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{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7900 }
Medical Text: Admission Date: [**2167-3-2**] Discharge Date: [**2167-3-15**] Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5790**] Chief Complaint: SOB Major Surgical or Invasive Procedure: VATS, talc pleuradesis Bronchoscopy Pleurax cath placement History of Present Illness: 82 F s/p RULobectomy for stage IIIA [**4-7**] Lung Ca now c/b malignant effusion s/p thoracentesis week prior to this now with SOB and recurrent effusion Past Medical History: Coronary artery disease s/p cardiac catheterization '[**61**], aortic stenosis, Abdmoninal aortic aneurysm s/p aortobifememoral graft '[**61**] ([**Doctor Last Name **]), Hypertension, hypercholesterolemia, s/p sigmoid colectomy for Cancer s/p chemotherapy/radiation therapy and anastamotic recurrence, nephrectomy (benign dz), Right internal carotid stenosis, Left knee neuropathy, Ejection fraction 76% Social History: 55 ppy smoking hx, quit 7 years ago previously married x2, 1st husband died of accident, 2nd died age 42- MI. 7 children, 9 grandchildren, 4 great grandchildren Family History: Father - died at 92- old age Mother -died at 92- old age brother died 60's- MI sister died [**2163**] of cerebreal aneurysm Physical Exam: per readmission note IRIRR decreased BS and crackles on R soft NT/ND no c/c/e Pertinent Results: [**2167-3-14**] 04:57AM BLOOD WBC-13.2* RBC-3.25* Hgb-8.8* Hct-27.6* MCV-85 MCH-27.1 MCHC-32.0 RDW-16.8* Plt Ct-288 [**2167-3-13**] 02:00AM BLOOD WBC-11.2* RBC-3.05* Hgb-8.4* Hct-26.0* MCV-85 MCH-27.5 MCHC-32.3 RDW-16.8* Plt Ct-288 [**2167-3-4**] 03:58PM BLOOD WBC-21.0* RBC-3.77* Hgb-10.0* Hct-32.3* MCV-86 MCH-26.5* MCHC-30.9* RDW-15.8* Plt Ct-504* [**2167-3-4**] 09:15AM BLOOD WBC-21.6*# RBC-3.68* Hgb-9.7* Hct-31.4* MCV-85 MCH-26.3* MCHC-30.8* RDW-15.7* Plt Ct-514* [**2167-3-3**] 11:14AM BLOOD WBC-13.2* RBC-3.96* Hgb-10.4* Hct-32.7* MCV-83 MCH-26.3* MCHC-31.8 RDW-15.9* Plt Ct-608* [**2167-3-2**] 09:25PM BLOOD WBC-11.7* RBC-4.00* Hgb-10.9* Hct-31.9* MCV-80*# MCH-27.2 MCHC-34.1 RDW-15.9* Plt Ct-565* [**2167-3-14**] 04:57AM BLOOD Glucose-142* UreaN-22* Creat-1.0 Na-140 K-4.1 Cl-94* HCO3-39* AnGap-11 [**2167-3-13**] 02:00AM BLOOD Glucose-111* UreaN-19 Creat-0.7 Na-144 K-3.8 Cl-103 HCO3-34* AnGap-11 [**2167-3-2**] 09:25PM BLOOD Glucose-100 UreaN-10 Creat-0.9 Na-135 K-4.3 Cl-95* HCO3-28 AnGap-16 [**2167-3-4**] 01:10PM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2167-3-4**] 09:40PM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2167-3-5**] 06:50AM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2167-3-14**] 02:51PM BLOOD Type-ART pO2-78* pCO2-69* pH-7.40 calTCO2-44* Base XS-13 [**2167-3-14**] 05:21AM BLOOD Type-ART pO2-118* pCO2-54* pH-7.47* calTCO2-40* Base XS-14 [**2167-3-13**] 06:32PM BLOOD Type-ART pO2-83* pCO2-51* pH-7.45 calTCO2-37* Base XS-9 [**2167-3-13**] 01:27PM BLOOD Type-ART pO2-168* pCO2-56* pH-7.42 calTCO2-38* Base XS-10 [**2167-3-12**] 06:53AM BLOOD Type-ART PEEP-5 FiO2-50 pO2-126* pCO2-44 pH-7.47* calTCO2-33* Base XS-8 Vent-SPONTANEOU Comment-PSV 12 [**2167-3-5**] 02:05PM BLOOD Type-ART Temp-36.2 pO2-266* pCO2-56* pH-7.22* calTCO2-24 Base XS--5 Intubat-NOT INTUBA [**3-2**] CXR - IMPRESSION: Large right-sided pleural effusion, which may mask a pneumonia or mass. [**3-5**] CTA - IMPRESSION: 1. Bilateral pleural effusions and sclerosis in the right pleural space consistent with prior pleurodesis. 2. Loculated fluid collection in the anterior right pleural space as well as multiple foci of gas which may be secondary to recent VATS procedure. 3. Pulmonary edema. 4. No evidence of pulmonary embolism. 5. Patchy airspace disease predominantly at the right lung base, which may represent aspiration or infection, clinical correlation is recommended. 6. Emphysema. Brief Hospital Course: She was readmitted on [**3-2**], made NPO, given lopressor for her A_fib, on [**3-3**] she had a R vats, talc pleurodesisShe was stable immediately post op, but did have low UOP requirng boluses. CT was left to suction post op. On [**3-5**] she desated on the floor and was solmnent - transferred to CSRU and intubated. CTA neg for PE. She was started on an amio gtt in the CSRU for A-fib control and Cipro for a UTI. CT was placed to waterseal and removed on [**3-6**]. She extubated on [**3-6**]. She had labored breathing post extubation and remained in the CSRU and was converted to PO Amio and lopressor. IV access was consulted for PICC line placement. IP was consulted and they did a bronch which showed thick secretion swere seen in the RML. on [**3-11**] in the early morning she was reitnubated for resp failure and required levophed. On [**3-12**] she had a CT guided pleurax cath placed - ~60 cc drained immediately. She also had been started on Vanc/Zosyn for ? VAP. She was diuresed with a hop of getting her pressure support down. She was extubated on [**3-14**] to see if she would make it - plan was she would be DNI after this. She extubated successfully that morning. Her respiratory situtation worsened and she decided she wanted to be comofrt measures only and was started on a morphine gtt for comfort. She had respiratory failure on [**3-15**] and went into asystole and was evaluated by the TICU resident who pronounced her as diseased on [**2167-3-15**] at 210PM. Medications on Admission: Toprol Norvsc Zocor Plavix Prilosec Folic acid ativan Zoloft Colace albuterol Discharge Medications: none Discharge Disposition: Home Discharge Diagnosis: Respiratory failure and death secondary to malignant effusion secondary to lung cancer Discharge Condition: expired Discharge Instructions: none Followup Instructions: none ICD9 Codes: 486, 5990, 4019, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7901 }
Medical Text: Admission Date: [**2200-2-4**] Discharge Date: [**2200-2-14**] Date of Birth: [**2143-12-24**] Sex: M Service: [**Hospital1 212**] CHIEF COMPLAINT: Left upper extremity numbness and weakness. HISTORY OF PRESENT ILLNESS: This is a 56-year-old male with no significant past medical history who presented to [**Hospital3 3834**] [**Hospital3 **] with acute onset of numbness and weakness on the left upper extremity. He initially noted paresthesias in the left lateral shoulder while working on his computer on the evening of admission. Within 5-10 minutes of onset, his entire left upper extremity became numb and paralyzed. He immediately went to [**Hospital3 3834**], where his left upper extremity was noted to be cold, pale, and pulseless from the axilla distally. He had no sensation from the forearm to the fingers. He was sent to [**Hospital1 346**] for insufficiency and Vascular Surgery consult. On arrival to the Emergency Department, he subjectively noted improvement in his symptoms, but persistent absent radial pulse in the left upper extremity and no pulse in the dorsalis pedis, posterior tibialis in the right lower extremity. His blood pressure was 183/141, and therefore he was taken for a CTA to rule out aortic dissection. He was found to have very large bilateral pulmonary embolism, splenic infarct, chronic infrarenal aortic and right common iliac dissections. He denied any trauma to the arm or shoulder. He had a 10 day history of dyspnea on exertion complaining of shortness of breath with two flights of stairs. He denies any chest pain, nausea, vomiting, or diaphoresis. There is no other weakness or numbness elsewhere on his body. He denies any bright red blood per rectum, melena, or bleeding gums. There is no recent history of travel, plane flights or long car rides. Again, he denies any fever, chills, night sweats, or weight loss. PAST MEDICAL HISTORY: 1. Gout. 2. Left Bell's palsy 10 years resolved after one year. 3. Hernia repair as a child. 4. Sciatica. 5. Questionable hypertension. 6. No history of coronary disease or coagulopathies. SOCIAL HISTORY: He has smoked for the past 40 years anywhere from half to [**4-1**] of a pack per day. He has episodically tried to quit smoking. He socially uses alcohol. He has a history of experiment drug use as a teenager which includes marijuana, cocaine, and LSD, but no current experimental drug use at this time. He denies any IV drug use. He works as a computer engineer living at home with his three children. He recently separated from his wife and moved into the area. He is not sexually active. FAMILY MEDICAL HISTORY: Mother died of brain cancer at age [**Age over 90 **]. Father with arrhythmia and died with a complication of a hernia repair, no bleeding disorders. ALLERGIES: None. OUTPATIENT MEDICATION: Indocin prn for gout, last use was a month ago. PHYSICAL EXAM UPON ADMISSION: Temperature is 96.6, blood pressure 175/128, pulse 92, respiratory rate 16, and 96% on room air. Generally, this is a pleasant male in no acute distress who is resting comfortably in bed. HEENT: Mucous membranes are moist and oropharynx is clear. Jugular venous pressure is not elevated. The neck is supple and without carotid bruits. His sclerae is anicteric. Chest was clear to auscultation bilaterally. Cardiovascular: Regular, rate, and rhythm. Normal S1, S2, no murmurs or gallops noted. Abdomen is soft, nontender, and nondistended with normoactive bowel sounds. No hepatosplenomegaly felt. Extremities: Pale left hand with capillary refill greater than three seconds. There is no radial pulse in the left upper extremity. There is presence of an ulnar pulse in the left upper extremity. There is also a presence of a dorsalis pedis and posterior tibial pulses bilaterally. Neurologically, the patient is alert and oriented times three. Cranial nerves II through XII intact except for the left lower facial weakness. The left is 4+/5 and left upper extremity flexion and extension is 4+/5. Right upper extremity is [**6-2**]. Decreased sensation in the left hand and forearm which have been improving. White count 10.8, hematocrit 45.8, platelets 154, chloride 142, potassium 3.9, 105 for chloride, bicarb of 22, BUN of 11, creatinine 0.9, glucose 110. Differential on the white count was 82% neutrophils, 12% lymphocytes, 4% monocytes, 1.5% eosinophils. PT is 13.6, PTT is 28.9, INR 1.2. Chest x-ray showed no infiltrate or effusion. CT scan showed bilateral large pulmonary embolism, splenic infarct, and chronic infrarenal, aortic, or right common iliac dissection. ELECTROCARDIOGRAM: Normal sinus rhythm at a rate of 84. There is a right heart strain pattern in V2 through V4 with T-wave inversion in III. Right bundle branch is noted. HOSPITAL COURSE: 1. Pulmonary system. Pulmonary embolism. Given that the patient had bilateral pulmonary embolism discovered on CTA, patient was put on Heparin for a PTT of 60-80. Doppler of the lower extremities showed a right popliteal deep venous thrombosis, but no deep venous thrombosis on the left. Patient was then sent for MRI of the pelvis which showed no evidence of clot in the femoral vein or IVC. Therefore, the patient did not require any IVC filters at this time. It is unusual why the patient would have pulmonary embolism since there is no recent history of travel or long car rides. His extensive smoking history may predispose him to neoplasm hypercoagulable state. Subsequent studies that his protein-C was normal at 66, protein-S at 139, anticardiolipin IgG as well as IgM were normal at 1.2 and 4.3 respectively. However, he was found to have high levels of homocystine at 70.5, where the high range of normal is 12.4. He was therefore then started on vitamin B6, vitamin B12, and folate. His prothrombin gene mutation and factor-[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 12843**] were still pending. He was then started on Coumadin 5 mg to reach an INR between [**3-3**]. He eventually reached 2.2 on the day of discharge with a regimen of Coumadin 5 and 7.5 mg alternating days. 2. Vascular system. Left subclavian artery clot status post embolectomy. Given the patient's symptoms of neurological and vascular compromise in his left upper extremity, Vascular Surgery was consulted. They eventually took him for embolectomy of a very large subclavian artery clot. After the embolectomy, neurological and vascular functions were returned to the patient's left upper extremity. 3. Cardiovascular. Patent foramen ovale status post clam-shell placement. Given that the patient had all of these clots, thrombolysis was a consideration, therefore Cardiology consult was called to do an echocardiogram. The echocardiogram actually revealed a patent foramen ovale with a right-to-left shunt in light of a normal pulmonary pressure with PR gradient of 17 mm Hg. Also noted on the echocardiogram was preserved left ventricular ejection fraction, mild right ventricular dilation, mildly depressed right ventricular function, and apical-septal aneurysm. Given the right-to-left shunting and embolization without elevated pulmonary artery pressure along with his known deep venous thrombosis, it was felt that a PF closure with a clam-shell would be best. The clam-shell was placed without complications. However, on hospital day five, the patient did spike a fever of 101.3. He was given 48 hours of Vancomycin along with other antibiotics which he was taking for his pneumonia until blood cultures were clear for 48 hours. The blood cultures did remain negative for 48 hours, so the Vancomycin was discontinued. Given the clam-shell placement, the patient should be on 75 mg of Plavix for the next three months. 4. Hematology. Homocystinemia. Given that the patient had many clots in a situation, where he did not have many risk factors that led to the tests that were mentioned above in the course of finding the etiology of the pulmonary embolism. It was discovered that he had elevated homocystine levels of 70.5. At that time, Hematology recommended starting vitamin B6, vitamin B12, and folate. He is to remain on these cofactors for breaking down the homocystine for life. He is to be on Coumadin with INR of 2.3 for at least six months. At that time, it should be reassessed whether the patient should be on life-long Coumadin. There is no literature mentioning whether life-long anticoagulation would be called for in the state of homocystinemia. 5. Infectious Disease. Pneumonia. When the patient spiked a fever on hospital day five, a chest x-ray was obtained along with blood and urine cultures. The chest x-ray revealed a left basilar infiltrate and left pleural effusion. Patient was empirically started on azithromycin for five days and ceftriaxone for 14 days. However, the course of ceftriaxone was decreased down to seven days given that the fever may also be due to the gout that the patient was having. 6. Rheumatology. Gout. In the middle of the hospital course, the patient complained of right ankle and right first metatarsal erythema, swelling, and pain. He says that these symptoms were similar to his gout flares, so he was given Indomethacin. The indomethacin helped resolve the symptoms on the right foot, but then he started noticing pain, swelling, and erythema with his left first metatarsal. He was continued on indomethacin until a day before discharge, where his gout flare had resolved. DISCHARGE DIAGNOSES: 1. Pulmonary embolism. 2. Patent foramen ovale status post clam-shell placement. 3. Homocystinemia. 4. Left subclavian artery clot status post embolectomy. 5. Pneumonia. 6. Gout. DISCHARGE MEDICATIONS: 1. Protonix 40 mg po q day. 2. Indomethacin 25-75 mg po tid prn gout. 3. Folate 2 mg po q day. 4. Pyridoxine 50 mg po q day. 5. .................... 400 mcg po q day. 6. Thiamine 100 mg po q day. 7. Plavix 75 mg po q day. 8. Aspirin 81 mg po q day. 9. Lisinopril 5 mg po q day. 10. Atenolol 100 mg po q day. 11. Warfarin 5 and 7.5 mg po alternating. DISCHARGE CONDITION: Stable. DISCHARGE STATUS: Home. FOLLOW-UP APPOINTMENT: The patient is to followup with Dr. [**First Name (STitle) **] [**Name (STitle) **] on [**2200-2-26**] for blood pressure and INR check. [**Name6 (MD) 2415**] [**Last Name (NamePattern4) 3474**], M.D. [**MD Number(1) 3475**] Dictated By:[**Last Name (NamePattern1) 4270**] MEDQUIST36 D: [**2200-2-21**] 03:41 T: [**2200-2-21**] 05:18 JOB#: [**Job Number 46529**] ICD9 Codes: 486
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7902 }
