, 2003

E. The accumulation of EECP clinical validation and removal of obstacles
to third-party insurance reimbursement. Numerous abstracts and
publications are presented each year at major scientific meetings
worldwide. The Company estimates that more than 300 third-party payers
reimburse for EECP therapy, many on a routine basis.
F. Expanded base of future FDA-cleared indications to more effectively
penetrate the hospital market, particularly with respect to heart
failure (for which FDA clearance was received in June 2002), acute
coronary syndromes (also cleared by FDA), diabetes management, and
peripheral and cerebrovascular diseases.
G. Initiatives planned to lower the cost of the Company's EECP systems,
thus improving margins or helping to preserve margins from further
price erosion.
H. The Company has a large, non-domestic market opportunity that it
intends to develop through a network of local independent
distributors. The Company has received the CE Mark (FDA-clearance
equivalent) and is ISO 13485 certified.
I. Continuing to prove more definitively the mechanism of action by which
EECP operates. Smaller scale clinical studies are aimed at convincing
those with lingering doubt about EECP's effectiveness that the therapy
is, indeed, safe and effective and serves to expand the market.
Studies have been presented and published in this area.
J. Increased hardware utility to allow for the use of EECP in an
increasing number of patient environments. The EECP TS4 system is
mobile, quieter and can be used more easily in the hospital
environment. Future system modifications could allow for emergency
room use.

The Company acknowledges that certain risk factors have the potential
to adversely affect the business opportunity that has been outlined.
Initiatives planned to mitigate the impact of such risks have been
addressed. They include:

A. Dependence on outcome of PEECH trial and related reimbursement
coverage policies. Presently, the Company is engaged in the PEECH
trial, a pivotal study to evaluate the effectiveness of EECP therapy
for congestive heart failure patients. The Company anticipates that
the results of this study will be the catalyst for Medicare and other
third-party reimbursement coverage policies specific to heart failure.
Although the Company has received clearance from the FDA to market for
heart failure, the medical community, market acceptance and insurance
coverage policies are highly influenced by scientifically proven
technologies. The Company had designed its PEECH protocol in
cooperation with the FDA and had reached a formal agreement with the
FDA that the key parameters of its investigational plan for this trial
were appropriate to determine the effectiveness of EECP as an adjunct
therapy for heart failure. The Company believes that its PEECH trial
is robust and will provide favorable results that should provide a
reasonable basis for market acceptance and insurance reimbursement.

B. Dependence on a single product platform. Current FDA labeling extends
beyond chronic stable angina and congestive heart failure to unstable
angina, myocardial infarction and cardiogenic shock (i.e., acute
coronary syndromes). The Company intends to pursue additional clinical
studies to validate the safety and effectiveness of EECP in acute
coronary syndromes over the next few years provided sufficient
financial resources are available.

C. Dependence on consistency of research findings about EECP efficacy and
increasing acceptance of EECP by the medical community. To that end,
the Company has sponsored the International EECP Patient Registry
(IEPR), maintained at the University of Pittsburgh. Results to date
(5,500 patients enrolled) have supported favorable results achieved in
the initial trials conducted at the State University of New York at
Stony Brook, as well the conclusions from the MUST-EECP multicenter,
controlled, randomized and double-blinded efficacy trial completed in
1997. Phase 2 of the registry, known as IEPR II, began enrollment of
2,500 patients in January 2002 and is capturing additional data from
angina patients that include, among other things, data related to
concomitant heart failure symptoms.

D. Technological obsolescence of EECP by newly developed process, device
or therapy. There is no assurance that such technology couldn't exist
in the future to make EECP obsolete. Several companies are evaluating
devices and drugs for heart failure but there is presently no
consensus treatment for those patients. Even in the event one or more
drugs are developed, it is unlikely that EECP would be replaced

13


completely as many ill patients suffer a myriad of conditions with
co-morbid disease states that would make them contraindicated for use.
The Company believes that the cardiovascular disease market is so
large and the disease so complex that numerous technologies can
aggressively and successfully compete in the marketplace.

E. Competition, through acquisition or development, from companies with
superior financial resources and marketing capabilities. The barriers
of entry for external counterpulsation therapy are relatively small
however, there are presently only two competitors with a marketed
external counterpulsation system. The Company believes that neither is
well capitalized or positioned within the medical community (neither
have done significant clinical trials). The Company estimates that it
has a 75% plus market share and does not foresee significant changes.

F. New or changed regulatory environment that creates unforeseen
obstacles, or costs, to continue to market and sell the EECP system.
None are known at this time. Such changes in this industry are
normally not swift and would allow, in the opinion of management,
sufficient time to modify its business plan or become compliant.

G. New or changed insurance reimbursement criteria that create, or
reinstate, obstacles to physician acceptance of EECP. With respect to
Medicare, CMS raised rates for EECP treatment by 35% in March 2003 and
then effective January 2004 lowered EECP treatment rates by 32% to
levels that are significantly below the pre-March 2003 rates. The
Company believes that the 2004 Medicare rates were dropped to a level
that may adversely effect the Company's future prospects and will be
evaluating the impact of the lower rates on its future prospects and
its ability to fully realize the deferred tax asset.

Ultimate realization of all deferred tax assets is not assured, due to the
uncertainty associated with estimates of future taxable income during the
carryforward period. Management is evaluating the amount of the deferred tax
asset in accordance with SFAS 109, to determine that based upon the weight of
available evidence, whether or not it is more likely than not that the deferred
tax asset will be realized. The amount of the deferred tax assets considered
realizable could be reduced in the future if estimates of future taxable income
during the carryforward period are reduced.

NOTE K - COMMITMENTS AND CONTINGENCIES

Litigation

In or about late June 2002, the Company was notified by a letter from the
domestic counsel for Foshan Life Sciences Co. Ltd. ("FLSC"), a joint venture
comprised of a Florida company and Vamed Medical Instrument Company Limited
("Vamed"), a Chinese company with whom the Company had an agreement to
manufacture the Company's EECP Model MC2 system, that FLSC was initiating an
arbitration proceeding before the Hong Kong International Arbitration Council
("HKIAC") to recover compensatory and punitive damages in excess of $1,000,000
and injunctive relief based upon claims of breach of the manufacturing
agreement, tortuous interference and misappropriation of confidential
information and trade secrets. Although possessing several substantive defenses
to these claims, the Company initially has challenged the HKIAC's right to hear
and determine the dispute on the ground that FLSC is neither a legitimate nor
recognized party to the manufacturing agreement which provides for such
arbitration and, therefore, is not entitled to enforce the same. The Company
demanded on July 3, 2002 that FLSC deposit with the HKIAC security to cover the
Company's costs of arbitration. To date, FLSC has neither responded to the
Company's demand for security nor apparently filed a formal statement of claim
with the HKIAC.

Employment Agreements

In October 2002, the Company entered into an employment agreement with its
new President and Chief Operating Officer. The agreement, which expires in
October 2004, provides for certain settlement benefits, including a lump-sum
payment of twelve months of base salary in the event of a change of control, as
defined, or a termination payment in an amount equal to six months of base
salary in the event of termination without cause, as defined. Such agreement was
modified on June 30, 2003 reflecting this employee's promotion to President and
Chief Executive Officer.

