PATIENT NAME: Hannibal Lector
PHYSICIANS IDENTITY: Kent Clark, MD
DATE: December twenty-five, 2112
The individual denies any kind of palpitations, heart problems, and fatigue. His light headed on exertion appears to be better. In physical exam, his blood pressure was120/60. His heartrate was 82 beats per minute. His weight is 141 pounds.
His heart was at regular rate and beat. There is no gallop or mussitation, mutter, muttering. Lungs will be clear to auscultation bilaterally, although air flow entry can be reduced. You cannot find any peripheral edema. Interrogation of his implantable cardioverter-defibrillator (ICD), which is a single-chamber St . Jude device, showed a total of 49 attacks of supraventricular tachycardia. These are either atrial fibrillation, or atrial tachycardia. 48 of 49 attacks were between 150 to 190 sounds per minute, which is within keep an eye on only sector of the ICD. None of the episodes survived more then one minute. He previously one show of supraventricular tachycardia, which has been more after that 190 beats per minute. This kind of episode was terminated by simply antitachycardia pacing. He was asymptomatic during these tachycardias. Interrogation with the lead revealed an increase in the best ventricular pacing threshold to 4. a few to?. five milla secs. Lead impedance is 428?.? are 12. 8 mil. He is spaced in the ventricle less then you % of times.
In view of his regular supraventricular tachycardia episode, We started him on Lexapro 180 magnesium p. o. daily. My spouse and i also warned him that Lexapro might cause constipation.
I will find him in follow-up in a single month. If perhaps he is constantly on the have repeated episodes of supraventricular tachycardia, I will begin him in comedone.
Kent Clark, MD
D: 12 , 25, 2112
T: January 08, 2113