Medical Text: Admission Date: [**2176-1-24**] Discharge Date: [**2176-1-25**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 7055**] Chief Complaint: Lower extremity edema; tachypnea Major Surgical or Invasive Procedure: none History of Present Illness: Mr. [**Known lastname **] is a [**Age over 90 **] year-old man with a history of CAD s/p CABG and prior CVA who presents with lower extremity edema and tachypnea. Per patient and son (who translated in Italian), the patient was feeling well until approximately one week prior to admission when he began noting increasing LE edema. He has also had insomnia, waking every 30 minutes or so. He uses one pillow at night; this has been stable. It is unclear on history if he has PND - he describes feeling "suffocated" at times though he doesn't wake up acutely short of breath. More often than not, he simply wakes up to so his wife can make food for him. Given these symptoms, he presented to his PCP who referred him to the ED. In the ED, initial vitals showed BP of 205/74, HR 65, RR 24 with 96% on room air. BP remained >190 systolic and was given SL nitro x3, aspirin and 40 IV lasix. After this, noted to be breathing more comfortably though RR remained elevated. As the BP did not improve, nitro gtt was started and increased 11.8 with a BP of 156/82 at the time of transfer. On review of systems, he reports a prior stroke with left-sided weakness. No history of deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. Also denies recent fevers, chills or rigors. Denies any dietary indiscretion or weight gain. Per son, he will frequently not take his antihypertensives. Has nocturia x4-5 per night though denies any fevers or dysuria. Cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. Past Medical History: 1. CARDIAC RISK FACTORS: (+) Diabetes (-) Dyslipidemia (+) Hypertension . 2. CARDIAC HISTORY: -CABG: Prior CABG ~23 years ago; unclear anatomy -PCI: None known -PACING/ICD: None known . 3. OTHER PAST MEDICAL HISTORY: - History of atrial fibrillation, [**2173**] after trauma - History of CVA, [**2172**] - Nephrolithiasis - L Total Hip Replacement Social History: - Italian speaking; lives with wife in grandson's house - Tobacco history: Smoked in the [**2117**] but quit. - ETOH: None currently. - Illicit drugs: None. Family History: NC Physical Exam: VS: T= BP=171/80 HR=68 RR=20-24 O2 sat= 97% on 2LNC GENERAL: Lying in bed in no distress. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric, pale. PERRL, brisk, EOMI. Conjunctiva were pink, no cyanosis of the oral mucosa dry. No xanthalesma. NECK: Supple with JVP of 8 cm. CARDIAC: RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3, ?S4. LUNGS: Increased AP diameter, resonant to percussion, resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Obese, Soft, NTND. No HSM or tenderness. Abd aorta not palpable. No abdominial bruits. EXTREMITIES: No femoral bruits. 2+ LE edema, pitting 1/3 up to tibia b/l. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: Carotid 2+ Femoral 2+ could not appreciate DP/PT [**3-18**] edema. Left: Carotid 2+ Femoral 2+ could not appreciate DP/PT [**3-18**] edema. Neuro: A&Ox3, goal directed communication, follows commands. Pupil 4->2mm b/l, brisk. EOMs intact. VF intact to threat b/l. no facial droop, V, VII, IX - XII intact. Motor: normal tone and bulk, [**Month/Day (2) **] [**6-19**] throughout, LUE limited ROM proximally, biceps 4+/5, triceps [**5-20**], wrist ext [**5-20**], [**6-19**] flxn. RLE [**6-19**] throughout. RLE [**6-19**] to foot, w/ [**5-20**] foot ext but [**6-19**] flx. Sensory: intact to Pain and LT b/l throughout, proprioception not assessed. DTRs: 1+ [**Name2 (NI) **] and RLE, 3+ LUE and LLE (C5,6 and L3,4 tested only). Negative babinski b/l; No pronator drift, HTS impaired b/l, FTN intact b/l, impaired [**Doctor First Name **] b/l with dysrhythmia and impaired amplitude, no tremor. Gait not tested. Pertinent Results: [**2176-1-24**] 11:56AM GLUCOSE-124* UREA N-27* CREAT-1.5* SODIUM-145 POTASSIUM-4.3 CHLORIDE-110* TOTAL CO2-24 ANION GAP-15 [**2176-1-24**] 11:56AM CK(CPK)-42 [**2176-1-24**] 11:56AM cTropnT-0.03* [**2176-1-24**] 11:56AM CK-MB-NotDone proBNP-[**Numeric Identifier 18214**]* [**2176-1-24**] 11:56AM CALCIUM-9.5 PHOSPHATE-2.9 MAGNESIUM-2.0 [**2176-1-24**] 11:56AM WBC-8.1 RBC-3.83* HGB-11.9* HCT-33.1* MCV-87 MCH-31.0 MCHC-35.9* RDW-13.5 [**2176-1-24**] 11:56AM NEUTS-63.1 LYMPHS-30.7 MONOS-4.0 EOS-1.9 BASOS-0.2 [**2176-1-24**] 03:30PM URINE BLOOD-MOD NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.0 LEUK-MOD [**2176-1-24**] 05:03PM TYPE-[**Last Name (un) **] PO2-103 PCO2-30* PH-7.50* TOTAL CO2-24 BASE XS-1 INTUBATED-NOT INTUBA [**2176-1-24**] 03:30PM URINE RBC-[**7-25**]* WBC->50 BACTERIA-OCC YEAST-NONE EPI-0 [**2176-1-24**] 12:06PM LACTATE-1.8 proBNP: [**Numeric Identifier 18214**] EKG ([**2173**]; old): RBBB with LAFB; old inferior MI EKG (admission): Similar to old. Lung Scan ([**1-24**]): 1. The above findings are consistent with low probability of pulmonary embolus. 2. Small airways disease. CXR ([**1-24**]): The lungs are clear. There is no evidence of pneumonia or congestive heart failure. The cardiac and mediastinal contours are stable in configuration. The patient is status post median sternotomy. There are multiple old healed rib fractures. The visualized osseous structures are otherwise unremarkable with no evidence of acute fractures. There is no evidence of pneumothorax or pleural effusions. LENIs ([**1-24**]): No evidence of bilateral lower extremity DVT. TTE ([**1-25**]): The left atrium is elongated. There is mild symmetric left ventricular hypertrophy. There is mild regional left ventricular systolic dysfunction with focal hypokinesis of the distal inferior wall, distal septum and apex. Tissue Doppler imaging suggests an increased left ventricular filling pressure (PCWP>18mmHg). There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic root is mildly dilated at the sinus level. The ascending aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Trivial mitral regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. IMPRESSION: Mild focal LV systolic dysfunction. Probable diastolic dysfunction. Mild aortic regurgitation. Mildly dilated aortic root and ascending aorta. Compared with the prior study (images reviewed) of [**2174-1-26**], the basal to mid inferior hypokinesis and apical lateral hypokinesis have improved. The other findings are similar. Brief Hospital Course: ASSESSMENT AND PLAN: [**Age over 90 **]M with history of CAD, CHF who presents with LE edema and tachypnea. # CONGESTIVE HEART FAILURE, DIASTOLIC and SYSTOLIC, ACUTE ON CHRONIC: Prior echo with EF of 45% and LVH. Presented this hospitalization with right heart > left heart failure. The right heart failure seems subacute. Given his hypertension to the high 180's to 190's in the ED, this may have been the percipitant to his acute heart failure. He was treated with 40 mg of lasix IV twice and diuresed over 2 L. He was continued on his [**Last Name (un) **] and metoprolol. By the morning of discharge his legs looked much less edematous and his tachypnea had resolved. A TTE showed an EF of 45-50% with mild focal LV systolic dysfunction, probable diastolic dysfunction and mild aortic regurgitation. When compared with the prior study of [**2174-1-26**], the basal to mid inferior hypokinesis and apical lateral hypokinesis were improved. The other findings are similar. His home po lasix was increased to 40 mg daily and he was discharged and asked to follow up with his PCP within the next two weeks. # TACHYPNEA/RESP ALK: Etiologies include dyspnea related to elevated pulmonary pressures in the setting of CHF (without overt hypoxia). PE (though low probability on V/Q), central process, pain/anxiety, among others. Does have pH of 7.5 with pCO2 of 30; this is consistent with acute resp alk. No apparent acidosis present. His tachypnea resolved over night and given that his the lower extremity ultrasounds were negative for DVT and his V/Q scan was low probability he was not suspected to have had a PE. Given the resolution with diuresis, this was likely due to acute CHF. # CORONARIES: The patient has a history of CAD s/p CABG > 20 years ago. He was asymptomatic during this hospitalization. He was continued on aspirin, a beta-blocker, and tricor. # RHYTHM: The patient remained in normal sinus rhythm during his hospitalization. # PYURIA: Patient with pyuria on his UA, but without dysuria, abdominal pain, or fever. Urine culture has been no growth to date. # ANEMIA: Patient with a stable hct in low 30s. Never had a colonoscopy and denies any symptoms of GIB. [**Month (only) 116**] be due to anemia of chronic kidney disease. No clinical evidence of bleeding during this hospitalization. # CHRONIC KIDNEY DISEASE: The patient's baseline is 1.8 to 1.9. Was below his baseline during this hospitalization. Medications on Admission: MEDICATIONS ([**Last Name (un) 3072**] Pharmacy, [**Location (un) 745**] MA [**Telephone/Fax (1) 48147**]) 1. Aspirin 81mg daily 2. Losartan 100mg [**Hospital1 **] 3. Amlodipine 10mg [**Hospital1 **] 4. Metoprolol 125mg [**Hospital1 **] 5. Hydralazine 50mg [**Hospital1 **] 6. Furosemide 20mg daily 7. Tricor 145mg daily 8. Levemir 26 units QAM 9. Haldol 1mg Q8H (last filled [**7-23**]) 10. Vitamin B12 Discharge Medications: 1. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 2. Hydralazine 50 mg Tablet Sig: One (1) Tablet PO twice a day. 3. Losartan 100 mg Tablet Sig: One (1) Tablet PO twice a day. 4. Metoprolol Tartrate 50 mg Tablet Sig: 2.5 Tablets PO BID (2 times a day). 5. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 6. Fenofibrate Micronized 145 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Insulin Detemir 100 unit/mL Solution Sig: Twenty Six (26) units Subcutaneous qam. 8. Amlodipine 10 mg Tablet Sig: One (1) Tablet PO twice a day. 9. Vitamin B-12 Oral Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Primary Diagnosis: 1. Congestive Heart Failure 2. Hypertension 3. Coronary Artery Disease Discharge Condition: afebrile, hemodynamically stable Discharge Instructions: You were admitted to the hospital with congestive heart failure and hypertension. You were treated with diuretics to remove the fluid from your legs. Your hypertension was controlled with medications. The following changes were made to your medications: Take Lasix 40mg by mouth once a day (this was increased from 20 mg daily). Otherwise continue your outpatient medications as prescribed. It is very important that you take your medication regularly and do not miss a dose. Limit your fluid intake to 1200ml per day. Limit your salt intake to less than 2gram per day. Weigh yourself everyday and call your doctor for any weight gain of > 3 lbs. Please call your doctor or come to the hospital for any fevers > 100.4, chills, night sweats, chest pain, shortness of breath, abdominal pain, nausea, vomiting, worsening leg swelling or any other symptoms that concern you. Followup Instructions: Please see your primary care physician, [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 16258**] within the next week. His phone number is [**Telephone/Fax (1) 19196**]. Completed by:[**2176-1-25**] ICD9 Codes: 4280, 412, 5859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7903 }
Medical Text: Admission Date: [**2181-10-17**] Discharge Date: [**2181-10-22**] Service: MEDICINE Allergies: Metronidazole / Morphine / Percocet Attending:[**Doctor Last Name 10493**] Chief Complaint: PCP: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 1007**], MD . REASON FOR MICU TRANSFER: Respiratory Failure. CHIEF COMPLAINT: Shortness of Breath. Major Surgical or Invasive Procedure: Mechanical Ventilation Endotracheal intubation History of Present Illness: Ms. [**Known lastname 20802**] is a [**Age over 90 **] y.o. F with diastolic CHF (EF 55% on [**9-2**] echo), recent PE on [**2-/2181**], recent GI bleeding attributed to colon diverticuli seen on colonoscopy during recent [**Hospital1 18**] hospitalization in [**2181-9-25**], transferred from OSH ([**Hospital1 **]) with respiratory failure attributed to flash pulmonary edema. . From [**10-11**] - [**2181-10-16**], the patient was admitted to [**Hospital1 18**] for rectal bleed for 2 days. On presentation, pt [**Name (NI) 4650**], stable Hct, and supratherapeutic INR 3.8. Rectal exam with gross blood in rectal vault. No other episodes of rectal bleeding in hospital. Transfused 2 pRBCs and given vitamin K for colonoscopy. [**Last Name (un) **] showed diverticuli. Hct stable. Patient was discharged without anticoagulation after discussing risk of GI bleed, fall risk and benefit of coumadin. Was also diuresed while in hospital with [**Hospital1 **] lasix (from home daily dose of lasix). Discharged to [**Location (un) 5481**] on [**2181-10-16**]. . The patient was admitted on [**2181-10-17**] to [**Hospital3 **] after episode of acute shortness of breath at [**Hospital1 1501**]. Per Patient Care Referral form, pt found pale, unable to breath with oxygen fluctuating between 60 and 70%, was on 2 L NC and then increased to 5 L NC. Transferred to [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. She was intubated for this. No documentation of DNR/DNI was with her at OSH. CXR showed pulmonary edema. Given lasix IV but limited by hypotension this AM to SBP 70s. Gave 200 cc IVF bolus ---> SBP 110. Troponins now 0.04 --> 0.29 --> 0.38 (cutoff 0.5). EKG initially in atrial fibrillation in ED and given cardizem x 1 with conversion to NSR. EKG this AM without ischemic changes [**Name8 (MD) **] MD. Bedside echo was ordered, but no report yet. Cardiology consulted and believed may be due to ischemia but hesitant to anticoagulate due to recent GI bleed. Noted to have leukocytosis that has been trending up to 18,000 today. Pt was cultured and placed on zosyn and vancomycin for broad coverage. Noted to have a UTI also. Attempted CPAP trial this morning, but she failed by report from MD. . Currently, pt is sedated and intubated. . ROS: Cannot obtain as intubated and sedated. Past Medical History: - CAD - stress [**2170**] showed 1-1.[**Street Address(2) 1755**] depression consistent with ischemia, nl echo treated medically. Repeat echo [**2175**]: LVEF>60%, 1+MR, trace AI. Exercise MIBI [**2175**]: nl study with EF 78% ; TTE [**11-1**]: hyperdynamic, EF 80% - LUL spiculated lung mass-likely bronchalveolar CA - recurrent R sided pleural effusion--likely due to dCHF, lower suspicion for TB. - Recent PE - HTN - Hyperlipidemia - Hypothyroidism - GERD - Breast ca, followed by Dr. [**Last Name (STitle) **] at [**Hospital1 2177**], dx [**2162**], s/p XRT - urge incontinence - Osteoporosis - s/p CCY [**2175**] - s/p TAH, BSO age 40 - Macular degeneration Social History: She lives in independent living at [**Location (un) 5481**]. Performs her own ADLs. She does not smoke or drink alcohol, but did smoke tobacco in the past (quit 38 yrs ago). She does not use any illicit drugs. . Family History: All female family members except 1 daughter with breast cancer. Mother with CVA. Mother and sister with CHF. No h/o colon cancer, GI bleed. Physical Exam: Vitals - T: 99.5 BP: 129/39 HR: 94 RR: 13 02 sat: 100% on AC 450 x 14, PEEP 5, FiO2 50% GENERAL: sedated and intubated HEENT: PERRL, OP - MM dry, no cervical LAD CARDIAC: RRR, nl S1, S2, II/VI SEM at LLSB, no r/g LUNG: anterior BS rhoncherous ABDOMEN: NDNT, soft, NABS EXT: no c/c/e NEURO: able to squeeze fingers on command Pertinent Results: [**Hospital1 **] LABS: [**10-17**] UA cloudy, trace blood, positive nitrite, moderate LE, WBC [**6-2**], bacteria 2+ . [**10-17**] WBC 18.1 Hgb 10.1 Hct 30.7 Plt 232 Neut 89 Band 6 Lymph 2 Mono 3 Trop 0.04 --> 0.29 --> 0.38 (range 0 - 0.5) BNP 396 . Na 138 K 3.9 Cl 96 CO2 35 BUN 15 Cr 1.0 Gluc 139 Alb 3.1 TP 5.5 Bilirubin 0.3 Direct bili 0.1 Ca 8.1 Alk phos 60 ALT 19 CK 78 AST 30 . 7.32 / 73 / 209 / 38 (drawn at [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] with NRB 100%) . INR 1.23 . MICROBIOLOGY: None. . STUDIES: OSH EKG [**10-17**]: atrial fibrillation with controlled ventricular response. nonspecific ST-T wave abnormalities . OSH PCXR [**10-17**]: R pleural effusion, pulmonary edema. Suggest CHF or volume overload. . CXR (my read): slightly congested pulm vasculature, R pleural effusion, no overt infiltrate. . EKG: NSR at 80 bpm, nl axis, nl intervals, no Q waves . TTE [**2181-8-28**]: The left atrium is moderately dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (LVEF>55%). Right ventricular chamber size and free wall motion are normal. There are three aortic valve leaflets. The aortic valve leaflets are moderately thickened. There is mild aortic valve stenosis (valve area 1.2-1.9cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is mild functional mitral stenosis (mean gradient 6 mmHg) due to mitral annular calcification. Mild (1+) mitral regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. . IMPRESSION: Mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. Mild calcific aortic stenosis. Mild calcific mitral stenosis. Moderate pulmonary hypertension. Bilateral pleural effusions. . Compared with the prior study (images reviewed) of [**2180-10-26**], pleural effusions are new. The other findings are similar. CXR - PORTABLE CHEST, [**2181-10-21**] FINDINGS: Pulmonary vascularity appears engorged, but there is no overt evidence of pulmonary edema. Bilateral moderate-to-large pleural effusions are again demonstrated with adjacent areas of basilar atelectasis. Interval removal of endotracheal tube and nasogastric tube. [**2181-10-22**] 07:10AM BLOOD WBC-8.4 RBC-3.05* Hgb-8.2* Hct-25.4* MCV-84 MCH-26.9* MCHC-32.2 RDW-15.3 Plt Ct-241 [**2181-10-17**] 06:00PM BLOOD PT-14.3* PTT-29.9 INR(PT)-1.2* [**2181-10-22**] 07:10AM BLOOD Glucose-118* UreaN-22* Creat-0.8 Na-140 K-4.5 Cl-98 HCO3-36* AnGap-11 Brief Hospital Course: [**Age over 90 **] y.o. F with diastolic CHF (EF 55% on [**9-2**] echo), recent PE on [**2-/2181**], recent GI bleeding attributed to colon diverticuli seen on colonoscopy during recent [**Hospital1 18**] hospitalization in [**Month (only) **] [**2181**], transferred from OSH ([**Hospital1 **]) with respiratory failure attributed to flash pulmonary edema. # Acute Respiratory Failure/Flash Pulmonary Edema: She required intubation for hypoxic respiratory failure in the setting of flash pulmonary edema. She was diuresed aggressively and extubated. She was also managed with a lasix gtt, nitro gtt and labetolol. Her blood pressure medications were titrated and blood pressure was well controlled on captopril and metoprolol. Her lasix was restarted at a lower dose