In October 2003, the Company entered into an employment agreement with its
new Chief Financial Officer. The agreement, which expires in September 2005,
provides for certain settlement benefits, including a lump-sum payment of twelve

14

Vasomedical, Inc. and Subsidiaries

NOTES TO CONSOLIDATED CONDENSED FINANCIAL STATEMENTS (unaudited)
November 30, 2003

months of base salary in the event of a change of control, as defined, or a
termination payment in an amount equal to six months of base salary in the event
of termination without cause, as defined.

The approximate aggregate minimum compensation obligation under active
employment agreements at November 30, 2003 are summarized as follows:



Fiscal Year Amount
----------- ------

2004 $529,167
2005 140,479
--------
$669,646
========


Consulting Agreements

In September 2003, the Company and its then Chief Financial Officer entered
into a termination and consulting agreement. As a result of this termination,
the Company will pay to the former employee a severance payment of $140,000 in
equal monthly installments through September 2004. The Company recorded a charge
to operations during the three-month period ended November 30, 2003 to reflect
this obligation. Further, the consulting agreement provides for the continued
vesting of stock options that had been previously granted to the employee, which
would have otherwise vested during the term of the agreement. The terms of the
original option grants provided for vesting throughout the period that the
former employee was employed by or provided services to the Company. There were
no other modifications to any of his previously granted stock options.

15

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION


Except for historical information contained in this report, the matters
discussed are forward-looking statements that involve risks and uncertainties.
When used in this report, words such as "anticipated", "believes", "could",
"estimates", "expects", "may" and "intends" and similar expressions, as they
relate to the Company or its management, identify forward-looking statements.
Such forward-looking statements are based on the beliefs of the Company's
management, as well as assumptions made by and information currently available
to the Company's management. Among the factors that could cause actual results
to differ materially are the following: the effect of the dramatic changes
taking place in the healthcare environment; the impact of competitive procedures
and products and their pricing; medical insurance reimbursement policies;
unexpected manufacturing problems in foreign supplier facilities; unforeseen
difficulties and delays in the conduct of clinical trials and other product
development programs; the actions of regulatory authorities and third-party
payers in the United States and overseas; uncertainties about the acceptance of
a novel therapeutic modality by the medical community; and the risk factors
reported from time to time in the Company's SEC reports. The Company undertakes
no obligation to update forward-looking statements as a result of future events
or developments.

General Overview

Vasomedical, Inc. (the "Company"), incorporated in Delaware in July 1987,
is primarily engaged in designing, manufacturing, marketing and supporting EECP
external counterpulsation systems based on the Company's proprietary technology
currently indicated for use in cases of angina (i.e., chest pain), cardiogenic
shock, acute myocardial infarction (i.e., heart attack) and congestive heart
failure ("CHF"). The Company is also actively engaged in research to determine
the potential benefits of EECP therapy in the setting of acute coronary
syndromes, as well as in the management of other major vascular disease states,
including congestive heart failure. EECP is a non-invasive, outpatient therapy
for the treatment of diseases of the cardiovascular system. The therapy serves
to increase circulation in areas of the heart with less than adequate blood
supply and may restore systemic vascular function. The Company provides
hospitals, clinics and private practices with EECP equipment, treatment
guidance, and a staff training and maintenance program designed to provide
optimal patient outcomes. EECP is a registered trademark for Vasomedical's
enhanced external counterpulsation systems.

EECP therapy is currently reimbursed by Medicare and numerous other
commercial third-party payers for the treatment of refractory angina. The
Medicare reimbursement rate in the continental United States for a full course
of 35 one-hour treatments ranges from $3,960 to $6,926. Although Medicare has
not modified its national coverage policy for EECP therapy to specifically
include CHF patients, the Company believes, based upon data published from the
International EECP Patient Registry ("IEPR"), that there exists a significant
subset of patients with CHF that also have disabling angina that would qualify
for Medicare reimbursement under its present coverage policy.

Critical Accounting Policies

Financial Reporting Release No. 60, which was released by the Securities
and Exchange Commission, or SEC, in December 2001, requires all companies to
include a discussion of critical accounting policies or methods used in the
preparation of financial statements. Note A of the Notes to Consolidated
Financial Statements included in the Company's Annual Report on Form 10-K for
the year ended May 31, 2003 includes a summary of the Company's significant
accounting policies and methods used in the preparation of our financial
statements. In preparing these financial statements, the Company has made its
best estimates and judgments of certain amounts included in the financial
statements. The application of these accounting policies involves the exercise
of judgment and use of assumptions as to future uncertainties and, as a result,
actual results could differ from these estimates. The Company's critical
accounting policies are as follows:

Revenue Recognition

The Company recognizes revenue when persuasive evidence of an arrangement
exists, delivery has occurred or service has been rendered, the price is fixed
or determinable and collectibility is reasonably assured. In the United States,
the Company recognizes revenue from the sale of its EECP systems in the period
in which the Company delivers the system to the customer. Revenue from the sale
of its EECP systems to international markets are recognized upon shipment,
during the period in which the Company delivers the product to a common carrier,
as well as supplies, accessories and spare parts to both domestic and

16

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION

international customers. The sale of EECP systems are not subject to a right of
return, other than for normal warranty matters, and the Company is not obligated
for post-sale upgrades to these systems.

In most cases, revenue from direct EECP system sales is generated from
multiple-element arrangements that require judgment in the areas of customer
acceptance, collectibility, the separability of units of accounting, and the
fair value of individual elements. Effective September 1, 2003, the Company
adopted the provisions of Emerging Issues Task Force, or EITF, Issue No. 00-21,
"Revenue Arrangements with Multiple Deliverables", ("EITF 00-21"), on a
prospective basis. The principles and guidance outlined in EITF 00-21 provide a
framework to determine (a) how the arrangement consideration should be measured
(b) whether the arrangement should be divided into separate units of accounting,
and (c) how the arrangement consideration should be allocated among the separate
units of accounting. The Company determined that its multiple-element
arrangements are generally comprised of the following elements that would
qualify as separate units of accounting: system sales, in-service support
consisting of equipment set-up and training provided at the customers facilities
and warranty service for system sales generally covered by a warranty period of
one year. Each of these elements represent individual units of accounting as the
delivered item has value to a customer on a stand-alone basis, objective and
reliable evidence of fair value exists for undelivered items, and arrangements
normally do not contain a general right of return relative to the delivered
item. The Company determines fair value based on the price of the deliverable
when it is sold separately or based on third- party evidence. In accordance with
the guidance in EITF 00-21, the Company uses the residual method to allocate the
arrangement consideration when it does not have fair value of the EECP system
sale. Under the residual method, the amount of consideration allocated to the
delivered item equals the total arrangement consideration less the aggregate
fair value of the undelivered items. Assuming all other criteria for revenue
recognition have been met, the Company recognizes revenue for EECP system sales
when delivery and acceptance occurs, for installation and in- service training
when the services are rendered, and for warranty service ratably over the
service period, which is generally one year.

Upon adoption of the provisions of EITF 00-21, the Company deferred $42,500
of revenue related to the fair value of installation and in-service training and
$253,750 of revenue related to the warranty service for EECP system sales
delivered during the second quarter of fiscal 2004. The amount related to
warranty service will be recognized as service revenue ratably over the related
service period, which is generally one year. Previously, in accordance with
Staff Accounting Bulletin No. 101, "Revenue Recognition in Financial
Statements," the Company accrued costs associated with these arrangements as
warranty expense in the period the system was delivered and accepted.