after the acute decompensation but will likely need uptitration of this medication. # Acute Renal Failure: She had ARF likely in the setting of diuresis. Her creatinine returned to her baseline of 0.9-1.0. # CAD/diastolic heart failure: She had no evidence of acute events and was continued on a beta blocker, aspirin, statin, beta blocker and aceI. Her lasix was restarted at a lower dose after the acute decompensation in her respiratory status but she will likely need uptitration of this medication (was on lasix 80 mg po daily at home). # Hyperlipidemia: resumed atorvastatin # Hypothyroidism: held levothyroxine initially and then restarted. # Urinary Incontinence: continued tolterodine # CODE: DNR/DNI --> no chest compression, no defibrillation, no ACLS medications. Pressors are okay # CONTACT: [**Name (NI) **] [**Name (NI) **] (son in law - HCP, [**Telephone/Fax (1) 20803**]) Medications on Admission: . MEDICATIONS: From Discharge Summary on [**2181-10-16**] Verapamil 120 mg po qhs Aspirin 81 mg po daily Atorvastatin 10 mg po daily Furosemide 80 mg po daily Multivitamin 1 tablet po qhs Isosorbide Mononitrate SR 30 mg po daily Levothyroxine 25 mcg po daily Lisinopril 40 mg po daily Metoprolol Succinate SR 300 mg po daily Omeprazole 20 mg po qhs Tolterodine 2 mg po BID Trazodone 75 mg po qhs prn insomnia . TRANSFER MEDICATIONS: Colace 100 mg po BID prn Humulin SSI Lasix 80 mg IV x 1 Lovenox 30 mg SQ daily MOM prn Maalox prn Nitrostat 0.4 mg SL q3 - 5 minutes prn Protonix 40 mg IV daily Tylenol 650 mg po/pr q6 hours prn Vancomycin 1 mg IV daily (day 1 = [**2181-10-17**]) Zosyn 2.25 mg IV daily ([**2181-10-17**]) Discharge Disposition: Extended Care Facility: [**Location (un) 5481**] TCU Discharge Diagnosis: Primary: Acute hypoxic respiratory failure Acute pulmonary edema Acute on chronic diastolic heart failure Secondary: Hypertension Hyperlipidemia Hypothyroidism Discharge Condition: Good Discharge Instructions: You were admitted because of high blood pressure, trouble breathing, and fluid in your lungs. You required breathing support with an endotracheal tube and also needed medications to reduce your blood pressure and reduce the fluid in your lungs. Please take all of your medications as prescribed. Please keep all of your follow-up appointments. Return to the hospital if you have trouble breathing, chest pain, shortness of breath, fevers, chills, or any other concerns. Followup Instructions: Scheduled Appointments : Provider [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 10491**], MD Phone:[**Telephone/Fax (1) 10492**] Date/Time:[**2181-10-31**] 11:15 Provider [**Name9 (PRE) 900**] [**Name8 (MD) 901**], M.D. Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2181-12-17**] 11:40 [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 10491**] MD, [**MD Number(3) 10495**] ICD9 Codes: 5849, 5990, 4280, 2449, 2724, 4019
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Medical Text: Admission Date: [**2187-8-31**] Discharge Date: [**2187-9-3**] Date of Birth: [**2133-11-10**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2901**] Chief Complaint: Hypertensive Urgency Major Surgical or Invasive Procedure: Hemodyalysis History of Present Illness: 53yo M w/ longstanding DM, IgA & diabetic nephropathy on HD, frequent admission for fluid overload and hypertensive urgency, who was sent to the ED from angiography today w/ BP 230/120. The pt speaks only cantonese, therefore the interview was conducted with his daughter interpreting & with the aid of ED&renal notes. Mr. [**Known lastname 724**] [**Last Name (Titles) 58901**] to the angio suite for b/l subclavian angiography to evaluate for fistula today; at start of porcedure SBP=200-->230/120 after procedure. He was sent to ED. On arrival to ED, BP as stated above, increasing to 242/136, HR 179. HE was given labetolol 20mg IV x 1 (w/ 2 more subsequent doses for total of 60mg), started on a nitro drip, and given hydralzaine 50mg po X 2, asa 325mg. HIs ekg demonstrated TWI in I, aVL, V4-6 & 0.5mm ST depression in I. CE's elevated with initial CK = 333, MB 5, trop 0.39-->253, 0.36-->222, 0.4. CXR revealed cardiomyopathy & mild CHF. He was seen by renal who did not fell he needed HD acutely. He got a head CT to r/o stroke, which did not demonstrate acute pathology (however, it was limited by residual contrast from earlier study). He was briefly started on heparin, however, on informal discussion with cardiology, it was felt that his increased enzymes were [**3-8**] ESRD & CHF, therefore heparin was d/c'd. BP decreased to 160's systolic with above medications. Txf'd to CCU on nitro gtt. Pt denies medication non-compliance. Denies CP, SOB, weakness, sensory changes. Past Medical History: -Hypertension -IgA & Diabetic nephropathy on HD since [**6-9**] (Tues, Thurs, Sat) -Diabetes -hypercholesterolemia -anemia of chronic disease -impaired vision/legally blind (? [**3-8**] diabetic retinopathy) -Right upper extremity DVT ([**7-10**]) Social History: Social History: Cantonese speaking only, immigrated to the US 10 yrs ago, currently lives with wife and 3 children, works in a restaurant, no health insurance, no history of tobacco use, alcohol, or illicit drug use Family History: No DM, CAD, Stroke, HTN, or Renal Disease Physical Exam: T 97.7 HR 87 BP 177/97 RR 16 O2 97% wt 63.4kg gen-awake, alert, in mild distress HEENT-anicteric sclera, no lymphadenopathy, no JVD Chest-normal resp effort, decreased bs's at bases w/ rales ~[**4-7**] way up Cardio-rr, nml s1s2, no m/r/g GI-(+)bs, soft, NT/ND, no organomegaly Ext-1(+) LE edema Neuro-moving all extremities, responding to q's. Pertinent Results: [**2187-8-31**] 08:21PM GLUCOSE-151* UREA N-24* CREAT-5.3* SODIUM-134 POTASSIUM-4.0 CHLORIDE-98 TOTAL CO2-28 ANION GAP-12 [**2187-8-31**] 08:21PM CK(CPK)-222* [**2187-8-31**] 08:21PM CK-MB-5 cTropnT-0.40* [**2187-8-31**] 02:25PM CK(CPK)-253* [**2187-8-31**] 02:25PM cTropnT-0.36* [**2187-8-31**] 07:20AM CK(CPK)-333* [**2187-8-31**] 07:20AM CK-MB-5 cTropnT-0.39* [**2187-8-31**] 07:20AM WBC-7.5 RBC-3.95* HGB-11.3* HCT-32.2* MCV-82 MCH-28.6 MCHC-35.1* RDW-15.0 . EKG: NSR @ TWI in I, aVL, V4-6 & 0.5mm ST depression in I Brief Hospital Course: 53yo male w/ HTN, DM2, IgA/DM nephropathy on HD, frequent admissions for fluid overload and hypertensive urgency, now here for hypertensive urgency which has improved w/ aggresive BP meds & nitro gtt w/ associated CHF. . #Hypertensive urgency: the pt was asymptomatic when he was found to have systolic pressures >200--no neurologic symptoms, no chest pain, nor shortness of breath. On exam, however, there was evidence of volume overload--crackles bilaterally on auscultation. The pt's signs of heart failure were likely due to hypertensive urgency as well as volume overload given his chronic renal failure. The pt was admitted to the CCU, where his BP was initially lowered with IV anti-hypertensives. Given the pt's reported baseline SBP between 140 and 160's, a goal SBP <160 was set. The pt was weaned off nitro gtt while his PO medications were restarted. His Losartan dose was increased from 25 mg to 50 mg daily. His dose of lisinopril was increased from 20 mg to 40 mg daily and amlodipine 10 mg was added. Hydralazine was discontinued. Regarding pt's increased cardiac enzymes, it was thought that this was due to enzyme leak in the setting of CHF coupled with poor enzyme clearance in the setting of CRI. He was not thought to have ACS. . #ESRD: the pt was volume overloaded upon admission despite having HD on the day prior to presentation. Renal was consulted and felt that the patient did not need urgent dialysis The pt underwent HD the morning after admission. He was continued on phosphate binders and EPO. . #DM2: He was covered with RISS and his NPH dose was halved since he was not eating as much in the hospital. He was discharged on his standard insulin dosing schedule. . #Hypercholesterolemia: pt received his regular dose of atorvastatin . #Anemia: pt has h/o anemia of chronic disease & prior GI bleed. Not an active issue while hospitalized. Continued EPO & iron. . #Diet: Of note, though pt & wife reported following low-salt diet, the pt was seen eating high-salt food here (Chinese food brought by his wife). The pt & his wife may need more teaching on what foods are low in salt. Medications on Admission: -atorvastatin 40qd -asa 325qd -losartan 25qd -lisinopril 20qd -metoprolol SA 200qd -hydralazine 50 qid -metoclopramide 10tid -pantoprazole 40qd -epo 10,000 QHD -CaCO3 500 TID, -NPH/reg 15 qam/4 qpm -simethicone 80-160 tid prn -sevelamer 800 tid Discharge Medications: 1. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 3. Metoclopramide 10 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 4. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 5. Epoetin Alfa 10,000 unit/mL Solution Sig: One (1) Injection ASDIR (AS DIRECTED). 6. Sevelamer 800 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 7. Simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed. 8. Losartan 50 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 9. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 10. Metoprolol Succinate 200 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO once a day. 11. Insulin NPH/reg 15 qam/4 qpm 12. Amlodipine 10 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 13. Lisinopril 40 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital6 1952**], [**Location (un) 86**] Discharge Diagnosis: Primary: Hypertensive Urgency Volume Overload Chronic renal insufficiency . Secondary: Diabetes IgA nephropathy Blindness Right subclavian thrombus Anemia of Chronic Disease Hypercholesterolemia Discharge Condition: Stable Discharge Instructions: -Please continue taking your blood pressure medications as prescribed. Please make the following changes to your medications: 1) Increased your dose of Losartan from 25 mg to 50 mg daily. Until you fill your new prescription you can take 2 of your old 25 mg tablets daily. 2) Increased your dose of lisinopril from 20 mg to 40 mg daily. You can take two of your old 20mg tablets daily until you run out, and then fill the 40 mg prescription. 3) We have added amlodipine (Norvasc) to your regimen, which you will take once a day. 4) STOP taking your hydralazine, as we have discontinued this medication. -YOU SHOULD ADHERE TO A 1 LITER FLUID RESTRICTION DAILY! Do not drink more than a liter of fluid for the whole day. -If you have chest pain, shortness of breath, severe headache, dizziness, weight gain >3lb, nauseau, vomiting, or diarrhea, please contact your PCP or go to the [**Name (NI) **]. -Please maintain a low salt diet. Followup Instructions: -Please make an appointment with your primary care [**First Name8 (NamePattern2) **] [**First Name11 (Name Pattern1) 3078**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 32199**] for follow-up of your blood pressure within one week--Phone# [**Telephone/Fax (1) 8236**]. Please keep the following appointments: -Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) **] TRANSPLANT SOCIAL WORK at [**Hospital1 18**] Date/Time:[**2187-9-3**] 1:00 Provider: [**Name10 (NameIs) 2105**] [**Name11 (NameIs) 2106**], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2187-9-3**] 2:00 [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2908**] MD, [**MD Number(3) 2909**] ICD9 Codes: 5856, 4280, 3572, 2720
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Medical Text: Admission Date: [**2132-1-15**] Discharge Date: [**2132-1-22**] Date of Birth: [**2070-3-3**] Sex: F Service: NEUROLOGY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 618**] Chief Complaint: - Vertigo, dysarthria, diplopia, left-sided paresthesia, muffled hearing in left ear. Major Surgical or Invasive Procedure: None. History of Present Illness: Ms. [**Known lastname 55542**] is [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 1425**] 61 year-old right-handed woman with a history of hypertension and hyperlipidemia who presented to [**Hospital1 **]-[**Location (un) 620**] following three days of vertigo, dysarthria, visual changes, left limb weakness and sensory changes, and was transferred to to the [**Hospital1 18**] [**1-15**] when found to have basilar artery occlusion. The patient explains she felt well until about one month ago when she developed a sinus infection. In the week prior to presentation she also developed [**Month/Day (4) **] typically associated with her migraine headaches such as positive visual phenomena and scintillating scotoma. However, she was struck by a new constellation of [**Month/Day (4) **] three days prior to presentation. On [**1-13**], she awakened with ringing in the left ear and the sensation that everything in her visual field was "flipping." After about one minute, it began to feel as if her head was spinning. The syndrome was associated with nausea, vomiting, and gait unsteadiness. She also noticed left face, arm, and leg "tingling" that can sometimes accompany her migraine. The syndrome was quite pronounced for 8 hours. She and her husband were away on [**Location (un) **], so she delayed seeking medical advice pending arrival home. She called her PCP [**Last Name (NamePattern4) **] [**1-14**]. She was given a prescription for meclizine and advised to try afrin. After the second dose of meclizine, at about [**2-19**] pm, she developed the onset of blurred vision, slurred speech, and weakness of the left arm and leg. The tingling sensation in the left hemibody evolved into a "numbness." However, she attributed the new [**Month/Day (1) **] to the meclizine, having read that many of the [**Month/Day (1) **] could represent adverse effects. She and her husband reasoned that the drug would be out of her system within about 8 hours and she would call the doctor [**First Name (Titles) **] [**Last Name (Titles) **] persisted this morning. The [**Last Name (Titles) **] continued this morning. When the patient called the PCP, [**Name10 (NameIs) **] was reportedly advised to present to the ED. She went first to [**Hospital1 **]-[**Location (un) 620**]. There, a CTA demonstrated a basilar artery thrombosis. A heparin drip was started and she was transferred to the [**Hospital1 18**] for further evaluation and care. NEUROLOGICAL REVIEW OF SYSTEMS - Positive for: as above, neck discomfort, muffled hearing on left - Negative for: lightheadedness, headache, trouble swallowing, difficulty producing or understanding speech, bowel incontinence, urinary incontinence or retention. GENERAL REVIEW OF SYSTEMS: - Positive for: as above - Negative for: fevers, chest discomfort, shortness of breath, abdominal pain, dysuria, rash. Past Medical History: PAST MEDICAL HISTORY: - hypertension - hyperlipidemia - GERD - migraine PAST SURGICAL HISTORY - hysterectomy Social History: - Married 39 years - Three children, 6 grand-children - Enjoys playing with granchildren Family History: - Positive for stroke (mother 72 years), migraine (brother, son), CAD/MI (brother had MI at 49 years) - Negative for seizure, clotting disorders, multiple pregnancy losses Physical Exam: Vitals: T: 98.2 P: 60 R: 16 BP: 133/76 SaO2: 100% RA General: Awake, cooperative, NAD. Dysarthric. HEENT: Normocepahlic, atruamatic, no scleral icterus noted. Mucus membranes moist, no lesions noted in oropharynx Neck: Supple. No evidence of nuchal rigidity. No carotid bruits appreciated. Cardiac: Regular rate, normal S1 and S2. Pulmonary: Lungs clear to auscultation bilaterally. Abdomen: Round. Normoactive bowel sounds. Soft. Non-tender, non-distended. Extremities: Warm, well-perfused. Skin: no rashes or concerning lesions noted. NEUROLOGIC EXAMINATION: Mental Status: * Degree of Alertness: Alert. Able to relate history without difficulty. * Orientation: Oriented to person, place, day, month, year, situation * Attention: Attentive. Able to name the [**Doctor Last Name 1841**] backwards without difficulty. * Memory: Pt able to repeat 3 words immediately and recall [**11-19**] unassisted at 30-seconds on initial trial --> after 2 additional trials [**1-17**] at 30 seconds and 5-minutes. * Language: Language is fluent without evidence of paraphasic errors. Repetition is intact. Comprehension appears intact; pt able to correctly follow midline and appendicular commands. Prosody is normal. Pt able to name high (pen) and low frequency objects (knuckles) without difficulty. [**Location (un) **] and writing abilities intact. * Neglect: No evidence of neglect. * Praxis: No evidence of apraxia. Cranial Nerves: * I: Olfaction not evaluated. * II: PERRL 3 to 2 mm and brisk. Visual fields full to confrontation. Fundi not well-visualized. * III, IV, VI: evidence of one and a half syndrome; most obvious eye movement is abduction of the left eye, which is associated with horizontal left-beating nystagmus. * V: Facial sensation intact to light touch in the V1, V2, V3 distributions. * VII: right facial asymmetry (family is uncertain but thinks it is different from baseline) * VIII: Hearing intact to finger-rub on right, "muffled" on left * IX, X: Palate elevates symmetrically. * [**Doctor First Name 81**]: 5/5 strength in trapezii bilaterally. * XII: Tongue protrudes in midline. Motor: * Tone: Normal. * Drift: left pronator drift. Strength: * Left Upper Extremity: 4 Delt, 5 Biceps, 4 Triceps, 5 Wrist Ext, 5 Wrist Flex, 4+ Finger Ext, 5 Finger Flex * Right Upper Extremity: 5 throughout Delt, Biceps, Triceps, Wrist Ext, Wrist Flex, Finger Ext, Finger Flex * Left Lower Extremity: 4 Iliopsoas, 5 Quad, breakable Ham, 5 throughout Tib Ant, Gastroc, Ext Hollucis Longis * Right Lower Extremity: 5 throughout Iliopsoas, Quad, Ham, Tib Ant, Gastroc, Ext Hollucis Longis Reflexes: * Left: brisk throughout Biceps, Triceps, Bracheoradialis, Patellar, 1+ Achilles * Right: brisk throughout Biceps, Triceps, Bracheoradialis, Patellar, 1+ Achilles * Babinski: strong withdrawal making interpretation difficult Sensation: * Light Touch: intact bilaterally in lower extremities, upper extremities, trunk, face * Pinprick: decreased in distal left lower extremity; intact bilaterally upper extremities, trunk, face * Temperature: decreased in distal left lower extremity; otherwise intact to cold sensation in arms, face * Vibration: decreased in distal left lower extremity; appreciated at level of left patella, intact at left index finger; intact at right great toe * Proprioception: decreased in distal left lower extremity (left great toe); intact at left ankle, intact at level of right great toe * Extinction: No extinction to double simultaneous stimulation Coordination * Finger-to-nose: decreased accuracy on left, intact on right * Heel-to-shin: intact bilaterally * Finger Tapping: decreased speed on left Gait: * Description: declined Pertinent Results: [**2132-1-22**] 05:35AM BLOOD WBC-5.1 RBC-3.58* Hgb-11.6* Hct-33.9* MCV-95 MCH-32.3* MCHC-34.2 RDW-13.2 Plt Ct-280 [**2132-1-15**] 04:57PM BLOOD Neuts-65.0 Lymphs-28.5 Monos-4.6 Eos-1.2 Baso-0.8 [**2132-1-21**] 12:40PM BLOOD PT-21.0* PTT-64.4* INR(PT)-2.0* [**2132-1-21**] 06:50AM BLOOD Glucose-91 UreaN-14 Creat-0.7 Na-136 K-4.7 Cl-101 HCO3-27 AnGap-13 [**2132-1-16**] 02:06AM BLOOD ALT-37 AST-42* LD(LDH)-200 AlkPhos-122* [**2132-1-21**] 06:50AM BLOOD Calcium-9.3 Phos-4.7* Mg-2.0 [**2132-1-16**] 02:06AM BLOOD %HbA1c-5.8 eAG-120 [**2132-1-16**] 02:06AM BLOOD Triglyc-95 HDL-56 CHOL/HD-3.4 LDLcalc-117 [**2132-1-17**] 12:19AM BLOOD TSH-1.6 [**2132-1-15**] 04:57PM BLOOD ASA-4.6 Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-POS Tricycl-NEG [**2132-1-16**] 02:06AM BLOOD FACTOR V LEIDEN-PND [**2132-1-15**] 06:20PM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.050* [**2132-1-15**] 06:20PM URINE Blood-NEG Nitrite-NEG Protein-TR Glucose-NEG Ketone-80 Bilirub-NEG Urobiln-NEG pH-6.0 Leuks-NEG [**2132-1-15**] 06:20PM URINE RBC-2 WBC-<1 Bacteri-NONE Yeast-NONE Epi-<1 [**2132-1-15**] 06:20PM URINE bnzodzp-NEG barbitr-POS opiates-NEG cocaine-NEG amphetm-NEG mthdone-NEG CTA Head and Neck [**2132-1-21**] IMPRESSION: 1. Slight increase in flow within the basilar artery, although a significant segment of the basilar artery is still occluded. 2. Likely patulous left A2 arterial segment, centered at a branch point. Less likely, this focal dilation could be a small, asymptomatic aneurysm. 3. Opacification of the right maxillary sinus, multiple right ethmoidal air cells, and the frontal sinuses bilaterally could represent an ongoing inflammatory process. The study and the report were reviewed by the staff radiologist. Transthoracic Echo [**2132-1-16**] The left atrium is elongated. No atrial septal defect or patent foramen ovale is seen by 2D, color Doppler or saline contrast with maneuvers. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%). There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic root is mildly dilated at the sinus level. The ascending aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No masses or vegetations are seen on the aortic valve. Mild (1+) aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. IMPRESSION: Normal regional and global biventricular systolic function. Focal calcifications on the aortic leaflets likely reflect the aging process. A healed/chronic vegetation cannot be excluded. Mild aortic regurgitation. Dilated thoracic aorta. Negative bubble study. MRI/MRA [**2132-1-16**] MRI IMPRESSION: Acute acute/subacute ischemic changes identified within the right side of the pons and anterior medulla oblongata, consistent with partial occlusion of the basilar artery. There is no evidence of acute intracranial hemorrhage. MRA IMPRESSION: IMPRESSION: Vascular occlusion of the mid segment of the basilar artery and also proximal segment with no visualization of the posterior inferior cerebellar arteries, the V3 segment of the left vertebral artery apparently is patent. There is no evidence of flow stenotic lesions or occlusions in the anterior circulation, no aneurysms are identified. Brief Hospital Course: Mrs. [**Known lastname 55542**] is a 61-year-old right-handed woman with hypertension and dyslipidemia, presenting with vertigo, dysarthria, diplopia, left-sided paresthesia, muffled hearing in left ear on [**2132-1-15**]. Presented to [**Hospital1 **] [**Location (un) 620**] with the above. The above [**Location (un) **] recapitulate those of prior migraine, likely delaying presentation by a few days. However, migraine had been present since fourth grade (precluding misdiagnosed basilar insufficiency). Heparin gtt and oral anticoagulation commenced, particularly given a new diagnosis of paroxysmal atrial fibrillation. There is little other evidence of cerebrovascular disease, so it seems most likely that this was cardioembolic. Nonetheless, given LDL above goal, simvastatin dose was increased to 20 mg daily. The length of the occlusion was decreased a small amount between the two CTA scans from [**2132-1-15**] to [**2132-1-21**]. TTE showed LVEF 60-65%, no ASD/PFO. N-acetylcysteine and fluids were given for renal protection in the context of receiving IV contrast. Mrs. [**Known lastname 55542**] was seen by Cardiology given new atrial fibrillation. Diltiazem and propranalol doses on admission were not tolerated given bradycardia, so diltiazem was stopped and propranalol dose was reduced, then propranolol was increased to two thirds of her home dose after a short episode of atrial fibrillation with rapid rate (home dose 240 mg daily, current dose 160 mg daily). She will follow-up with Cardiology for consideration of rhythm control after a period of anticoagulation. Anticoagulation will be followed by her primary care doctor [**First Name8 (NamePattern2) **] [**Location (un) 33570**], Dr. [**First Name8 (NamePattern2) 803**] [**Last Name (NamePattern1) 931**]. Alkaline phosphatase was elevated at admission, but liver enzymes were normal on discharge. Medications on Admission: - meclizine 25 mg po tid prn vertigo - firoicet 2 tabs at onset of migraine - propanolol ER 240 mg po daily - diltiazem ER 120 mg po daily - carafate 1 gram po QID - nexium 40 mg po bid - simvastatin 20 mg po daily - tylenol PM prn insomnia Discharge Medications: 1. propranolol 160 mg Capsule,Extended Release 24 hr Sig: One (1) Capsule,Extended Release 24 hr PO once a day. Disp:*30 Capsule,Extended Release 24 hr(s)* Refills:*2* 2. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Nexium 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO twice a day. 4. sucralfate 1 gram Tablet Sig: One (1) Tablet PO QID (4 times a day). 5. warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM: Will likely need less than 5 mg daily on an ongoing basis. Rehabilitation will adjust and write the appropriate script. . 6. Benadryl 25 mg Capsule Sig: Two (2) Capsule PO at bedtime as needed for insomnia. 7. Tylenol 8 Hour 650 mg Tablet Extended Release Sig: One (1) Tablet Extended Release PO three times a day as needed for pain: Do not exceed 2 g daily given interaction with coumadin. 8. Fioricet 50-325-40 mg Tablet Sig: Two (2) Tablet PO At onset of migraine as needed for headache: This contains Tylenol - do not use both medications. . 9. Outpatient Lab Work Please check PT/INR and fax to: Dr. [**First Name8 (NamePattern2) 803**] [**Last Name (NamePattern1) 931**], Fax: ([**Telephone/Fax (1) 55736**]. Discharge Disposition: Extended Care Facility: [**Hospital3 1107**] [**Hospital **] [**Hospital 1108**] Rehab Unit at [**Hospital6 1109**] - [**Location (un) 1110**] Discharge Diagnosis: Primary Brainstem ischemic stroke, basilar artery occlusion Atrial fibrillation, paroxysmal Secondary Dyslipidemia Hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You came to [**Hospital1 18**] from [**Hospital1 **] [**Location (un) 620**] after it was found that a portion of your basilar artery was occluded. Heparin IV and coumadin were started given that this was likely embolic. An embolic cause seems more likely given that your heart was found to be irregular at time - atrial fibrillation. Cardiology were consulted and you will also see them as an outpatient. We have changed your medications: - STOP taking diltiazem (your heart rate was low on this medication while you were here) - DECREASE propranolol to 160 mg daily - INCREASE simvastatin to 40 mg daily (after this event your goal cholesterol is lower) Followup Instructions: You have a follow up appointment with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] in Internal Medicine at [**Hospital1 **] [**Location (un) 620**] ([**Telephone/Fax (1) 3070**]) on [**2-5**] at 11:20. Once you are discharged from rehab, contact Dr. [**Last Name (STitle) 931**] to monitor your INR lab values. Dr. [**Last Name (STitle) 931**] will organize for you to be followed by the coumadin clinic at [**Location (un) 620**]. You have a follow up appointment with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] in Cardiology ([**Telephone/Fax (1) 62**]) on [**2-22**] at 9:20 in the [**Hospital Ward Name 23**] Building, [**Location (un) **]. You have a follow up appointment with Dr. [**Last Name (STitle) **] in Neurology ([**Telephone/Fax (1) 2574**]) on [**4-1**] at 5:00 in the [**Hospital Ward Name 23**] Building, [**Location (un) 6749**]. [**Name6 (MD) **] [**Name8 (MD) **] MD, [**MD Number(3) 632**] ICD9 Codes: 4019, 2724
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Medical Text: Admission Date: [**2195-6-18**] Discharge Date: [**2195-6-28**] Date of Birth: [**2127-6-26**] Sex: M Service: CARDIOTHORACIC Allergies: Latex / Shellfish Derived Attending:[**First Name3 (LF) 1505**] Chief Complaint: dyspnea Major Surgical or Invasive Procedure: [**2195-6-22**] Aortic valve replacement (23mm St. [**Male First Name (un) 923**] Mechanical), Coronary artery bypass grafting times one (Left internal mammary artery to Left anterior descending artery) History of Present Illness: Mr. [**Known lastname 1124**] is a 67 year-old male with known aortic stenosis/bicuspid aortic valve/coronary artery disease, now with increasing dyspnea. Past Medical History: 1. Coronary artery disease one vessel disease status post catheterization on [**11-23**] with an left anterior descending coronary artery stent. 2. Atrial fibrillation status post DCCV on the [**12-5**]. This was unsuccessful and he was subsequently started on Amiodarone. 3. Hypercholesterolemia. 4. Status post acetabular fracture. 5. Seizure disorder 15 years ago. Percutaneous coronary intervention in [**2188**]: 90% proxLAD, 70% midLAD, 95% D1, 60% RI, mid systolic and diastolic dysfunction. Social History: Social history: Lives in [**Hospital1 **] with his Wife. [**Name (NI) 1403**] at home making signs for museums and galleries is significant for the absence of current . There is no history of alcohol abuse or IVDU/illicit drug use or tobacco use. Family History: There is no family history of premature coronary artery disease or sudden death. Physical Exam: Pulse: 56 Resp:18 O2 sat: 98 RA B/P Right:100/61 Left: Height: 5'4" Weight:180lbs General: Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [] Neck: Supple [x] Full ROM []kyphosis Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur III/VI SEM throughout precordium Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema Varicosities: None [x] Neuro: Grossly intact Pulses: Femoral Right: 1+ Left:1+ DP Right: 2+ Left:2+ PT [**Name (NI) 167**]:2+ Left:2+ Radial Right: 2+ Left:2+ Pertinent Results: [**2195-6-26**] 04:24AM BLOOD WBC-9.6 RBC-3.05* Hgb-9.2* Hct-27.0* MCV-88 MCH-30.1 MCHC-34.1 RDW-15.6* Plt Ct-192 [**2195-6-26**] 04:24AM BLOOD PT-19.9* PTT-52.3* INR(PT)-1.9* [**2195-6-25**] 07:00PM BLOOD PT-16.9* PTT-35.8* INR(PT)-1.5* [**2195-6-26**] 04:24AM BLOOD Glucose-104 UreaN-20 Creat-1.0 Na-142 K-3.4 Cl-104 HCO3-30 AnGap-11 [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 99258**] (Complete) Done [**2195-6-22**] at 12:25:07 PM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) **] R. [**Hospital1 18**], Division of Cardiothorac [**Hospital Unit Name 4081**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2127-6-26**] Age (years): 67 M Hgt (in): 65 BP (mm Hg): 108/60 Wgt (lb): 170 HR (bpm): 45 BSA (m2): 1.85 m2 Indication: Intra-op TEE for AVR, CABG ICD-9 Codes: 440.0, 424.1 Test Information Date/Time: [**2195-6-22**] at 12:25 Interpret MD: [**Name6 (MD) 928**] [**Name8 (MD) 929**], MD, MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Adequate Tape #: 2009AW03-: Machine: Echocardiographic Measurements Results Measurements Normal Range Left Ventricle - Septal Wall Thickness: *1.7 cm 0.6 - 1.1 cm Left Ventricle - Inferolateral Thickness: *1.8 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: 5.2 cm <= 5.6 cm Left Ventricle - Ejection Fraction: 55% >= 55% Aorta - Annulus: 2.3 cm <= 3.0 cm Aorta - Sinus Level: *3.8 cm <= 3.6 cm Aorta - Sinotubular Ridge: 2.9 cm <= 3.0 cm Aorta - Ascending: *3.9 cm <= 3.4 cm Aorta - Descending Thoracic: 2.5 cm <= 2.5 cm Aortic Valve - Peak Velocity: *4.1 m/sec <= 2.0 m/sec Aortic Valve - Peak Gradient: *68 mm Hg < 20 mm Hg Aortic Valve - Mean Gradient: 45 mm Hg Aortic Valve - LVOT diam: 2.3 cm Aortic Valve - Valve Area: *0.6 cm2 >= 3.0 cm2 Findings pre-bypass exam revealed normal wall function and severely stenotic aortic valve. No PFO was recognized. LEFT ATRIUM: Mild LA enlargement. No spontaneous echo contrast is seen in the LAA. Good (>20 cm/s) LAA ejection velocity. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. Normal interatrial septum. No ASD by 2D or color Doppler. LEFT VENTRICLE: Severe symmetric LVH. Normal LV cavity size. Normal regional LV systolic function. Overall normal LVEF (>55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Mildly dilated aortic sinus. Simple atheroma in aortic root. Mildly dilated ascending aorta. Mildly dilated descending aorta. AORTIC VALVE: Bicuspid aortic valve. Severely thickened/deformed aortic valve leaflets. Critical AS (area <0.8cm2). Moderate (2+) AR. MITRAL VALVE: Mild mitral annular calcification. Mild (1+) MR. TRICUSPID VALVE: Physiologic TR. PULMONIC VALVE/PULMONARY ARTERY: Physiologic (normal) PR. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. The patient appears to be in sinus rhythm. Results were personally reviewed with the MD caring for the patient. See Conclusions for post-bypass data The post-bypass study was performed while the patient was receiving vasoactive infusions (see Conclusions for listing of medications). post-bypass: Conclusions PRE-BYPASS: The left atrium is mildly dilated. No spontaneous echo contrast is seen in the left atrial appendage. No atrial septal defect is seen by 2D or color Doppler. There is severe symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The aortic root is mildly dilated at the sinus level. There are simple atheroma in the aortic root. The ascending aorta is mildly dilated. The descending thoracic aorta is mildly dilated. The aortic valve is bicuspid. The aortic valve leaflets are severely thickened/deformed. There is critical aortic valve stenosis (valve area <0.8cm2). Moderate (2+) aortic regurgitation is seen. Mild (1+) mitral regurgitation is seen. There is no pericardial effusion. POST-BYPASS: For the post-bypass study, the patient was receiving vasoactive infusions including phenylephrine and is being AV paced 1. A mechanical prosthesis is well positioned in the aortic position. Annulus is stable, leaflets open well. Washing jets are seen. No perivalvular leaks are noted. Mean gradient is 4 mm of Hg. 2. Bi ventricular function is preserved. 3. Aorta is intact post decannulation. 4. Other findings are unchanged Brief Hospital Course: Mr. [**Known lastname 1124**] was admitted on [**2195-6-18**] for a cardiac catheterization, pre-operative work-up and intra-venous heparin. His surgery was post-poned for an elevated INR and then his INR was allowed to drift down without intervention. On [**2195-6-22**] he underwent an aortic valve replacement (23mm St. [**Male First Name (un) 923**] Mechanical), coronary artery bypass grafting times one (LIMA to LAD). Please see the operative note for details. His bypass time was 133 minutes with a crossclamp x of 104 minutes He tolerated this procedure well and was transferred in critical but stable condition to the surgical intensive care unit. He remained hemodynamically stable in the immediate post-op period and on the morning of POD1 he was extubated. On post-operative day two he was transferred to the stepdown floor for continued recovery and post-op care. His tubes, lines and drains were removed according to cardiac surgery protocol. His activity was advanced with the assistance of physical therapy and on POD #6 he was discharged home with visiting nurses Medications on Admission: coumadin 2, ASA 81, lopressor 75, lasix 40 [**Hospital1 **], lipitor 80, amiodarone 200 Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 4. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Ipratropium-Albuterol 18-103 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q6H (every 6 hours). Disp:*1 mdi* Refills:*2* 7. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*2* 8. Tramadol 50 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. Disp:*65 Tablet(s)* Refills:*1* 9. Warfarin 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) as needed for AVR mech : Dr. [**Last Name (STitle) 99259**] to deose couamdin based on INR for Mech AVR. Disp:*30 Tablet(s)* Refills:*1* 10. Furosemide 40 mg Tablet Sig: One (1) Tablet PO three times a day for 7 days: 3 times daily for 7 days then twice daily on going. Disp:*75 Tablet(s)* Refills:*1* 11. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO Q12H (every 12 hours) for 7 days: check with your cardiologist if you should continue this medication. Disp:*14 Tab Sust.Rel. Particle/Crystal(s)* Refills:*1* 12. Outpatient Lab Work check bun/creat, potassium and INR on [**6-29**]. Discharge Disposition: Home With Service Facility: [**Company 1519**] Discharge Diagnosis: aortic stenosis s/p Aortic Valve Replacement(mech), coronary artery disease s/p Coronary artery bypass graft x1 , atrial fibrillation PMH: Congestive heart failure(diastolic), Hyperlipidemia, seizure disorder, Rt hip fracture s/p repair, PTCA-stent(LAD), Discharge Condition: good Discharge Instructions: Please shower daily including washing incisions, no baths or swimming Monitor wounds for infection - redness, drainage, or increased pain Report any fever greater than 101 Report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week No creams, lotions, powders, or ointments to incisions No driving for approximately one month No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Followup Instructions: Dr [**Last Name (STitle) **] (cardiac surgery) in 4 weeks ([**Telephone/Fax (1) 170**]), please call for appointment. Dr [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 838**] (PCP) in [**1-23**] weeks ([**Telephone/Fax (1) 4775**]), please call for appointment. Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] (cardiologist) in [**1-23**] weeks, please call for appointment. Wound check appointment [**Hospital Ward Name 121**] 2 as instructed by nurse ([**Telephone/Fax (1) 3071**]) INR to be drawn on [**2195-6-29**] with results sent to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2716**] at the Cardiology [**Hospital3 **] Fax [**Telephone/Fax (1) 9672**], Phone [**Telephone/Fax (1) 99260**]. Plan confirmed with Ms. [**Name13 (STitle) 2716**] on [**6-26**]. Completed by:[**2195-6-28**] ICD9 Codes: 4241, 4280, 2724