The Company also recognizes revenue generated from servicing EECP systems
that are no longer covered by a warranty agreement, or by providing sites with
additional training, in the period that these services are provided. Revenue
related to future commitments under separately priced extended warranty
agreements on the EECP system are deferred and recognized ratably over the
service period, generally ranging from one year to four years. Deferred revenues
related to extended warranty agreements that have been paid by customers prior
to the performance of extended warranty services were $1,987,916 as of November
30, 2003. Costs associated with the provision of service and maintenance,
including salaries, benefits, travel, spare parts and equipment, are recognized
in cost of sales as incurred.

Amounts billed in excess of revenue recognized are included as deferred
revenue in the condensed consolidated balance sheets.

The Company has also entered into lease agreements for its EECP system,
generally for terms of one year or less, that are classified as operating
leases. Revenues from operating leases are generally recognized, in accordance
with the terms of the lease agreements, on a straight-line basis over the life
of the respective leases. For certain operating leases in which payment terms
are determined on a "fee-per-use" basis, revenues are recognized as incurred
(i.e., as actual usage occurs). The cost of the EECP system utilized under
operating leases is recorded as a component of property and equipment and is
amortized to cost of sales over the estimated useful life of the equipment, not
to exceed five years. There are no significant minimum rental commitments on
these operating leases at November 30, 2003.

The Company follows SFAS No. 13, "Accounting For Leases," for its sales of
EECP units under sales-type leases it presently has with one customer. In
accordance with SFAS No. 13, the Company records the sale and financing
receivable at the amount of the minimum lease payment, less unearned interest
income, which is computed at the interest rate implicit in the lease, an
allowance for bad debt and executory costs, which are primarily related to

17

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION

product warranties on each unit sold. Unearned interest income is amortized to
income in a manner that produces a constant rate of return on the investment in
the sales-type lease. The cost of the EECP unit acquired by the customer is
recorded as cost of sales in the same period that the sale is recorded.

Accounts Receivable/Financing Receivables

The Company's accounts receivable trade are due from customers engaged in
the provision of medical services. Credit is extended based on evaluation of a
customer's financial condition and, generally, collateral is not required.
Accounts receivable are generally due 30 to 90 days from shipment and are stated
at amounts due from customers net of allowances for doubtful accounts, returns,
term discounts and other allowances. Accounts outstanding longer than the
contractual payment terms are considered past due. Estimates are used in
determining our allowance for doubtful accounts based on our historical
collections experience, current trends, credit policy and a percentage of our
accounts receivable by aging category. In determining these percentages, we look
at historical write-offs of our receivables. The Company also looks at the
credit quality of its customer base as well as changes in its credit policies.
The Company continuously monitors collections and payments from its customers.
While credit losses have historically been within expectations and the
provisions established, the Company cannot guarantee that it will continue to
experience the same credit loss rates that it has in the past.

In addition, the Company periodically reviews and assesses the net
realizability of its receivables arising from sales-type leases. If this review
results in a lower estimate of the net realizable value of the receivable, an
allowance for the unrealized amount is established in the period in which the
estimate is changed. In the first quarter of fiscal 2003 and the second quarter
of fiscal 2004, management decided to write-off financing receivables under
sales-type leases of approximately $2,558,000 and $680,000, respectively, as a
result of significant uncertainties with respect to these customers' ability to
meet their financial obligations.

Inventories

The Company values inventory at the lower of cost or estimated market, cost
being determined on a first-in, first-out basis. The Company often places EECP
systems at various field locations for demonstration, training, evaluation, and
other similar purposes at no charge. The cost of these EECP systems is
transferred to property and equipment and is amortized over the next two to five
years. The Company records the cost of refurbished components of EECP systems
and critical components at cost plus the cost of refurbishment. The Company
regularly reviews inventory quantities on hand, particularly raw materials and
components, and records a provision for excess and obsolete inventory based
primarily on existing and anticipated design and engineering changes to our
products as well as forecasts of future product demand.

Warranty Costs

Equipment sold is generally covered by a warranty period of one year.
Effective September 1, 2003, the Company adopted the provisions of EITF 00-21 on
a prospective basis. Under EITF 00-21, for certain arrangements, a portion of
the overall system price attributable to the first year warranty service is
deferred and recognized as revenue over the service period. As such, the Company
no longer accrues warranty costs upon delivery but rather recognizes warranty
and related service costs as incurred. Prior to September 1, 2003, the Company
accrued a warranty reserve for estimated costs to provide warranty services when
the equipment sale is recognized. The factors affecting the Company's warranty
liability included the number of units sold and historical and anticipated rates
of claims and costs per claim. The warranty provision resulting from
transactions prior to September 1, 2003 will be reduced in future periods for
material and labor costs incurred as related product is returned during the
warranty period or when the warranty period elapses. A review of warranty
obligations is performed regularly to determine the adequacy of the reserve.
Based on the outcome of this review, revisions to the estimated warranty
liability are recorded as appropriate. Warranty reserves related to units sold
under sales-type leases are recorded as executory costs, which serve to reduce
the amount of financing receivables reported in the consolidated balance sheets.
The Company records revenue on extended warranties on a straight-line basis over
the term of the related warranty contracts. Service costs are expensed as
incurred.

Deferred revenues related to extended warranties are $1,987,916 and
$1,186,450 at November 30, 2003, and 2002, respectively.

18

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION

Income Taxes

Deferred income taxes are recognized for temporary differences between
financial statement and income tax bases of assets and liabilities and loss
carryforwards for which income tax benefits are expected to be realized in
future years. A valuation allowance is established, when necessary, to reduce
deferred tax assets to the amount expected to be realized. In estimating future
tax consequences, the Company generally considers all expected future events
other than an enactment of changes in the tax laws or rates. The deferred tax
asset is continually evaluated for realizability. To the extent management's
judgment regarding the realization of the deferred tax assets change, an
adjustment to the allowance is recorded, with an offsetting increase or
decrease, as appropriate, in income tax expense. Such adjustments are recorded
in the period in which management's estimate as to the realizability of the
asset changed.

Deferred tax liabilities and assets shall be classified as current or
non-current based on the classification of the related asset or liability for
financial reporting. A deferred tax liability or asset that is not related to an
asset or liability for financial reporting, including deferred tax assets
related to carryforwards, shall be classified according to the expected reversal
date of the temporary difference. The deferred tax asset recorded by the Company
relates primarily to the realization of net operating loss carryforwards, of
which the allocation of the current portion reflects the expected utilization of
such net operating losses in fiscal 2004. Such allocation is based upon
management's internal financial forecast for fiscal 2004 and may be subject to
revision based upon actual results.

Stock Compensation

The Company has four stock-based employee compensation plans. . The Company
accounts for stock-based compensation using the intrinsic value method in
accordance with Accounting Principles Board Opinion No. 25, "Accounting for
Stock Issued to Employees," and related Interpretations ("APB No. 25") and has
adopted the disclosure provisions of Statement of Financial Accounting Standards
No. 148, "Accounting for Stock-Based Compensation - Transition and Disclosure,
an amendment of FASB Statement No. 123." under APB No. 25, when the exercise
price of the Company's employee stock options equals the market price of the
underlying stock on the date of grant, no compensation expense is recognized.
Accordingly, no compensation expense has been recognized in the consolidated
financial statements in connection with employee stock option grants.

Pro forma compensation expense may not be indicative of future disclosures
because it does not take into effect pro forma compensation expense related to
grants before 1995. For purposes of estimating the fair value of each option on
the date of grant, the Company utilized the Black-Scholes option-pricing model.

The Black-Scholes option valuation model was developed for use in
estimating the fair value of traded options, which have no vesting restrictions
and are fully transferable. In addition, option valuation models require the
input of highly subjective assumptions including the expected stock price
volatility. Because the Company's employee stock options have characteristics
significantly different from those of traded options and because changes in the
subjective input assumptions can materially affect the fair value estimate, in
management's opinion, the existing models do not necessarily provide a reliable
single measure of the fair value of its employee stock options.

Equity instruments issued to non-employees in exchange for goods, fees and
services are accounted for under the fair value-based method of SFAS No. 123.

Recently Issued Accounting Standards

In April 2003, the FASB issued Statement of Financial Accounting Standards
No. 149 ("SFAS No. 149"), "Amendment of Statement 133 on Derivative Instruments
and Hedging Activities," which amends and clarifies financial accounting and
reporting for derivative instruments, including certain derivative instruments
embedded in other contracts and for hedging activities under SFAS No. 133. SFAS
No. 149 is effective for contracts entered into or modified after June 30, 2003
except for the provisions that were cleared by the FASB in prior pronouncements.
The adoption of SFAS No. 149 has not had a material impact on the Company's
financial position and results of operations.

In May 2003, the FASB issued Statement of Financial Accounting Standards
No. 150 ("SFAS No. 150"), "Accounting for Certain Financial Instruments with
Characteristics of both Liabilities and Equity." This statement establishes
standards for how an issuer classifies and measures in its statement of
financial position certain financial instruments with characteristics of both
liabilities and equity. In accordance with the standard, financial instruments

19

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION

that embody obligations for the issuer are required to be classified as
liabilities. This Statement shall be effective for financial instruments entered
into or modified after May 31, 2003, and otherwise shall be effective at the
beginning of the first interim period beginning after June 15, 2003. The Company
is currently evaluating the effect of the adoption of SFAS No. 150 on its
financial position and results of operations.

In January 2003, the FASB issued FASB Interpretation No. 46 "Consolidation
of Variable Interest Entities" ("FIN 46"). In general, a variable interest
entity is a corporation, partnership, trust, or any other legal structure used
for business purposes that either (a) does not have equity investors with voting
rights or (b) has equity investors that do not provide sufficient financial
resources for the entity to support its activities. A variable interest entity
often holds financial assets, including loans or receivables, real estate or
other property. A variable interest entity may be essentially passive or it may
engage in activities on behalf of another company. Until now, a company
generally has included another entity in its consolidated financial statements
only if it controlled the entity through voting interests. FIN 46 changes that
by requiring a variable interest entity to be consolidated by a company if that
company is subject to a majority of the risk of loss from the variable interest
entity's activities or entitled to receive a majority of the entity's residual
returns or both. FIN 46's consolidation requirements apply immediately to
variable interest entities created or acquired after January 31, 2003. The
consolidation requirements apply to older entities in the first interim period
beginning after June 15, 2003. Certain of the disclosure requirements apply in
all financial statements issued after January 31, 2003, regardless of when the
variable interest entity was established. The Company adopted FIN 46 effective
January 31, 2003. The adoption of FIN 46 did not have a material impact on the
Company's financial position or results of operations.

In November 2002, the Emerging Issues Task Force, ("EITF") reached a
consensus opinion on, "Revenue Arrangements with Multiple Deliverables", "(EITF
00-21)". That consensus provides that revenue arrangements with multiple
deliverables should be divided into separate units of accounting if certain
criteria are met. The consideration of the arrangement should be allocated to
the separate units of accounting based on their relative fair values, with
different provisions if the fair value is contingent on delivery of specified
items or performance conditions. Applicable revenue criteria should be
considered separately for each separate unit of accounting. EITF 00-21 is
effective for revenue arrangements entered into in fiscal periods beginning
after June 15, 2003. Effective September 1, 2003, the Company prospectively
adopted the provisions of EITF 00-21. Upon adoption of the provisions of EITF
00-21, the Company deferred $42,500 of revenue related to the fair value of
installation and in- service training and $253,750 of revenue related to the
warranty service for EECP system sales recognized during the second quarter of
fiscal 2004.

Results of Operations

Three Months Ended November 30, 2003 and 2002
- ---------------------------------------------

Net revenue from sales, leases and service of the Company's external
counterpulsation systems ("EECP" systems) for the three-month periods ended
November 30, 2003 and 2002, were $4,903,129 and $6,644,268 which represented a
decline of $1,741,139 or 26%. The Company's loss before income taxes for the
three-month periods ended November 30, 2003 and 2002 was ($2,076,942) and
($895,692), respectively. The Company reported a net loss of ($2,086,942) and
($596,792) for the three-month periods ended November 30, 2003 and 2002,
respectively.

The decline in revenues is due primarily to lower sales of EECP systems in
both the domestic and international markets. Domestic equipment sales for the
three-month period ended November 30, 2003, were down approximately 24% compared
to the same three-month period in the prior year. The decline in domestic
equipment sales reflects a 16% reduction in EECP system volume plus the impact
from lower average selling prices of approximately 11% when compared to the
average selling prices for the same three-month period in the prior year.
Domestic sales of EECP systems were negatively impacted by the announced
reduction by CMS of approximately 34% in Medicare rates for the calendar year
2004 plus the impact of increased competition, and a longer selling cycle. In
addition, the Company has recently rebuilt its sales force and filled a number
of US sales territory vacancies. The Company estimates that a new sales
representative will need between six and nine months from date of hire to become
fully effective and 15 of the Company's 24 sales territories have been filled
with representatives less than nine months. International sales of EECP systems
declined approximately 58% to $279,000 due to lower volume. In addition, the
Company adopted EITF 00-21 during the period. Upon adoption of the provisions of
EITF 00-21, the Company deferred $42,500 of revenue related to the fair value of
installation and in-service training and $253,750 of revenue related to the

20

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION

warranty service for EECP system sales delivered during the second quarter of
fiscal 2004. This amount related to warranty service will be recognized as
service revenue ratably over the related service period, which is generally one
year. Previously, in accordance with Staff Accounting Bulletin No. 101, "Revenue
Recognition in Financial Statements," the Company accrued costs associated with
these arrangements as warranty expense in the period the system was delivered
and accepted.

The above was partially offset by a 68% increase in revenue from equipment
rental and services reflecting primarily an increase of approximately 90% in
service related revenue. The higher service revenue reflects an increase in
service, spare parts and consumables as a result of the continued growth of the
installed base of EECP systems and greater marketing focus on the sale of
extended service contracts.