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Medical Text: Unit No: [**Numeric Identifier 76691**] Admission Date: [**2192-2-1**] Discharge Date: [**2192-2-24**] Date of Birth: [**2192-2-1**] Sex: F Service: NB HISTORY OF PRESENT ILLNESS: The patient was born at 32 6/7 weeks' gestational age on [**2192-2-1**]. Birth weight was 1705g (25th %ile), length is 44.5 cm (50th %ile), head circumference 29.5 cm, (25th %ile), born to a 21-year-old, G1, P0, now 2, A+, antibody negative, hepatitis B surface antigen negative, rubella immune, RPR nonreactive, GBS unknown, HIV negative. Mom had a history of HSV with active lesions, gonorrhea and chlamydia in the past, spontaneous rupture of mono-di twins due to preterm labor. Preterm labor was treated with magnesium, had a complete course of betamethasone, spontaneous onset of labor led to cesarean section under spinal anesthesia. Rupture of membranes was at delivery. There was no intrapartum fever or chorioamnionitis. Intrapartum antibiotic therapy was not administered. The infant was vigorous at delivery. She was orally and nasally bulb suctioned and dried and tactile stimulation was provided for apnea. Subsequently she was pink with no distress on room air until onset of intercostal retractions on admission to the NICU. Apgars were 8 at one minute and 9 at five minutes. DISCHARGE PHYSICAL EXAM: Weight 2205g (10-25th %ile), length 45.5 cm (25th %ile), head circumference 32.5 cm (25-50th%ile) Gen: alert, NAD, In open crib Heent: AFOSF, posterior fontanel is open, palate intact, no lesions, red reflex present bilaterally, no ovious strabismus Resp: NAD, CTA Bilaterally, no wheeze or rhonchi, no distress Cards: RRR, no murmur, Good pulses, no Brachial-Femoral delay Abd: Soft NT ND no mass,+Bs, no organomegaly Ext: WWP, moves all four spontaneous, negative Barlow, ortalani, and galeazzi signs on hip examination GU: Normal female, small sacral pigmented nevus Neuro: Alert, no focal deficits, normal DTR??????s HOSPITAL COURSE: Respiratory: On admission to the NICU the patient was initially put on a CPAP of 6. She had increasing work of breathing with subcostal suprasternal retractions and nasal flaring which required intubation. The patient was intubated and was given 2 doses of surfactant. The patient continued to be intubated until day of life 2 and the patient was extubated to room air. Respiratory course was also complicated by apnea and bradycardia which were not severe enough to require caffeine treatment. The patient had no apnea or bradycardia for greater than 5 days prior to discharge. Cardiovascular: The patient had no central lines and blood pressure was stable throughout hospital course. The patient had some desaturations and bradycardia which did not occur 5 days prior to discharge. Fluid, electrolyte and nutrition: The patient was put on IV fluids initially and started per gastric enteral feeds on day of life 2. She remained on enteral feeds on day of life 5 and was taking this volume by mouth by day of life 20. Electrolytes throughout the NICU course were normal. GI: The patient had a maximum bilirubin on day of life 4 of 9.7 mg/dL and was started on phototherapy. On day of life 5 bilirubin was down to 6.4. Phototherapy was discontinued and had a rebound bilirubin on day of life 6 of 5.4. She also had a bili sent on DOL 16 that was 4.1 (0.3) mg/dL. Infectious disease: Due to respiratory distress and prematurity, the infant had a rule out sepsis evaluation. No growth on blood cultures after 48 hours and antibiotics were discontinued. She had viral culture sent after birth for HSV that was negative from [**2-3**]. Heme: Her hct upon admission was 43.9%. She had a hematocrit of 32% on DOL 16. She is on iron supplementation. Neurology: Ultrasound was not done due to gestational age at birth of 33 weeks. Sensory: Audiology hearing screen was performed by automated auditory brainstem response. Results were normal bilaterally. She needs f/u as an outpatient with repeat testing secondary to active maternal HSV lesions at the time of birth. Ophthalmology response: The patient did not have an examination secondary to gestational age of 33-2/7 weeks. CONDITION ON DISCHARGE: Stable. DISCHARGE DISPOSITION: To home. PRIMARY CARE PEDIATRICIAN: Dr. [**First Name (STitle) **] [**Hospital1 37224**]Health Center, [**Telephone/Fax (1) 3581**]. PSYCHOSOCIAL: [**Hospital6 256**] Social Work was involved with family. Social work can be contact[**Name (NI) **] at [**Telephone/Fax (1) **]. There was reported domestic violence early in pregnancy. A letter for Scattered Shelter has been written on behalf of Ms. [**Known lastname **]. CARE RECOMMENDATIONS: Feedings at discharge: The patient was discharged on Enfamil 24 feeds. The patient should continue on the fortified feeds until 6-9 months of corrected age. Medications: Ferrous Sulfate 6.25 mg by mouth daily (2 mg/kg/day) The patient is currently receiving formula. Vitamin D supplementation is unnecessary at this time. The patient's birth weight was 1705, therefore should receive a total of 4 mg/kg/day of iron. her formula provides 2 mg/kg/day iron. Car seat position screen: Passed prior to discharge. State newborn screen: Done on day of life 2 and day of life 14. Screen was normal. IMMUNIZATIONS RECEIVED: The patient received hepatitis B vaccination on [**2192-2-20**]. The patient also received Synagis prior to discharge. Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for all infants who meet any of the following criteria: 1) born at less than 32 weeks, 2) born between 32 and 35-0/7 weeks with 2 of the following: Day care during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities, or school-age siblings, 3) with chronic lung disease, or 4) hemodynamic significant CHD. Influenza immunization is recommended annually in the Fall for all infants once they reach 6 months of age. Before this age (and for the first 24 months of the child's life), immunization against influenza is recommended for household contacts and out-of-home caregivers. This infant did not receive the Rotavirus vaccine. The American Academy of Pediatrics recommend initial vaccination of preterm infants at or following discharge from the hospital if they are clinically stable and at least 6 but not fewer than 12 weeks of age. Follow-up appointment is to be scheduled with Dr. [**First Name (STitle) **] within 2 days of discharge. DISCHARGE DIAGNOSIS: Prematurity, respiratory distress syndrome, rule out sepsis, twin gestation. [**Doctor First Name 11709**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 41519**], M.D. [**MD Number(2) 75306**] Dictated By:[**Last Name (NamePattern1) 76457**] MEDQUIST36 D: [**2192-2-22**] 13:39:36 T: [**2192-2-22**] 15:48:50 Job#: [**Job Number 76692**] ICD9 Codes: 769, 7742, V053, V290
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Medical Text: Admission Date: [**2169-5-23**] Discharge Date: [**2169-6-2**] Service: Neurosurgery/cardiac medicine HISTORY OF PRESENTING ILLNESS: Mr. [**Known lastname 30097**] is a 79 year-old Russian male with history of renal cell carcinoma diagnosed in [**2166**], status post left nephrectomy in 2,000, status post IL2 therapy, with lung metastasis, hypertension, atrial fibrillation, and diabetes who presented one year ago with an metastatic renal cell carcinoma in [**Month (only) 547**] of this year. An MRI on [**2169-5-1**] showed a dural based mass involving the calvarium and superior sagittal sinus. He was admitted on [**5-23**] for tumor embolization and left frontal parietal craniectomy with resection of the tumor and cranioplasty on the 13th. The patient's surgery was uneventful. On the evening of [**5-24**], however, the patient developed right arm Enzymes were cycled at that time and the patient ruled in for non-Q wave myocardial infarction with troponin peaking at greater than 50 and CK of 1,014 with an MB of 82. Electrocardiogram showed a new left bundle branch with ST elevation and T wave inversions in V3 and V4. The patient was started on intravenous Lopressor and nitroglycerin. The patient was then taken for cardiac catheterization which revealed three vessel disease with left main disease and an intra-aortic balloon pump was placed prophylactically. At this time the patient came under care at the Cardiac Care Unit team. At the time of our evaluation the patient had no complaints. PAST MEDICAL HISTORY: 1) Metastatic renal cell carcinoma left, diagnosed in [**2167-11-11**] with lung metastasis at diagnosis. Patient underwent IL2 therapy beginning in [**Month (only) 956**] of 2,000 complicated by atrial fibrillation. Patient underwent left nephrectomy in [**2168-5-12**]. Brain metastasis a per History of Present Illness. 2) Non-insulin dependent diabetes mellitus. 3) Hypertension. 4) Anemia. 5) Paroxysmal atrial fibrillation secondary to IL2 treatment. 6) Status post appendectomy. MEDICATIONS (Outpatient): 1) Digoxin 0.25 mg q. day, 2) Atenolol 25 mg p.o. q. day, 3) Coumadin. 4) Colace. 5) Multivitamin. 6) Boost. TRANSFER MEDICATIONS: 1) Insulin sliding scale. 2) Lopressor 25 mg b.i.d. 3) Nitroglycerin drip. 4) aspirin 325 mg q. day. 5) Captopril 25 mg t.i.d. SOCIAL HISTORY: The patient moved to the U.S. in [**2126**] from [**Country 12930**]. He has worked as an engineer until retirement last month. He has a tobacco history but said he quit in the [**2117**]. PHYSICAL EXAMINATION: On transfer temperature of 99, blood pressure of 150/90, pulse was 75, O2 saturation was 95% on three liters. In general the patient was an elderly male who was lying flat in bed and appeared comfortable. He was in no acute distress. Head, eyes, ears, nose and throat examination revealed a bandaged scalp with an incision that went across the top of his head. Pupils are equal, round and reactive to light. There were no oral lesions. Mucous membranes were moist. Neck was supple without bruits. Heart was regular rate and rhythm with a grade II/VI holosystolic murmur at the apex radiating to the axilla. Lungs were clear to auscultation anteriorly. Abdomen was soft and nontender. Extremities were without edema. A balloon pump was placed in the right femoral vein. Patient had warm feet. On brief neurologic testing the patient showed no focal signs. Cranial nerves appeared to be intact and patient was alert and oriented with fluent language. LABORATORY STUDIES: White count was 8.2 with hematocrit of 28 and platelets of 194. Chem-7 was remarkable only for BUN of 36, creatinine of 1.7 which was the patient's baseline. Serum glucose was 285. CKs peaked at 1,014 with an MB of 82 and MB index of 8. Troponin was greater than 50. Chest x-ray showed mild congestive heart failure and no focal infiltrates. Electrocardiogram on [**5-17**] showed sinus bradycardia with left ventricular hypertrophy and left axis deviation. There was poor R wave progression and left anterior vesicular block. Electrocardiogram on [**5-24**] showed bigeminy with flattened T waves anteriorly and later in the evening with development of chest pain and new left bundle branch block. Electrocardiogram on [**5-25**] elevations in V3 and V4 with T wave inversion. Echocardiogram from [**2168-4-11**] showed left atrial enlargement with slight left ventricular hypertrophy. Ejection fraction was measured at 45 percent. Echocardiogram postoperatively on this admission showed left atrial enlargement as well as right atrial enlargement. There was left ventricular hypertrophy. Ejection fraction was estimated at 20 to 25 percent. Patient had pulmonary hypertension, moderate aortic stenosis, 1 to 2+ mitral regurgitation and wall motion abnormality. Cardiac catheterization on [**5-25**] showed left main disease with an ostial 38 or 40 percent, distal 90 percent, mid LAD lesion of 80 percent, diagonal of 100 percent, mid left circumflex of 90 percent with right to left collateral flow distally, RCA with 90 percent involving the PDA. HOSPITAL COURSE AFTER TO CARDIAC CARE UNIT BY SYSTEMS: 1) Cardiovascular. Given the patient's three vessel with left main disease the patient was evaluated by CT surgery. With the severity of his disease, decreased ejection fraction, and other co-morbid illnesses the patient was thought to be too high risk exceeding the possible benefit of bypass grafting. The patient was initially maintained on intravenous nitroglycerin and intravenous heparin was discontinued after removal of intra-aortic balloon pump and intravenous nitroglycerin was weaned. The patient was maintained on daily dose of aspirin and Lopressor was increased gradually to 100 mg t.i.d. and later switched to 150 mg b.i.d. Accupril was increased slowly to 100 mg t.i.d. Given the patient's elevated left ventricular and diastolic pressure of 26 the patient was diuresed and later started on a daily dose of Lasix orally. As for the patient's atrial fibrillation with the patient's increasing risk of falling anticoagulation was discussed wit the neurosurgery team who felt that it would be wise to hold off on restarting Coumadin postoperatively and to re-evaluate this in one month after the patient is back on his feet. 2) Hematology. The patient's hematocrit stayed persistently between 28 and 30 while the intra-aortic balloon pump was in. Hemolysis laboratories were sent ruling this out as the etiology. Patient was transfused several units of blood with inappropriate bumps after intra-aortic balloon pump was removed hematocrit climbed to the 33 and was stable for several days. During the time the balloon pump was in the platelets also fell from approximately 200 to low 100s. Heparin was discontinued and Zantac was changed to Prilosec. Platelet count began to rise after the balloon pump was removed. 3) Neurology. On postoperative day #6 the patient' activity the was changed from out of bed to chair. At this point it was noted that he was not able to bear weight on his right lower extremity. On muscle strength testing the patient showed an upper motor neuron distribution of weakness with proximal muscle strength muscle groups being 4 to 4+/5 on motor testing. A head CT obtained showed postoperative changes with edema and effacement of the sulci over the left parietal region. There was no hemorrhage or infarction in any major territory noted. MRI obtained showed mild compression of the lateral [**Doctor Last Name 534**] on the left . After discussion with neurosurgery these changes were considered normal for his postoperative course and the patient's strength was expected to improve. On subsequent days motor strength was improved. On the date of discharge right and left biceps were noted to 4+/5, triceps were 5-/5, right iliopsoas was -[**4-15**], quads and hamstrings were [**4-15**], tibialis anterior was [**4-15**] and plantar flexors were [**4-15**]. The remainder of the neurologic examination was unremarkable. The patient will have follow up radiation therapy in one week with radiation of the sagittal sinus portion of the tumor that was unresectable. 