The gross profit decreased to $3,209,880 or 65% of revenues for the
three-month period ended November 30, 2003, compared to $4,639,731 or 70% of
revenues for the three-month period ended November 30, 2002. Gross profits are
dependent on a number of factors, particularly the mix of EECP models sold and
their respective average selling prices, the mix of EECP units sold, rented or
placed during the period, the ongoing costs of servicing such units, and certain
fixed period costs, including facilities, payroll and insurance. Gross profit
margins are generally less on non-domestic business due to the use of
distributors, which results in lower selling prices. Consequently, the gross
profit realized during the current period may not be indicative of future
margins. The reduction in gross profit as a percentage of sales for the quarter
primarily reflects the impact of lower average domestic selling prices for EECP
systems plus the lower volume resulting in increased overhead absorption rates.

Selling, general and administrative ("SG&A") expenses for the three-months
ended November 30, 2003 and 2002 were $3,512,977 or 72% of revenues and
$4,176,948 or 63% of revenues, respectively. The decrease of SG&A in absolute
amount resulted primarily from lower selling and marketing expenditures
primarily for international travel, outside services, commissions, promotional
spending for advertising and printing partially offset by higher personnel
expenses during the three-month period ended November 30, 2003, as compared to
the same period for the prior year. Administrative expenses reflected lower
expenses for consulting services and legal fees partially offset by increased
fees for accounting services.

Research and development ("R&D") expenses of $997,830 or 20% of revenues
for the three months ended November 30, 2003, decreased by $328,810 or 25%, from
the prior three months ended November 30, 2002, of $1,326,640 or 20% of
revenues. The decrease is due primarily to reduced expenditures for clinical
consulting services, the completion of several smaller clinical trials and lower
outside services related to new product development. Expenses related to the
prospective evaluation of EECP in congestive heart failure, ("PEECH") clinical
trial increased for the three months ended November 30, 2003, partially
offsetting the above. R&D expenses are primarily impacted by the PEECH clinical
trial in heart failure and other clinical initiatives (including the
International EECP Patient Registry), as well as continued product design and
development costs. The Company expects to continue its investments in product
development and clinical trials in fiscal 2004 and beyond to further validate
and expand the clinical applications of EECP, including, but not limited to,
heart failure and acute coronary syndromes. As of December 31, 2003, the PEECH
trial was 95% enrolled.

During the three-month period ended November 30, 2003, the Company charged
$796,830 to its provision for doubtful accounts as compared to $11,834 during
the three-month period ended November 30, 2002. In fiscal 2002, the Company sold
its EECP systems to a major customer engaged in establishing independent
networks of EECP centers under a sales-type lease aggregating revenues of
$1,271,888. No additional equipment was sold to this customer during fiscal 2003
or 2004. This customer became delinquent in its scheduled monthly payments
during the fourth quarter of fiscal 2003. During the first and second quarters
of fiscal 2004 the customer attempted to remedy the situation and made payments
to the Company totaling $70,000. In December 2003, the customer ceased
operations. Accordingly, management decided to record an additional $680,000
provision to the allowance for doubtful accounts, which represents all funds due
from this customer as of November 30, 2003, less the anticipated recovery of
equipment and the reduction of related liabilities for sales tax and
commissions. The Company is currently negotiating with other third parties and
anticipates that it may be able to redeployed certain pieces of the equipment
while other pieces will be returned to the Company's inventory for resale.
Additionally, the Company is evaluating its ability to seek additional recovery
from the customer. In fiscal 2003 the Company recorded a bad debt recovery of
$470,408 related to the successful recovery of equipment that it had sold to a
different customer under a sales-type lease that was written off in full during
the first quarter of fiscal 2003. This recovery partially offset a charge for
$482,242 primarily related to specific reserves that were established for
international accounts for which extended credit terms were offered.

21

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION

Interest expense and financing costs decreased to $32,880 in the
three-month period ended November 30, 2003, from $48,215 for the same period in
the prior year due to repayment of the Company's revolving secured credit
facility in May 2003. Interest expense reflects interest on loans secured to
refinance the November 2000 purchase of the Company's headquarters and warehouse
facility, as well as on loans secured to finance the cost and implementation of
a new management information system.

Interest and other income for the three-month period ended November 30,
2003 and 2002, were $53,195 and $28,214, respectively. The increase in interest
income from the prior periods is the direct result of the higher average cash
balances invested during the quarter compared to the prior period. The absence
of interest income related to certain equipment sold under sales-type leases
reported in fiscal 2002, as well as declining interest rates this year over last
year earned on the average cash balances partially offset the above.

During the three-months ended November 30, 2003, the Company recorded a
provision for state income taxes of $10,000. This is in contrast to an income
tax benefit of $298,900 reported during the three-months ended November 30,
2002. As of November 30, 2003, the Company had recorded deferred tax assets of
$14,582,000 net of a $1,357,000 valuation allowance related to the anticipated
recovery of tax loss carryforwards. The amount of the deferred tax assets
considered realizable could be reduced in the future if estimates of future
taxable income during the carryforward period are reduced. Ultimate realization
of the deferred tax assets is dependent upon the Company generating sufficient
taxable income prior to the expiration of the tax loss carryforwards. In
accordance with the Statement of Financial Accounting Standard No. 109
"Accounting for Income Taxes" ("SFAS 109"), management concluded at the end of
fiscal 2003, based upon the weight of available evidence at that time, that it
was more likely than not that all of the deferred tax assets would be realized.
It was management's belief that realization of the deferred tax asset was not
dependent on material improvements over the average of fiscal 2000 through
fiscal 2002 levels of pre-tax income, and that the Company is positioned for
long-term growth despite the results achieved in fiscal 2003, much of which was
unexpected and non-recurring. Management is currently evaluating the impact of
the average 34% reduction in Medicare reimbursement rates for EECP treatments in
2004 that was recently announced by CMS plus other factors currently influencing
market conditions including the impact of increased competition, declining sales
prices and lower volume on the Company's estimates of future taxable income. Due
to the uncertainty associated with estimates of future taxable income during the
carryforward period and the net value of the recorded deferred tax asset
relative to the Company's historical taxable income, management has decided to
provide a valuation allowance for all potential deferred tax assets generated
during fiscal 2004. The recorded deferred tax asset and increase to the
valuation allowance during the second quarter for fiscal 2004 was $460,000.

Six Months Ended November 30, 2003 and 2002
- -------------------------------------------

The Company generated revenues from the sale, lease and service of its
EECP" systems of $10,329,661 and $11,183,438 for the six-month periods ended
November 30, 2003 and 2002, respectively, reflecting a decrease of $853,777 or
8%. The Company's loss before income taxes was ($2,333,536) and ($6,414,992) for
the six-month periods ended November 30, 2003 and 2002, respectively. The
Company reported a net loss of ($2,353,536) and ($4,831,070) for the six-month
periods ended November 30, 2003 and 2002, respectively.

The decline in revenues is due to lower sales of EECP systems in both the
domestic and international markets. Domestic equipment sales for the six-month
period ended November 30, 2003, were down approximately 8% compared to the same
six-month period in the prior year. The decline in domestic equipment sales is
primarily due to a reduction in the average sales price for EECP systems of
approximately 13% when compared to the average sales price for the same
six-month period last year. EECP system volume increased over the period by
approximately 3% when compared to the same period for the prior year.
International shipments of EECP systems declined approximately 50% to $390,000
due to a higher sales rate in the previous year upon receipt of the CE Mark. In
addition, the Company adopted EITF 00-21 during the period. Upon adoption of the
provisions of EITF 00-21, the Company deferred $42,500 of revenue related to the
fair value of installation and in-service training and $253,750 of revenue
related to the warranty service for EECP system sales delivered during the
second quarter of fiscal 2004. The impact of lower prices resulting from price
compaction from competitive products continues to have a negative impact on
revenue when compared with prior periods. Management believes that the EECP
systems currently sell at a significant price premium to competitive products


22


reflecting the clinical efficacy and superior quality of the system plus the
many value added services offered by the Company. The above was partially offset
by a 78% increase in revenue from equipment rental and services reflecting
primarily an increase of approximately 101% in service related revenue. The
higher service revenue reflects an increase in service, spare parts and
consumables as a result of the continued growth of the installed base of EECP
systems and greater marketing focus on the sale of extended service contracts.

The gross profit declined to $6,697,738 or 65% of revenues for the
six-month period ended November 30, 2003, compared to $7,219,549 or 65% of
revenues for the six-month period ended November 30, 2002. The gross profit
margin as a percentage of revenue for the six-month period ended November 30,
2003, remained unchanged compared to the same six-month period of the prior
fiscal year despite the lower revenue due primarily to planned cost reductions
in manufacturing overhead reflecting decreased personnel cost and lower expenses
for service travel and spare parts, which offset the impact of lower unit volume
and reduced average selling prices.

Selling, general and administrative expenses for the six-months ended
November 30, 2003 and 2002, were $6,134,429 or 59% of revenues and $7,863,844 or
70% of revenues, respectively. The decrease of SG&A in both absolute amount and
as a percentage of sales resulted primarily from a one-time $600,000 accrual
arising from the settlement of litigation plus a severance charges for
approximately $300,000 in the prior year, as well as lower selling and marketing
expenditures primarily for outside services, promotional spending for
advertising and printing plus lower travel costs during the six-month period
ended November 30, 2003 as compared to the same period for the prior year. The
above decreases were partially offset by higher administrative expenses, which
reflected increased personnel and insurance expenses.

Research and development ("R&D") expenses of $1,953,375 or 19% of revenues
for the six-month period ended November 30, 2003, decreased by $564,251, or 22%,
from the prior six-month period ended November 30, 2002, of $2,517,626 or 23% of
revenues. The decrease is due primarily to reduced expenditures for clinical
consulting services related several smaller clinical studies that were completed
plus lower product development costs.

During the six-month period ended November 30, 2003, the Company charged
$985,511 to its provision for doubtful accounts as compared to $3,260,708 during
the six-month period ended November 30, 2002. In fiscal 2004, these charges
reflect management decision to record a $680,000 provision to the allowance for
doubtful accounts, which represents all funds due from a major customer as of
November 30, 2003, as detailed above under management's discussion for the
three-month period ended November 30, 2003 plus additional provisions for all
other accounts totaling $305,511. In fiscal 2003, these charges primarily
resulted from a approximately $2.5 million for the capital lease and $500,000
for the notes receivable write-off of receivables, with respect to another major
customer, as well as specific reserves against certain international accounts
for which extended credit terms were offered.

Interest expense and financing costs decreased to $66,246 in the six-month
period ended November 30, 2003, from $97,067 for the same period in the prior
year due to repayment of the Company's revolving secured credit facility in May
2003. Interest income and other income for the six-month period ended November
30, 2003 and 2002, was $108,287 and $104,704, respectively. The small increase
reflects an increase in the average cash balances invested during the period
which were partially offset by the absence of interest income related to certain
equipment sold under sales-type lease reported in fiscal 2003.

During the six-month period ended November 30, 2003, the Company recorded a
provision for state income taxes of $20,000. This is in contrast to an income
tax benefit of $1,583,922 reported during the six-month period ended November
30, 2002. As of November 30, 2003, the Company had recorded deferred tax assets
of $14,582,000 net of a $1,357,000 valuation allowance related to the
anticipated recovery of tax loss carryforwards. The amount of the deferred tax
assets considered realizable could be reduced in the future if estimates of
future taxable income during the carryforward period are reduced. Ultimate
realization of the deferred tax assets is dependent upon the Company generating
sufficient taxable income prior to the expiration of the tax loss carryforwards.
In accordance with the Statement of Financial Accounting Standard No. 109
"Accounting for Income Taxes" ("SFAS 109"), management concluded at the end of
fiscal 2003, based upon the weight of available evidence at that time, that it
was more likely than not that all of the deferred tax assets would be realized.
It was management's belief that realization of the deferred tax asset was not
dependent on material improvements over the average of fiscal 2000 through
fiscal 2002 levels of pre-tax income, and that the Company is positioned for
long-term growth despite the results achieved in fiscal 2003, much of which was
unexpected and non-recurring. Management is currently evaluating the impact of
the average 34% reduction in Medicare reimbursement rates for EECP treatments in
2004 that was recently announced by CMS plus other factors currently influencing
market conditions including the impact of increased competition, declining sales


23

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION

prices and lower volume on the Company's estimates of future taxable income. Due
to the uncertainty associated with estimates of future taxable income during the
carryforward period and the net value of the recorded deferred tax asset
relative to the Company's historical taxable income, management has decided to
provide a valuation allowance for all potential deferred tax assets generated
during fiscal 2004. The recorded deferred tax asset and increase to the
valuation allowance during first six months of fiscal 2004 was $735,000.

The following factors are anticipated to positively impact the future of
the Company's business activities and initiatives:

A. A large and increasing worldwide patient population with
cardiovascular disease demanding new choices of therapy, leading to
increased reimbursement coverage in the United States and other
countries. The estimated US patient population for angina patients is
approximately 6.2 million and approximately 5 million patients for
heart failure.

B. Approval of Medicare coverage and other third-party payer policies
specific to the congestive heart failure indication. The results of
the Company's ongoing PEECH trial are likely a pre-requisite for
significant coverage policies. The Company anticipates that the
results from the PEECH trial will be favorable (based upon a published
feasibility study and other analyses). The results should be available
for submission to CMS in late 2004 and a coverage decision is
anticipated in mid 2005. The combination of favorable PEECH trial
results and Medicare reimbursement would likely be a significant
catalyst for significant Company growth.

C. Potential extension of Medicare coverage to include all classes of
angina (beyond the present Class III/IV indication for refractory
angina, for which the Company estimates the annual patient population
in the US alone is 150,000.

D. A cardiology community with a mandate to offer patients new disease
management solutions providing effective clinical and economic
outcomes. The Company has cultivated relationships with many of the
leading institutions and cardiologists (as evidenced in its roster of
PEECH study sites).

E. The accumulation of EECP clinical validation and removal of obstacles
to third-party insurance reimbursement. Numerous abstracts and
publications are presented each year at major scientific meetings
worldwide. The Company estimates that more than 300 third-party payers
reimburse for EECP therapy, many on a routine basis.

F. Expanded base of future FDA-cleared indications to more effectively
penetrate the hospital market, particularly with respect to heart
failure (for which FDA clearance was received in June 2002), acute
coronary syndromes (also cleared by FDA), diabetes management, and
peripheral and cerebrovascular diseases.

G. Initiatives planned to lower the cost of the Company's EECP systems,
thus improving margins or helping to preserve margins from further
price erosion.

H. The Company has a large, non-domestic market opportunity that it
intends to develop through a network of local independent
distributors. The Company has received the CE Mark (FDA-clearance
equivalent) and is ISO 13485 certified.