3) Diabetes mellitus. The patient was maintained on a regular insulin sliding scale with fingerstick blood glucose checks. The patient will likely benefit from daily doses of scheduled NPH and regular insulin. 4) Renal. Given the patient's chronic renal insufficiency creatinine was followed daily, especially when the intra-aortic balloon pump was in place. Patient' creatinine stayed stable at 1.7 to 1.9 with adequate urine output. 5) Infection disease. The patient was eventually started on ciprofloxacin renally dosed for his creatinine clearance of a sterile pyuria. 6) Oncology. The patient will have follow up with Dr. [**Last Name (STitle) 17466**] in the radiation therapy clinic. As per discussion with Dr. [**Last Name (STitle) 17466**] prognosis is good given tumor responsiveness to IL2 therapy. For prophylaxis the patient was prophylaxed with heparin subcutaneously a well as pneumoboots and Prilosec p.o. DIAGNOSIS ON DISCHARGE: 1. Metastatic renal cell carcinoma. 2. Status post tumor embolization and left frontoparietal craniotomy with resection of tumor and cranioplasty. 3. Postoperative non-Q wave myocardial infarction. 4. Congestive heart failure with decreased left ventricular systolic function. 5. Anemia. 6. Resolving right sided lower extremity hemiparesis secondary to postoperative surgical edema. 7. Diabetes mellitus. MEDICATIONS ON DISCHARGE: 1) Lopresor 150 mg p.o. b.i.d., 2) Captopril 100 mg t.i.d., 3) Lipitor 10 mg p.o. q. day, 4) Isordil 20 mg p.o. t.i.d., 5) Lasix 20 mg p.o. q. day. 6) enteric coated aspirin 325 mg p.o. q. day. 7) Colace 100 mg p.o. b.i.d. 8) Prilosec 20 mg q. day. 9) Heparin subcutaneously 5,000 units subcutaneously t.i.d. 10) Dulcolax 10 mg p.o./p.r. p.r.n. 11) sublingual nitroglycerin 0.4 mg sublingual q. 5 minutes times 3 p.r.n. 12) regular insulin sliding scale 0 to 70 give D50 or juice, 71 to 160 give nothing, 161 to 200 give 2 units, 201 to 250 give 4 units, 251 to 300 give 6 units, 301 to 350 give 8 units, 351 to 400 give 10 units, greater than 401 give 12 units. STATUS: To [**Hospital3 **]. CONDITION: Satisfactory. FOLLOW UP: The patient will follow up with the brain tumor clinic on [**6-12**] at 3 P.M. for radiation therapy. The patient will follow up with his primary care physician. [**Name10 (NameIs) **] note, the patient had a mildly elevated heart rate at discharge to rehabilitation in the 80s given his high dose of beta blocker. Hematocrit was found to be within normal limits. TSH was still pending at the time of discharge. Please follow up with these results. [**First Name11 (Name Pattern1) 125**] [**Last Name (NamePattern4) 342**], M.D. [**MD Number(1) 343**] Dictated By:[**Name8 (MD) 10039**] MEDQUIST36 D: [**2169-6-2**] 11:01 T: [**2169-6-2**] 12:14 JOB#: [**Job Number 9901**] ICD9 Codes: 9971, 5990, 4280
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Medical Text: Admission Date: [**2164-7-4**] Discharge Date: [**2164-7-20**] Date of Birth: [**2164-6-29**] Sex: M Service: NBB HISTORY OF PRESENT ILLNESS: [**Known lastname **] [**Known lastname **], surname after discharge to be [**Last Name (un) 22107**], is the former 34 and [**4-10**] week gestation infant, born to a 20 year-old, Gravida I, Para 0 woman with the following prenatal screens: A positive, DAT negative, Hepatitis B surface antigen, rubella immune, GBS unknown. Birth occurred at [**Hospital **] Hospital on [**2164-6-29**]. Pregnancy was notable for delivery at 34 and 3/7 weeks gestation pregnancy. The pregnancy was complicated by premature rupture of membranes occurring 24 hours prior to delivery. The mother proceeded to spontaneous vaginal delivery. She received multiple courses of Penicillin prior to delivery for unknown group beta strep status. The infant emerged depressed, requiring positive pressure ventilation in the delivery room. He developed respiratory distress and was intubated and started on mechanical ventilation. He received a dose of Surfactant. He was also noted to have mild hypotension, treated with normal saline. The infant was transferred to [**Hospital3 1810**], [**Location (un) 86**], for further care. Hospital course at [**Hospital3 1810**] was notable for rapid improvement in respiratory status, exhibited by extubation to room air by day of life #2. Chest x-ray was notable for faint, diffuse opacifications, consistent with pneumonia. Hemodynamic instability resolved. Cardiac echo was performed on [**2164-6-30**] showing a structurally normal heart with a small patent ductus arteriosus and mildly depressed biventricular function. Enteral feeds were introduced and advanced without difficulty. Multiple lumbar puncture attempts were unsuccessful. The blood culture from [**Hospital **] Hospital was negative. There was some concern for slightly depressed neurologic exam on admission and a head ultrasound was obtained on [**2164-7-3**] which showed small bilateral germinal matrix hemorrhages. Due to concern for possible meningitis and a prolonged antibiotic course, transfer was arranged to [**Hospital1 69**] on day of life #5, [**2164-7-4**]. PHYSICAL EXAMINATION: Upon admission to the Neonatal Intensive Care Unit at [**Hospital1 69**], weight was 2.155 kg. Birth weight was 2.150 kg with a birth length of 43 cm and a head circumference of 30 cm. General: Active and vigorous infant, responsive to exam. Skin: Jaundiced, ruddy and warm. Underlying color pink. Head, eyes, ears, nose and throat: Fontanel soft and flat. Ears and nares patent. Palate intact. Palpebral fissures slightly down sloping. Neck supple, no lesions. Chest: Clear to auscultation. No grunting, flaring or retracting. Cardiac: Regular rate and rhythm without murmur. Normal S1 and S2. Femoral pulses +2. Abdomen soft, no organomegaly, no masses. Active bowel sounds. Genitourinary: Normal male. Testes descended bilaterally. Anus patent. Extremities, hips and back normal. Neuro: Appropriate tone and activity. Intact Moro. HOSPITAL COURSE: 1. Respiratory: [**Known lastname **] was in room air for his entire Neonatal Intensive Care Unit admission at the [**Hospital1 29402**]. No spontaneous episodes of apnea were noted. 2. Cardiovascular: An intermittent murmur has been audible. [**Known lastname **] has maintained normal heart rates and blood pressures. Baseline heart rate is 140 to 160 beats per minute with a recent blood pressure of 73/40 mmHg with a mean blood pressure of 52 mmHg. 3. Fluids, electrolytes and nutrition: [**Known lastname **] has been on full volume enteral feedings during admission. He was initially receiving most of his feedings by gavage. He has transitioned to all oral feeds. At the time of discharge, he is breast feeding or taking expressed breast milk fortified to 24 calories per ounce with 4 calories of Similac powder. Weight on the day of discharge is 2.565 kg with a corresponding length of 45.5 cm and a head circumference of 31 cm. 4. Infectious disease: A lumbar puncture was performed on [**2164-7-5**] showing 44,500 red blood cells and [**Pager number **] white blood cells. Protein was 280 mg/dl and glucose was 18 mg/dl. These findings were consistent with meningitis and [**Known lastname **] received a 21 day course of Ampicillin and Gentamycin. The antibiotics were discontinued on [**2164-7-20**]. Cerebrospinal fluid culture was no growth. 5. Gastrointestinal: Peak serum bilirubin occurred on day of life #5, total of 8.4 mg per dl. He did not require any treatment with phototherapy. [**Known lastname **] has had a significant diaper dermatitis that is being treated with Criticaid ointment. There are open areas of excoriation in the perianal area. 6. Hematologic: [**Known lastname **] did not receive any transfusions of blood products during admission. 7. Neurology: Repeat head ultrasounds were obtained on [**7-9**] and [**2164-7-19**]. Both showed persistence of the bilateral germinal matrix hemorrhages with the scan on [**2164-7-19**] showing slight extension of the hemorrhage still limited to the germinal matrix, more significant on the left than the right. A repeat head ultrasound has been scheduled as an outpatient for [**8-2**] at 1:50 p.m. at [**Hospital1 62374**]. [**Known lastname **] has maintained a normal neurologic exam during admission. 8. Sensory: Hearing screening was initially performed at [**Hospital3 1810**] on [**2164-7-3**] with [**Known lastname **] passing in both ears. Repeat hearing screen was passed at [**Hospital1 35990**] on [**2164-7-20**]. Due to the concern for meningitis, a repeat hearing screen is recommended at 3 months of age. 9. Psychosocial: As previously noted, surname after delivery will be [**Last Name (un) 22107**]. Both parents have been very involved in [**Known lastname 22033**] care. CONDITION ON DISCHARGE: Good. DISCHARGE DISPOSITION: Home with the parents. PRIMARY PEDIATRICIAN: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], MD, [**Location (un) 67370**]., [**Location (un) 67371**], [**Numeric Identifier 67372**]. Phone number [**Telephone/Fax (1) 65703**]. CARE AND RECOMMENDATIONS: Ad lib breast feeding or oral feeding. Breast milk fortified to 24 calories per ounce with 4 calories by Similac powder. MEDICATIONS: 1. Ferrous sulfate 0.3 ml p.o. once daily of 25 mg per ml dilution. 2. Tri-vi-[**Male First Name (un) **] 1 ml p.o. once daily. 3. Car seat position screening was performed. [**Known lastname **] was observed for 90 minutes in his car seat without any episodes of bradycardia or oxygen desaturation. 4. State newborn screens have been sent 3x on [**4-17**] and [**2164-7-13**]. No notification of abnormal results has been received to date. 5. Immunizations: Hepatitis B vaccine was administered on [**2164-7-16**]. 6. Immunizations recommended: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following three criteria: (1) Born at less than 32 weeks; (2) Born between 32 weeks and 35 weeks with two of the following: Day care during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities or school age siblings; (3) chronic lung disease. Influenza immunization is recommended annually in the Fall for all infants once they reach 6 months of age. Before this age, and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out-of-home caregivers. 1. Follow-up appointments: Appointment with Dr. [**Last Name (STitle) **], primary pediatrician, on [**2164-7-23**] at 9:15 a.m. Head ultrasound on [**8-2**], 1:50 p.m. at [**Hospital3 1810**], [**Location (un) 86**]. Hearing screening at 3 months of age. DISCHARGE DIAGNOSES: 1. Prematurity at 34 and [**4-10**] week gestation. 2. Status post respiratory distress and pneumonia. 3. Presumed meningitis. 4. Diaper dermatitis. Reviewed By: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 53043**], [**MD Number(1) 53044**] Dictated By:[**Last Name (Titles) **] MEDQUIST36 D: [**2164-7-20**] 02:15:16 T: [**2164-7-20**] 05:04:07 Job#: [**Job Number 67373**] ICD9 Codes: V053
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Medical Text: Admission Date: [**2160-12-9**] Discharge Date: [**2160-12-13**] Date of Birth: [**2160-12-9**] Sex: M Service: NEONATOLOG HISTORY OF PRESENT ILLNESS: The child was the 3.755 kg product of a full term gestation born to a 32 year old G2 P1-2 mother. Maternal screen notable for maternal blood type O positive, antibody negative, hep B surface antigen negative, RPR nonreactive, rubella immune, group B strep an absent left kidney and later a constellation of findings consistent with tuberous sclerosis complex including cardiac rhabdomyomas and subependymal CNS tubers. The child was delivered by C-section, emerged vigorous and looked good initially. HOSPITAL COURSE: He was started on CPAP and then rapidly weaned to room air. He subseuqently had multiple desaturation episodes of undetermined etiology. Sepsis, cardiac and neurological evaluations were negative. The episodes resolved spontaneously, and he has been asymptomatic for a period of 5 days prior to discharge. They are being attributed to respiratory immaturity, now resolved. 2. Cardiovascular. He developed some mild hypotension. He was given normal saline boluses times two. Cardiac rhythm was also noted to be mildly abnormal. Hypotension rapidly resolved and he did not require any further boluses or blood pressure medications. Echo was performed which showed the presence of rhabdomyomas, but no outflow obstruction and good ventricular function. EKG was consistent with intermittent sinus arrhythmia with premature atrial contractions. At this time patient's cardiac status is stable. He will require cardiac followup. He had one episode of bradycardia with desaturation which was self-resolving. Cardiology and neurology were involved. The event was thought to be clinically insignificant and idd not recur in the 5 days prior to discharge. 3. FEN. He was initially started on IV fluids. Gradually feeds were advanced. At the time of dictation he is tolerating full enteral feeds of approximately 100 cc per kg per day. His weight is 3.695 kg. 4. Neurology. He had an MRI done which showed the presence of multiple subependymal tubers in a classic distribution for tuberous sclerosis. He has not had any evidence of seizures. He is on no neurologic medications. 72-hour intermittent EEG was ordered because of the desaturation episodes, but these resolved before the test was started. The report on this investigation is pending at the time of discharge. 5. Infectious disease. CBC and blood culture were done. He was given 48 hours of antibiotics. His culture remained negative and he is no longer on antibiotics. 6. Renal. Post natal ultrasound was done which showed the presence of both kidneys with normal parenchyma. CONDITION ON DISCHARGE: Good. RECOMMENDATIONS: Continue to monitor his growth and feeding. Follow up in cardiology clinic. Follow up with neurology as an outpatient for followup head imaging in approximately six to eight weeks. He should be followed up by ophthalmology as an outpatient. An appointment should be made with Dr. [**Last Name (STitle) 44853**] at [**Telephone/Fax (1) 43283**]. He should follow up with genetics. Genetic testing has been sent. The child should have a followup renal ultrasound in approximately one to two months. DISCHARGE DIAGNOSES: Tuberous sclerosis complex. [**Doctor Last Name **] [**Last Name (NamePattern5) 36094**], M.D. [**MD Number(1) 36095**] Dictated By:[**Doctor Last Name 44592**] MEDQUIST36 D: [**2160-12-12**] 18:01 T: [**2160-12-12**] 19:38 JOB#: [**Job Number **] ICD9 Codes: V053
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Medical Text: Admission Date: [**2120-6-20**] Discharge Date: [**2120-6-24**] Date of Birth: [**2046-10-18**] Sex: M Service: MEDICINE Allergies: Iodine; Iodine Containing / Imdur / Lisinopril Attending:[**Last Name (NamePattern1) 1167**] Chief Complaint: unresponsiveness/s/p cardiac arrest Major Surgical or Invasive Procedure: intubation therapeutic hypothermia protocol History of Present Illness: 73M with h/o severe cardiomyopathy (EF [**9-19**]) s/p biV/ICD ([**2115**]), afib on coumadin and dig, rheumatic heart disease s/p mitral valve repair in [**2109**] with residual 3+ MR, CRI, h/o CVA, who was found unresponsive on park bench s/p cardiac arrest and loss of pulse during EMS transport on way to [**Hospital1 18**] ED. . Complex story pieced together with family report, ED records, OMR, and info from ICD interrogation. Per OMR note, patient had increasing LE edema since 6 days PTA, called Dr. [**First Name (STitle) 437**] and was told to restart lasix 20mg [**Hospital1 **]. Per family report, patient had not been feeling well for 2 days PTA with fatigue, vague symptoms. On AM of admission, pt had ICD firing for sensed VT at 11am with LOC prior to shock, with episode of incontinence. Pt called Dr. [**First Name (STitle) 437**] at 2pm who thought that patient may be hypokalemic, told to take 40meq KCL with planned f/u in [**Hospital 3782**] clinic. Patient then went to park to meet friends with possible marijuana use (?laced with cocaine) and was found unresponsive on park bench for unknown amt of time and EMS called. . No EMS records, but per ED report, pt had loss of pulse in transport, was given seconds of chest compressions, and on arrival in ED at 5:20pm, was in pulseless wide complex tachycardia concerning for polymorphic VT. CPR commenced and pt given epi 1mg x 1, atropine 1mg x 1, and intubated (initial gas 7/16/32/189), femoral line placed. During course in ED, patient went in and out of pulseless VT/WCT (loss of pulse for minutes at a time) requiring intermittent shocks by ICD (x 5 shocks per ICD interrogation between 4:46pm and 5:39pm), external defibrillation, and medications (amiodarone, epi, vasopressin, atropine). When regained pulse, pt hypotensive (SBP 36-67/26-29) so pt started on Neosynephrine and Levophed. Labs significant for INR 4.4, Hct 28.2, Cr 1.2, K 2.8. Given 30mg IV KCL, 2mg Mag sulfate, and given Hct drop from b/l of 32-35, sent for CT head for concern of bleed in setting of elevated INR. Wet read of CT head with no bleed, mass effect, or shift. Also given 4amps of Digibind after labs drawn. Patient lost pulse while down at CT scan, required one round of epi/atropine/CPR and regained pulse after 3 min, and was sent up to CCU directly on Neosynephrine at 4.8 and Levophed at 2.6. . On arrival to CCU, patient was intubated, sedated with fentanyl and versed. Met with family for