I. Continuing to prove more definitively the mechanism of action by which
EECP operates. These smaller scale clinical studies are aimed at
convincing those with lingering doubt about EECP's effectiveness that
the therapy is, indeed, safe and effective and serves to expand the
market. Studies have been presented and published in this area.

J. Increased hardware utility to allow for the use of EECP in an
increasing number of patient environments. The EECP TS4 system is
mobile, quieter and can be used more easily in the hospital
environment. Future system modifications could allow for emergency
room use.

The Company acknowledges that certain risk factors have the potential to
adversely affect the business opportunity that has been outlined. Initiatives
planned to mitigate the impact of such risks have been addressed. They include:

A. Dependence on outcome of PEECH trial and related reimbursement
coverage policies. Presently, the Company is engaged in the PEECH
trial, a pivotal study to evaluate the effectiveness of EECP therapy
for congestive heart failure patients. The Company anticipates that
the results of this study will be the catalyst for Medicare and other
third-party reimbursement coverage policies specific to heart failure.
Although the Company has received clearance from the FDA to market for
24

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION

heart failure, the medical community, market acceptance and insurance
coverage policies are highly influenced by scientifically proven
technologies. The Company had designed its PEECH protocol in
cooperation with the FDA and had reached a formal agreement with the
FDA that the key parameters of its investigational plan for this trial
were appropriate to determine the effectiveness of EECP as an adjunct
therapy for heart failure. The Company believes that its PEECH trial
is robust and will provide favorable results that should provide a
reasonable basis for market acceptance and insurance reimbursement.

B. Dependence on a single product platform. Current FDA labeling extends
beyond chronic stable angina and congestive heart failure to unstable
angina, myocardial infarction and cardiogenic shock (i.e., acute
coronary syndromes). The Company intends to pursue additional clinical
studies to validate the safety and effectiveness of EECP in acute
coronary syndromes over the next few years provided sufficient
financial resources are available.

C. Dependence on consistency of research findings about EECP efficacy and
increasing acceptance of EECP by the medical community. To that end,
the Company has sponsored the International EECP Patient Registry
(IEPR), maintained at the University of Pittsburgh. Results to date
(5,500 patients enrolled) have supported favorable results achieved in
the initial trials conducted at the State University of New York at
Stony Brook, as well the conclusions from the MUST-EECP multicenter,
controlled, randomized and double-blinded efficacy trial completed in
1997. Phase 2 of the registry, known as IEPR II, began enrollment of
2,500 patients in January 2002 and is capturing additional data from
angina patients that include, among other things, data related to
concomitant heart failure symptoms.

D. Technological obsolescence of EECP by newly developed process, device
or therapy. There is no assurance that such technology couldn't exist
in the future to make EECP obsolete. Several companies are evaluating
devices and drugs for heart failure but there is presently no
consensus treatment for those patients. Even in the event one or more
drugs are developed, it is unlikely that EECP would be replaced
completely as many ill patients suffer a myriad of conditions with
co-morbid disease states that would make them contraindicated for use.
The Company believes that the cardiovascular disease market is so
large and the disease so complex that numerous technologies can
aggressively and successfully compete in the marketplace.

E. Competition, through acquisition or development, from companies with
superior financial resources and marketing capabilities. The barriers
of entry for external counterpulsation therapy are relatively small
however, there are presently only two competitors with a marketed
external counterpulsation system. The Company believes that neither is
well capitalized or positioned within the medical community (neither
have done significant clinical trials). The Company estimates that it
has a 75% plus market share and does not foresee significant changes
in the immediate future.

F. New or changed regulatory environment that creates unforeseen
obstacles, or costs, to continue to market and sell the EECP system.
None are known at this time. Such changes in this industry are
normally not swift and would allow, in the opinion of management,
sufficient time to modify is business plan or become compliant.

G. New or changed insurance reimbursement criteria that create, or
reinstate, obstacles to physician acceptance of EECP. With respect to
Medicare, CMS raised rates for EECP treatment by 35% in March 2003 and
then effective January 2004 lowered EECP treatment rates by 32% to
levels that are significantly below the pre-March 2003 rates. The
Company believes that the 2004 Medicare rates were dropped to a level
that may adversely effect the Company's future prospects and will be
evaluating the impact of the lower rates on its future prospects and
its ability to fully realize the deferred tax asset.

Ultimate realization of all deferred tax assets is not assured, due to the
uncertainty associate with estimates of future taxable income during the
carryforward period. Management is evaluating the amount of the deferred tax
asset, in accordance with SFAS 109, to determine that based upon the weight of
available evidence, whether or not it is more likely than not that the deferred
tax asset will be realized. The amount of the deferred tax assets considered
realizable could be reduced in the future if estimates of future taxable income
during the carryforward period are reduced.

25

Vasomedical, Inc. and Subsidiaries

MANAGEMENT DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION
AND RESULTS OF OPERATION

Liquidity and Capital Resources

The Company has financed its operations in fiscal 2004 and 2003 primarily
from working capital and operating results. At November 30, 2003, the Company
had a cash balance of $7,554,220 and working capital of $9,917,259 compared to a
cash balance of $5,222,847 and working capital of $11,478,092 at May 31, 2003.
The Company's cash balances increased $2,331,373 in the six-month period
compared to May 31, 2003 primarily due to $2,499,205 cash provided by operating
activities.

The increase in cash provided by the Company's operating activities
resulted primarily from lower accounts receivable, which provided cash of
$2,867,497 for the six-month period ended November 30, 2003. Net accounts
receivable were 92% of quarterly revenues for the three-month period ended
November 30, 2003, compared to 113% at the end of the six-month period ended May
31, 2003, and accounts receivable turnover improved to 3.5 times as of November
30, 2003 compared to 3.2 times as of May 31, 2003. The Company's management has
tightened its sales credit policy, reduced extended payment terms and provides
routine oversight with respect to its accounts receivable credit and collection
efforts.

The Company's standard payment terms on its equipment sales are generally
net 30 to 90 days from shipment and do not contain "right of return" provisions.
The Company has historically offered a variety of extended payment terms,
including sales-type leases, in certain situations and to certain customers in
order to expand the market for its EECP products in the US and internationally.
Such extended payment terms were offered in lieu of price concessions, in
competitive situations, when opening new markets or geographies and for repeat
customers. Extended payment terms cover a variety of negotiated terms, including
payment in full - net 120, net 180 days or some fixed or variable monthly
payment amount for a six to twelve month period followed by a balloon payment,
if applicable. During the six-month periods ended November 30, 2003 and 2002,
less than 1% and 3% of revenues, respectively, were generated from sales in
which payment terms were greater than 90 days and no sales-type leases were
offered by the Company during either period. At November 30, 2003, approximately
$270,867 or 35% of the allowance for doubtful accounts was related to specific
accounts that had been offered extended credit terms and $688,653 or 13%, of
gross accounts receivable represent accounts offered extended payment terms. In
general, reserves are calculated on a formula basis considering factors such as
the aging of the receivables, time past due, and the customer's credit history
and their current financial status. In most instances where reserves are
required, or accounts are ultimately written-off, customers have been unable to
successfully implement their EECP program. As the Company is creating a new
market for EECP and recognizes the challenges that some customers may encounter,
it has opted, at times, on a customer-by-customer basis, to recover its
equipment instead of pursuing other legal remedies against these customers,
which necessitated the recording of a reserve or a write-off by the Company.

Additionally, the lower revenue for the three-month period ended November
30, 2003, compared to the three- month period ended May 31, 2003, resulted in
reduced accounts receivable and financing receivables of $2,867,497 and
$113,999, respectively at the end of the period. Other key factors causing the
increase in cash provided by the Company's operating activities included
inventories, which decreased by $645,361 reflecting efforts to improve
procurement of its raw materials and management of finished goods inventory
levels, an increase in accounts payable, accrued expenses and other current
liabilities of $456,737 and non-cash adjustments to reconcile the net loss of
$2,353,536 to net cash provided by operating activities totaling $1,090,261
primarily for depreciation, amortization and allowance for doubtful accounts.
Partially offsetting the above was an increase of $226,492 in other current
assets reflecting the prepayment of the Company's annual insurance policies and
a decrease in other assets and other liabilities of $53,372 and $41,250,
respectively.

Investing activities used net cash of $120,362 during the six-month period
ended November 30, 2003. The principal use of cash was for the implementation of
the Company's new enterprise resource planning software.

Financing activities used net cash of $47,470 during the six-month period
ended November 30, 2003, reflecting principal payments on loans partially offset
by proceeds from the exercise of stock options.

In fiscal 2002, the Company refinanced its long-term obligations on the
purchase of its headquarters and warehouse facility. In October 2002, the
Company amended its existing credit facility to provide for borrowings up to
$5,000,000 ($2,000,000, at any time that consolidated net income for the
immediately preceding six-month period is less than $1), primarily based upon
eligible accounts receivable, as defined therein, at the Libor Rate plus 200
basis points or the published Prime Rate plus 50 basis points. Under the terms
of the agreement, which expires in February 2005, the Company is required to
meet certain quarterly covenants, including leverage ratio, liquidity, capital
expenditures, minimum net income, minimum interest coverage and minimum tangible
net worth. Although the Company was not in compliance with certain financial
covenants during each of its first three fiscal quarters of 2003, the bank
26

issued waivers to the Company for those periods. In April 2003, the agreement
was further amended to allow for borrowings absent compliance with the financial
covenants as long as cash collateralizes such eligible borrowings. In April
2003, the Company repaid all outstanding borrowings under the agreement instead
of maintaining restricted cash balances. At November 30, 2003, the Company did
not meet the minimum interest coverage, tangible net worth and minimum net
earnings covenants and future compliance with each of these covenants in the
near term is not certain. Management believes, based upon its cash balance at
November 30, 2003 and its internal forecasts, that any limitation on the
Company's ability to borrow against this credit facility through the remainder
of fiscal 2004 and the first quarter of fiscal 2005 would not have an adverse
effect on the Company's operations.

Management believes that its working capital position at November 30, 2003,
the ongoing commercialization of the EECP system, and the effect of initiatives
undertaken to improve our cash position by managing operating expense levels and
by strengthening our sales and credit policies will make it possible for the
Company to support its operating expenses and to implement its business plans
for at least the next twelve months.

The following table presents the Company's expected cash requirements for
contractual obligations outstanding as of November 30, 2003:


Due as of Due as of
Due as of 11/30/05 and 11/30/07 and Due
Total 11/30/04 11/30/06 11/30/08 Thereafter
- --------------------------------------------------------------------------------------------------------------------

Long-Term Debt $1,233,837 $112,658 $238,187 $131,619 $751,373
Operating Leases 113,500 46,400 67,100 -- --
Litigation Settlement 400,000 100,000 300,000 -- --
Severance obligations 105,000 105,000 -- -- --
Employment Agreements 669,646 529,167 140,479 -- --
- --------------------------------------------------------------------------------------------------------------------
Total Contractual Cash $2,521,983 $893,225 $745,766 $131,619 $751,373
Obligations
====================================================================================================================


Effects of Inflation

The Company believes that inflation and changing prices over the past three
years have not had a significant impact on our revenue or on our results of
operations.


ITEM 3 - QUALITATIVE AND QUANTITATIVE DISCLOSURES ABOUT MARKET RISK

The Company is exposed to certain financial market risks, including changes
in interest rates. All of the Company's revenue, expenses and capital spending
are transacted in US dollars. The Company's exposure to market risk for changes
in interest rates relates primarily to our cash and cash equivalent balances,
investments in sales-type leases and the line of credit agreement. The majority
of our investments are in short-term instruments and subject to fluctuations in
US interest rates. Due to the nature of our short-term investments, we believe
that there is no material risk exposure.

ITEM 4 - PROCEDURES AND CONTROLS

The Company carried out an evaluation, under the supervision and with the
participation of the Company's management, including the Company's Chief
Executive Officer and Chief Financial Officer, of the effectiveness of the
design and operation of the Company's disclosure controls and procedures
pursuant to Exchange Act Rule 13a- 15. Based upon that evaluation, the Chief
Executive Officer and Chief Financial Officer concluded that the Company's
disclosure controls and procedures are effective. There were no significant
changes in the Company's internal controls or in other factors that could
significantly affect these controls subsequent to the date of their evaluation.


27

Vasomedical, Inc. and Subsidiaries


PART II - OTHER INFORMATION

ITEM 1 - LEGAL PROCEEDINGS:

Previously reported.

ITEM 2 - CHANGES IN SECURITIES AND USE OF PROCEEDS:

None

ITEM 3 - DEFAULTS UPON SENIOR SECURITIES:

None

ITEM 4 - SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS

A. The registrant held its Annual Meeting of Stockholders on October 30,
2003.
B. Not applicable
C. Five directors were elected. Abraham E. Cohen, John C. K. Hui, Photios
T. Paulson, and Forrest R. Whittaker were elected to serve until the
2006 Annual Meeting of Stockholders or until their successors are duly
elected and qualified and Mr. Gregory D. Cash was elected to serve
until the 2004 Annual Meeting of Stockholders or until his successor
is duly elected and qualified. The minimum number of votes cast in
favor of their elections was 50,719,799.

The other matter voted upon was the ratification of the
appointment of Grant Thornton, LLP as the Company's independent
certified public accountants for the fiscal year ended May 31, 2003.
The votes cast were as follows Votes for: 51,650,527; Votes Against:
323,533; Votes Abstained: 124,863.

ITEM 5 - OTHER INFORMATION:

None

ITEM 6 - EXHIBITS AND REPORTS ON FORM 8-K:
Exhibits

31 Certifications pursuant to Rules 13a-14(a) as adopted pursuant to Section
302 of the Sarbanes-Oxley Act of 2002.

32 Certifications pursuant to 18 U.S.C. Section 1350 as adopted pursuant to
Section 906 of the Sarbanes-Oxley Act of 2002.

Reports on Form 8-K

None


28

Vasomedical, Inc. and Subsidiaries



In accordance with to the requirements of the Exchange Act, the Registrant
caused this report to be signed on its behalf by the undersigned, thereunto duly
authorized.


VASOMEDICAL, INC.

By: /s/ Gregory D. Cash
------------------------------------
Gregory D. Cash
Chief Executive Officer and Director
(Principal Executive Officer)

/s/ Thomas W. Fry
------------------------------------
Thomas W. Fry
Chief Financial Officer
(Principal Financial and Accounting
Officer)

Date: January 14, 2004