update, identification, and confirmed full code. Overnight, Arctic sun cooling protocol initiated, reached goal temperature at 8:30pm. Started on dopamine, levophed and neosynephrine weaned off. ICD interrogated showing 6 episodes of ATP/shock for sensed VT/VF. Bedside ECHO done showing no large change from prior. ECG showed v-pacing and resolution of global WCT in limb leads, continued to have ACT in precordial leads with changed morphology from old ECG. Repeat ABG was 7/22/45/70, PEEP increased to 10. Cr increased from 1.2-> 1.9, INR decreased to 3.3, K was 5, lactate was 5.6. Given 20mg IV lasix with no response, then 40mg IV x 1 for volume overload by exam, CXR, no UOP ->50cc urine output. BNP [**Numeric Identifier **]. Cardiac arrest team notified, patient enrolled in IV steroid clinical trial with family consent. . Unable to obtain review of systems as patient unresponsive. Per OMR, patient with recent increase in LE edema. Past Medical History: 1. CARDIAC RISK FACTORS: (-)Diabetes, (-)Dyslipidemia, (-)Hypertension 2. CARDIAC HISTORY: -severe dilated cardiomyopathy w/ valvular heart dz, LVEF 10-15%, -rheumatic heart dz -s/p mitral valve repair in [**2109**] with residual moderate MR [**Name13 (STitle) **] on Coumadin, status post cardioversion in the past, but in afib recently (Recent INR 1.5-2.8) -mild renal insufficiency (Cr baseline is 1.2-1.6) -hx of CVA. -PACING/ICD: BiV ICD placed in [**2115**] Social History: -Tobacco history: none -ETOH: Alcohol abuse until 25 years ago -Illicit drugs: + marijuana currently Family History: NC Physical Exam: VS: T= 94.6 BP=82/63 - 108/67 HR=72 - 91 Sat: 95-100%, AC(550/20/10/100%) GENERAL: Pt intubated. Sedated. HEENT: Sclera anicteric. Pupuls 7mm bilaterally, PERRL. NECK: Supple with JVP of 16cm. CARDIAC: Heart sounds soft and difficult to hear with ventilator. Irregular with no murmur/rubs/gallops appreciated LUNGS: Course breath sounds anterior lung fields, no rhonchi/crackles. Unable to assess lower lobes given positioning. ABDOMEN: Difficult to assess given cool suit. Soft, ND. EXTREMITIES: 1+ dependent lower extremity edema. No clubbing/cyanosis appreciated. Distal extremities cool to touch. SKIN: Hematoma right arm. No other rashes, bruising appreciated. PULSES: R: Diminished Radial, DP, PT L: Diminished Radial, DP, PT Neuro: Pupils 7mm equal and reactive to light. Increased tone in bilateral upper and lower extremity. Unable to illicit patellar, tricep, or bicep reflex. Bilateral upgoing toes. Pertinent Results: EKG: Multiple EKGs, 1723 - 1745 in ED. Rate ranged from 83 - 150 highly irregular polymorphic wide complex tachycardia. With pacer spike occasionally prior to QRS complex and occasionally within QRS complex. Multiple QRS morphology. EKG from 1744, shows possible concordance in precordial leads. [**2043**] on arrival to CCU, EKG compared to prior EKG prior negative deflection in V3 now positive. . 2D-ECHOCARDIOGRAM: [**8-11**] 1.The left atrium is moderately dilated. The left atrium is elongated. The right atrium is moderately dilated. 2.There is mild symmetric left ventricular hypertrophy. The left ventricular cavity is severely dilated. There is severe global left ventricular hypokinesis. Resting regional wall motion abnormalities include akinesis of the mid and distal septum, mid and distal inferior wall and apex. The remaining segments are severely hypokinetic. The remaining left ventricular segments are hypokinetic. 3. Right ventricular systolic function appears depressed. There is an echogenic density in the RV consistent with a pacemaker lead. 4.The aortic root is mildly dilated. The ascending aorta is mildly dilated. The aortic arch is mildly dilated. 5.The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. 6.The mitral valve leaflets are mildly thickened. Moderate to severe (3+) mitral regurgitation is seen. The left ventricular inflow pattern suggests a restrictive filling abnormality, with elevated left atrial pressure. 7.There is mild pulmonary artery systolic hypertension. 8.There is no pericardial effusion. . ETT: [**2120-4-11**] Negative dipyridamole stress test . CARDIAC CATH: [**6-8**] 1. Selective coronary angiography showed a right dominant system without evidence for angiographically significant stenoses. 2. Limited resting hemodynamics revealed moderate pulmonary hypertension (PA mean 39 mmHg). The right and left sided filling pressures were elevated (RA mean 18 mmHg, RVEDP 20 mmHg, PCW mean 24 mmHg). Cardiac output and index were reduced (CO 3.5 l/min, CI 1.7 l/min/m2). FINAL DIAGNOSIS: 1. Coronary arteries are normal. 2. Elevated left and right sided filling pressures 3. Moderate pulmonary hypertension. . LABS ON ADMISSION: Initial labs in ED: 3.1\_8.4_/100 / 28.2\ ABG: 7.16/32/189/12 ( initial ABG after intubation) . K: 3.1 BUN: 22 Cr: 1.2 . PT/PTT/INR: 41.3/51.5/4.4 Fibrinogen: 146 Lip: 34 MOST RECENT LABS: [**2120-6-23**] 03:54AM BLOOD WBC-11.0 RBC-3.49* Hgb-9.5* Hct-30.9* MCV-89 MCH-27.2 MCHC-30.8* RDW-17.6* Plt Ct-133* [**2120-6-23**] 03:54AM BLOOD Plt Ct-133* [**2120-6-23**] 03:54AM BLOOD PT-31.0* PTT-40.9* INR(PT)-3.1* [**2120-6-23**] 03:54AM BLOOD FDP-80-160* [**2120-6-22**] 08:00PM BLOOD FDP-10-40* [**2120-6-23**] 03:54AM BLOOD Glucose-162* UreaN-65* Creat-4.6* Na-138 K-4.3 Cl-103 HCO3-17* AnGap-22* [**2120-6-23**] 04:18AM BLOOD Lactate-3.1* Brief Hospital Course: 73M with h/o severe cardiomyopathy (EF [**9-19**]) s/p biV/ICD ([**2115**]), afib on coumadin and dig, rheumatic heart disease s/p mitral valve repair in [**2109**] with residual 3+ MR, CRI, h/o CVA who was found unreponsive and s/p cardiac arrest from unknown etiology with multiple rounds of ICD firing and ACLS/CPR admitted on cooling protocol and pressor support. Patient found to be in polymorphic ventricular tachycardia in setting of hypokalemia and worsened severe end stage cardiomyopathy (Patient with known severe cardiomyopathy from valvular dz/NYHA IV sCHF with EF 10-15%). By ICD interrogation, patient had 6 episodes of ineffective ATP leading to shock with one episode at 11am, and one at 4:46pm which may have correlated with patient's episodes of unresponsiveness. Initial lytes showed hypokalemia, acidemia. Utox for cocaine negative and dig level normal. No evidence of ACS as etiology. Patient was s/p multiple episodes of loss of pulse with wide complex tachycardia, so started on cooling protocol on admission. Patient cooled on Arctic Sun protocol with goal cooling achieved at 8:30pm of night of admission. Continuous EEG in place, and per cardiac arrest team, per EEG and neuro exam post sedation, patient had very little chance of meaningful neurologic recovery. Patient required pressors for BP support, which was switched to milrinone and neosynephrine with no ability to achieve urine output with lasix. Patient's renal function continued to deteriorate from Cr 1.2 to 4.6, he went into DIC. Given patient's poor prognosis, critical condition, and low chance of meaningful neurologic recovery, family meeting was held on [**6-23**] and patient was made comfort measures only and kept comfortable with versed for myoclonic movements, morphine gtt, scopolamine patch, and ativan prn. His pressors were discontinued, and the patient was extubated at 5:45pm on [**6-23**]. The patient passed away at 2:20 am on [**2120-6-24**] comfortable, with family at the bedside. COMM: Daughter [**First Name8 (NamePattern2) 12556**] [**Known lastname **] ([**Telephone/Fax (1) 104570**], Sister [**Name (NI) 2048**] [**Name (NI) 6515**] ([**Telephone/Fax (1) 104571**]. Medications on Admission: - carvedilol 3.125 mg tablets three tablets in the morning, two tablets at bedtime - digoxin 0.125 mg Monday through Friday - nasal spray as needed - Lasix 20 mg twice a day (unclear if patient taking) - potassium 20 mg daily (unclear if patient taking) - Coumadin Discharge Medications: Patient expired Discharge Disposition: Expired Discharge Diagnosis: Cardiac arrest Discharge Condition: Patient expired Discharge Instructions: Patient expired Followup Instructions: Patient expired ICD9 Codes: 5849, 2762, 2768, 5859, 4271, 4254, 4168, 4280
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Medical Text: Admission Date: [**2116-5-2**] Discharge Date: [**2116-5-8**] Date of Birth: [**2067-9-11**] Sex: M Service: VASC [**Doctor First Name 147**] HISTORY OF PRESENT ILLNESS: Mr. [**Known lastname 15537**] is a 48 year old male who is status post aortobifemoral bypass grafting as well as right sided femoral to popliteal artery bypass grafting, right sided iliac stenting and aortohepatic bypass grafting with erosion of his graft into his duodenum requiring repair approximately four months ago, as well as a history of a left sided axillary femoral artery with fem-[**Doctor Last Name **] bypass grafting in [**2116-1-17**], and redo of his left femoral popliteal bypass in [**Month (only) 958**] of this year with a left sided toe amputation, who presented complaining of two days of drainage of his left groin incision and tenderness. HOSPITAL COURSE: This was diagnosed as a wound infection and he was placed on broad-spectrum antibiotics and had wound management performed at this time. He was admitted to the Floor and was doing well up until hospital day number three where he was noted to have a large amount of bloody emesis, approximately two liters, with hypotension. He was subsequently transported into the Intensive Care Unit, had large bore intravenous access obtained, and had an esophagogastroduodenoscopy performed showing a large duodenal blood clot. He continued to require large amounts of blood and went down to Angiography the next morning. In the Angio Suite, it was found that his axillary to femoral bypass graft was thrombosed, requiring TPA administration. He also had evidence of active bleeding requiring multiple coil embolization of multiple aortic branches. He returned to the Intensive Care Unit following this procedure in very critically ill condition. He was maintained on high inotropic support and aggressive fluid and blood products administration. However, he went into liver failure that morning and given the poor prognosis, a discussion was carried out with the family and they felt that continuing further support was against his wishes and made the patient comfort measures only. Following this, all inotropic support was removed, and the patient expired at 09:51 a.m. on [**2116-5-8**]. No post-mortem examination was to be performed by the family's request. DISCHARGE DIAGNOSES: 1. Massive upper gastrointestinal bleed of unknown origin. 2. Thrombosed axillary femoral bypass graft. 3. Sepsis. 4. Multi-organ failure. 5. Status post multiple vascular bypass procedures. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], M.D. [**MD Number(1) 6223**] Dictated By:[**Name8 (MD) 15538**] MEDQUIST36 D: [**2116-5-8**] 11:25 T: [**2116-5-11**] 11:28 JOB#: [**Job Number 15539**] ICD9 Codes: 0389
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Medical Text: Admission Date: [**2187-3-13**] Discharge Date: [**2187-3-22**] Date of Birth: [**2127-10-1**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 922**] Chief Complaint: Emesis, Low blood glucose Major Surgical or Invasive Procedure: [**3-16**]: Coronary artery bypass grafting x3 with left internal mammary artery to left anterior descending coronary artery; reverse saphenous vein single graft from the aorta to the first obtuse marginal coronary; as well as reverse saphenous vein single graft from the aorta to the posterior descending coronary artery. Endoscopic left greater saphenous vein harvesting. [**3-14**]: Cardiac Catheterization History of Present Illness: 59 year old male with Type I Diabetes Mellitus who has felt ill for past week (poor oral intake, dizziness and emesis). He was found yesterday morning with fasting blood glucose of 19. Taken to ED where Troponin was found to be elevated (2.21) and he was brought for a cardiac cath on [**3-14**]. Cath revealed severe three vessel coronary artery disease and he was referred for surgical revascularization. Past Medical History: Diabetes Mellitus Hypertension Gastroesophageal reflux disease Melanoma s/p removal left leg Social History: Race: Caucasian Last Dental Exam: many yrs ago Lives: alone Occupation: does not work Tobacco: [**4-5**] cigs/day ETOH: social Enrolled in any clinical/research study? Family History: non-contributory Physical Exam: Height: 5'[**87**]" Weight: 68kg General: well-developed thin male lying supine in bed in bo acute distress Skin: Dry [X] intact [X] HEENT: PERRLA [X] EOMI [X] Poor dentitian Neck: Supple [X] Full ROM [X] Chest: Lungs clear bilaterally [X] Anterior Heart: RRR [X] Irregular [] Murmur Abdomen: Soft [X] non-distended [X] non-tender [X] bowel sounds + [X] Extremities: Warm [X], well-perfused [X] Edema/Varicosities: None [X] Neuro: Grossly intact [X] Pulses: Femoral Right: 2+ Left: bandage from cath DP Right: 2+ Left: 2+ PT [**Name (NI) 167**]: 2+ Left: 2+ Radial Right: 2+ Left: 2+ Carotid Bruit Right/Left: - Pertinent Results: [**2187-3-21**] 07:35AM BLOOD WBC-7.7 RBC-3.48* Hgb-10.5* Hct-31.2* MCV-90 MCH-30.2 MCHC-33.7 RDW-14.5 Plt Ct-330 [**2187-3-20**] 05:35AM BLOOD WBC-6.7 RBC-3.49* Hgb-10.7* Hct-31.8* MCV-91 MCH-30.8 MCHC-33.8 RDW-14.8 Plt Ct-259# [**2187-3-21**] 07:35AM BLOOD Glucose-49* UreaN-19 Creat-1.3* Na-140 K-4.4 Cl-101 HCO3-33* AnGap-10 Prebypass No mass/thrombus is seen in the left atrium or left atrial appendage. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. There is moderate regional left ventricular systolic dysfunction with hypokinesia of the apex, apical portions of the inferior, anterior and septal walls. The mid portion of the inferior and anterospetal walls are also hypokinetic. Overall left ventricular systolic function is moderately depressed (LVEF= 35 %). No masses or thrombi are seen in the left ventricle. Right ventricular chamber size and free wall motion are normal. There are complex (>4mm) atheroma in the descending thoracic aorta. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. No aortic regurgitation is seen. The mitral valve leaflets are structurally normal. Mild (1+) mitral regurgitation is seen. There is no pericardial effusion. Dr. [**Last Name (STitle) 914**] was notified in person of the results on [**2187-3-16**] at 830am. Post bypass Patient is in sinus rhythm and receiving an infusion of phenylephrine. LVEF is now 40%. RV function is normal. Mild mitral regurgitation persists. Aorta is intact post decannulation. Brief Hospital Course: 59 year old male with Type I Diabetes Mellitus who has felt ill for past week (poor oral intake, dizziness and emesis). He was found yesterday morning with fasting blood glucose of 19. Taken to ED where Troponin was found to be elevated (2.21) and he was brought for a cardiac cath on [**3-14**]. Cath revealed severe three vessel coronary artery disease and he was referred for surgical revascularization. He was taken to The Operating Room on [**2187-3-13**] and underwent a CABG x3 (LIMA-LAD, SVG to OM,PDA)-see operative note for details. Post operatively he remained intubated and was admitted to the ICU for invasive hemodynamic monitoring. He awoke neurologically intact and was extubated. His chest tubes and temporary pacing wires were removed per protocol. His statin therapy was resumed and he was started on betablockers and diuresed toward his pre-op weight. He remained in the ICU due to hyperglycemia requiring an insulin drip. [**Last Name (un) **] was consulted. Insulin drip was stopped and euglycemia was achieved with lantus and sliding scale humalog. Once glucoses were stablized, he was transferred to the step down unit. He was evaluated by physical therapy for strength and conditioning and was cleared for discharge to home on POD#6. Medications on Admission: Lovastatin 20mg qd, Naprosyn 500mg [**Hospital1 **], Lantus 16 units qhs and SSI, Prilosec 20mg [**Hospital1 **], Neurontin 300mg [**Hospital1 **], Iron 325mg qd or MVI, Aspirin 81mg qd, Nitro prn Plavix - last dose: 600mg [**3-14**] Discharge Medications: 1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 2. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for temperature >38.0. 3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*65 Tablet(s)* Refills:*0* 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*2* 7. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 8. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO BID (2 times a day). 9. Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. lantus lantus insulin 30 units SQ qam. 11. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day for 7 days. Disp:*7 Tablet(s)* Refills:*0* 12. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: One (1) Capsule, Sustained Release PO once a day for 7 days. Disp:*7 Capsule, Sustained Release(s)* Refills:*0* 13. Humalog 100 unit/mL Solution Sig: per sliding scale Subcutaneous four times a day. Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: s/p CABGx3 (LIMA>LAD, SVG>OM, SVG>PDA) Past Medical History: Diabetes Mellitus TYPE 1, Hypertension, gastroesophageal reflux disease, Melanoma s/p removal left leg, ? Splenectomy [**2185**] Discharge Condition: Mental Status:Clear and coherent Level of Consciousness:Alert and interactive Activity Status:Ambulatory - Independent Sternal wound healing well, no erythema or drainage Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month until follow up with surgeon No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Followup Instructions: Provider: [**First Name8 (NamePattern2) 177**] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 170**] [**2187-4-3**] @1:00PM Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 7449**], MD Phone:[**Telephone/Fax (1) 1971**] [**2187-5-4**] @ 8:30AM Please call for appointments: PCP: [**Name10 (NameIs) **],[**First Name3 (LF) **] S. [**Telephone/Fax (1) 608**] in [**3-7**] weeks Cardiologist: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Last Name (NamePattern1) **] [**Telephone/Fax (1) 81063**] in [**3-7**] weeks Completed by:[**2187-3-22**] ICD9 Codes: 5849, 4019, 3572
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Medical Text: Admission Date: [**2146-9-12**] Discharge Date: [**2146-9-15**] Date of Birth: [**2073-4-21**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 7223**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: implantable pacemaker placement History of Present Illness: Mrs. [**Known lastname 12967**] is a 73 yo woman from [**Country 3587**] with history of HTN who presented to a hospital in [**Country 3587**] about two weeks prior to admission with a heart block which she was told would require pacemaker implantation. She left the hospital without getting a pacemaker and travelled to the United States. Per chart, she reported that she had CP, palpitations and dyspnea 2 weeks ago when she was seen in [**Country 3587**]. She however reports that she has never had CP, palpitations or dyspnea and that when she was diagnosed with the "[**Last Name **] problem" that she did not have any symptoms. She also reports having recent fevers and chills. No cough, rashes, arthralgia. . She reports that today, she came to the ED because she felt that her blood pressure was high. She says that when her blood pressure is elevated, she has "tongue heaviness" which she currently endorses. Otherwise she denies headache, weakness. She does report slurred speech which has been progressive for 1 month. . She presented to [**Hospital1 18**] and was found to have complete heart block on her initial EKG. Initial VSs were 96.8 HR 40 178/64 RR 16 97% RA . On review of symptoms, she denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. Past Medical History: Hypertension Social History: Flew over from [**First Name9 (NamePattern2) 74912**] [**Country **] last week, staying with family. Family History: non-contributory Physical Exam: VS: T Afebrile, BP 182/61 , HR 90, RR 22, O2 97% on RA Gen: WDWN elderly woman in NAD, resp or otherwise. Pleasant, appropriate. HEENT: NCAT. Sclera anicteric. EOMI. Neck: JVP of 8 cm. CV: Bradycardic but regular, normal S1, S2. No S4, no S3. Chest: No crackles, wheeze, rhonchi anteriorly Abd: Obese, soft, NTND, No HSM or tenderness Ext: No c/c/e Pulses: Right: Carotid 2+ without bruit; 2+ DP Left: Carotid 2+ without bruit; 2+ DP Pertinent Results: [**2146-9-12**] ADMISSION LABS: CBC: WBC-16.8* RBC-4.66 Hgb-14.3 Hct-41.0 MCV-88 MCH-30.6 MCHC-34.8 RDW-13.8 Plt Ct-297 Neuts-58.0 Lymphs-29.4 Monos-5.2 Eos-7.1* Baso-0.2 . COAGS: PT-12.1 PTT-28.0 INR(PT)-1.0 . CHEM: Glucose-133* UreaN-18 Creat-1.1 Na-140 K-4.0 Cl-101 HCO3-27 AnGap-16 Calcium-9.9 Phos-4.2 Mg-2.4 . LFTs: ALT-28 AST-20 CK(CPK)-68 AlkPhos-98 Amylase-92 TotBili-0.5 Lipase-57 Albumin-4.1 . cTropnT-<0.01 . TSH-2.2 . COMPLETE HEART BLOCK AND EOSINOPHILIA WORKUP: RPR: negative [**2146-9-13**] 9:17 am STOOL CONSISTENCY: LOOSE Source: Stool. **FINAL REPORT [**2146-9-14**]** OVA + PARASITES (Final [**2146-9-14**]): NO OVA AND PARASITES SEEN. . Blood Cultures: negative Urine Culture: negative Toxo: IgG positive, IgM negative Lyme: negative Strongyloides: POSITIVE (result returned after discharge) Chagas: negative . [**2146-9-15**] DISCHARGE LABS: CBC: WBC-13.6* RBC-4.35 Hgb-13.3 Hct-38.4 MCV-88 MCH-30.5 MCHC-34.5 RDW-13.9 Plt Ct-213 Neuts-66.9 Lymphs-19.1 Monos-4.1 Eos-9.8* Baso-0.1 . CHEM: Glucose-98 UreaN-13 Creat-0.9 Na-139 K-4.2 Cl-102 HCO3-27 AnGap-14 Calcium-9.3 Phos-4.2 Mg-2.2 . STUDIES: CT head: no intracranial process . Admission EKG: Sinus rhythm, rate 95-100. There is high degree or complete A-V block with junctional pacemaker at rate 40. No previous tracing available for comparison. TRACING #1 . ECHO: Conclusions: The left atrium is mildly dilated. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF 70%) There is no left ventricular outflow obstruction at rest or with Valsalva. There is no ventricular septal defect. The right ventricular cavity is dilated. Right ventricular systolic function is borderline normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild (1+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. . POST-PACEMAKER EKG: Normal sinus rhythm, rate 78, with ventricular synchronous pacing. Compared with tracing of [**2146-9-13**] the rhythm has changed from sinus at rate 70 with probable high degree A-V block to sinus at rate 78 with ventricular synchronous pacing. The ventricular rate has increased from 35 to 78. Brief Hospital Course: 75F with HTN presents with complete heart block. Hospital course by problem. . # CHB - patient was monitored on telemetry and was taken to the EP lab where a dual chamber pacmaker was placed. An echo showed a normal EF of 70%. Surveillence telemetry and CXR indicated a malpositioned atrial lead, and she was taken back to the EP lab for revision. Subsequent pacing was appropriate and leads were confirmed on CXR. She was discharged with follow up in the device clinic, and with 3 additional doses of post-procedure prophylactic Kefzol. Infectious etiologies for CHB including syphilis and chagas disease were negative. Of note, the patient's strongyloides antibody titer did return postitive (see "Eosinophilia" below), but strongyloides infection is not known to cause CHB. . # HTN - patient reported being on HCTZ in the past. Was restarted on HCTZ with only marginal BP control. Amlodipine 5mg was also begun prior to discharge. . # Eosiniophilia - ranged from 6.4 to 9% on differential. No known allergies or asthma. An infectious workup was pursued, including stool O+P, which was negative, and blood and urine cultures, which were also negative. A lyme antibody was negative. However, after discharge, her strongyloides antibody returned positive. Interestingly, the stronglyoides [**Doctor First Name **] may be positive even when repeated examinations of stool samples have been unrevealing, as was the case in this patient. Also of note, rhe anti-strongyloides antibody assayed in the [**Doctor First Name **] serology can persist for years after treatment. It is currently unknown whether or not the patient has ever been treated for strongyloides. However, given her high degree of peripheral eospinophilia, it is not unreasonable to assume that she may currently be infected. PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) 11616**] was notified via email, patient has appointment with him on [**10-18**] (in 12 days time). Medications on Admission: HCTZ 25mg daily occasional metaclopramide Discharge Medications: 1. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 2. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Keflex 500 mg Tablet Sig: One (1) Tablet PO twice a day for 3 doses. Disp:*3 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: primary: complete heart block secondary: hypertension Discharge Condition: good, stable Discharge Instructions: You were admitted tot he hospital with an abnormal heart rhythm called complete heart block. You received an implantable pacemaker to treat this condition. After discharge, you will need to take 3 more doses of antibiotics to protect against infection. You will also need to follow up with the electrical device clinic to make sure the pacemaker is working properly. . You were also found to have high blood pressure. You are now taking 2 blood pressure medicines, called hydrochlorothiazide and amlodipine. . Please take all medications as prescribed. Please attend all follow up appointments. If you experience any chest pain, shortness of breath, lightheadedness, or other symptoms, please call your doctor or return to the ER. Followup Instructions: Provider: [**Name10 (NameIs) 676**] CLINIC Phone:[**Telephone/Fax (1) 59**] Date/Time:[**2146-9-21**] 9:30 Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD, MPH[**MD Number(3) 708**]:[**Telephone/Fax (1) 7976**] Date/Time:[**2146-10-18**] 4:15 ICD9 Codes: 4019
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Medical Text: Admission Date: [**2168-11-28**] Discharge Date: [**2168-12-2**] Date of Birth: [**2092-3-27**] Sex: F Service: CCU HISTORY OF PRESENT ILLNESS: This is a 76 year-old female with coronary artery disease status post coronary artery bypass graft in [**2153**] and multiple percutaneous interventions who was brought to the Emergency Department after a witnessed cardiac arrest. The patient was in the mall and had a witness cardiac arrest. There was bystander CPR at two minutes and after eight minutes an AED arrived and the patient was shocked. CPR continued for five to six minutes and then EMS arrived. Initial rhythm was complete heart block and the patient was treated with epinephrine. This led to ventricular tachycardia and the patient was shocked leading to a rhythm of ventricular fibrillation, which converted to sinus rhythm after two further shocks. Electrocardiogram showed inferior ST elevations and lateral ST depressions. The patient was intubated and brought to the Emergency Department. In the Emergency Department she was treated with heparin and Integrilin, but this was discontinued due to coffee ground emesis. A chest x-ray showed a right pneumothorax and a chest tube was placed. The patient became hypotensive and Dobutamine and Levophed were started for blood pressure support. The patient was transferred to the Coronary Care Unit and the pressors were weaned off with fluid boluses. PAST MEDICAL HISTORY: 1. Hypertension. 2. Hyperlipidemia. 3. Coronary artery disease status post coronary artery bypass graft in [**2153**], multiple PCIs and a redo coronary artery bypass graft in [**2163**]. 4. Bladder prolapse. PHYSICAL EXAMINATION ON ADMISSION: Pulse 100 to 120. Blood pressure 60 to 80/40 to 60. Oxygen saturation 86 to 90% on the ventilator. Her heart was regular with no murmurs. There were rhonchorous breath sounds bilaterally. The abdomen was benign and there was no edema. HOSPITAL COURSE: The patient was admitted to the Coronary Care Unit status post cardiac arrest and resuscitation. The main concern of the family from the time of admission was the patient's wishes regarding end of life care and previous discussions suggesting that she wished not to be intubated or resuscitated. After extensive discussions with the family it was determined to give the patient 48 hours to determine, which direction her neurologic status would go. The neurology consult team followed throughout the hospitalization and while she initially showed some positive signs by [**12-1**] it appeared that the patient was not going to make a rapid recovery back to her baseline functional status as she would have wished. Additionally the patient's respiratory status was compromised both by right pneumothorax secondary to rib fracture sustained during CPR as well as probable aspiration pneumonia. On [**12-2**] another meeting with the patient's two sons and daughter was held. They believed firmly that it would be their mother's wishes to withdraw care as she never wished to have her life sustained with heroic measures. Therefore in the afternoon of [**12-2**] the patient's mechanical ventilation was discontinued and she quickly had a respiratory arrest. The patient was pronounced dead at 2:40 p.m. The family declines postmortem examination. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1008**], M.D. [**MD Number(1) 1009**] Dictated By:[**Last Name (NamePattern1) 15468**] MEDQUIST36 D: [**2168-12-2**] 03:09 T: [**2168-12-7**] 07:08 JOB#: [**Job Number 95435**] ICD9 Codes: 5070, 4280, 5990
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Medical Text: Admission Date: [**2185-2-21**] Discharge Date: [**2185-2-24**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 106**] Chief Complaint: Admitted from clinic for cardiac tamponade. Major Surgical or Invasive Procedure: Pericardial drainage. History of Present Illness: [**Age over 90 **] yo male w no significant past medical history, who was seen in clinic this a.m. and scheduled for ECHO. Was in his usual state of health until a few weeks prior to admission when he had an episode of shaking chills at his home in [**State 108**] and was taken to the hospital. At the [**Hospital 108**] Hospital, he was admitted for two nights and apparently told that he had a "big heart" on (x-ray) and lower extremity edema and was discharged on 40mg PO lasix. Of note, pt. reports that he had two previous episodes of shaking chills a few months ago while he was in [**Location (un) 86**] which resolved overnight without medical intervention. Also reports a non-productive cough over the same timeline. He denies any chest pain, no shortness of breath, no orthopnea, no PND, no decrease in exercise tolerance, no history of malignancy and no sick contacts. [**Name (NI) **] returned to [**Location 86**] and daughter had him see Dr. [**First Name (STitle) 437**] in clinic on the morning of admission. Was tachycardic in clinic with distant heart sounds and elevated JVP. Had ECHO which demonstrated 3 cm pericardial effusion, evidence of R ventricular collapse and tamponade physiology. Was taken to the cath lab for pericardial drainage with removal of 2L of brownish fluid and insertion of pericardial drain. Pt was then transferred to the CCU for further management. Past Medical History: hx of GI bleeds Right colon adenoma s/p R hemicolectomy in [**2180**] Anemia DM II - on oral hypoglycemics umbilical hernia s/p appendectomy s/p TURP h/o nephrolithiasis Social History: No tobacco, Occasional alcohol. Widowed, lives alone in [**State 108**] part of the year. Family History: Non-contributory Physical Exam: Vitals: T - 98.4, HR - 99, BP - 120/66, SpO2 - 99% on 2L NC. . PE: General: Pleasant gentleman, looks younger than stated age. In bed lying flat, looks comfortable, in NAD HEENT: PERRLA, sclera anicteric, MMM NECK: No carotid bruits. CHEST: CTAB, decreased breath sounds at bases, no w/r/r CARDIAC: RRR, nl. S1 S2, 2/6 SEM @ L upper sternal border. JVP not elevated. Pericardial drain present. ABDOMEN: Soft, NT, ND, + BS, R lateral vertical scar in abdomen w healed osotomy scar. EXT: No edema, warm, well-perfused NEURO: Alert & Oriented X 3 Pertinent Results: Admission labs: 141 102 38 AGap=16 ------------< 4.3 27 2.1 estGFR: 30/36 (click for details) RheuFac: 4 . 11.7 6.8>---<269 34.1 . PT: 14.8 PTT: 27.3 INR: 1.3 . Pericardial fluid: TotProt: 4.2 Glucose: 97 LD(LDH): 1110 Amylase: 21 Albumin: 3.0 WBC: 3700 Hct,Fl: 5.0 Polys: 2 Lymphs: 95 Monos: 2 Atyps: 1 Plasma: 0 . [**Doctor First Name **]: Negative . EKG: Sinus tach @ 100bpm, low voltages, no ST changes. . Imaging: [**2185-2-21**] ECHO:Large circumferential pericardial effusion with echocardiographic findings c/w tamponade physiology. At least mild aortic stenosis. Mild symmetric left ventricular hypertrophy with preserved global biventricular systolic function. EF - 55% . Cardiac Cath ([**2185-2-21**]) 1. Pericardial tamponade. 2. Successful removal of 2050cc dark, bloody fluid. 3. No significant residual pericardial fluid at the conclusion of the procedure. . Hemodynamics: Pre-Cath: Baseline resting hemodynamics revealed tamponade physiology with a mean RA of 20mmHg, RVED of 22mmHg, mean PCWP of 23mmHg, PAD of 27mmHg, and a pericardial pressure of 23mmHg. The pulsus paradoxus was approximately 31mmHg. Initial femoral artery systolic pressure was 118mmHg. The cardiac index was depressed at 2.0l/min/m2. . Post-Cath: Post procedure hemodynamics revealed a mean RA of 9mmHg, PCWP of 11mmHg, and pericardial pressure of -5mmHg. The femoral systolic pressure increased to 144mmHg and the cardiac index increased to 3.8l/min/m2. . CXR [**2185-2-23**]: Pericardial drainage catheter has been removed. There has been no change in the cardiomediastinal contour. Small bilateral pleural effusions are still present. No pneumothorax. Left basal atelectasis is stable. Lungs, otherwise clear. Brief Hospital Course: A/P: 93-yo gentleman with no significant PMH, admitted with large chronic pericardial effusion and tamponade, of unknown etiology, stable s/p cardiac cath with drainage of 2L of dark, bloody fluid. . 1. Pericardial Effusion/Tamponade: s/p drainage of large chronic pericardial effusion with pericardial drain. Etiology is unclear at this time but could most likely be secondary to malignancy (no clear source at this time), occult infection given his h/o shaking chills although no fevers/white count, uremia/ renal failure or connective tissue disease or idiopathic. The pericardial drain put out minimal fluid after initial placement and was uneventfully removed. Pulsus remained low after initial drainage. Cultures were pending with NGTD at time of discharge. ECHO post catheter removal showed trivial pericardial effusion. The evening of catheter placement he was febrile to 101.4. He was cultured (blood and urine) and started on ceftriaxone and vanco out of concern for catheter related infection. Since all cultures were negative these were stopped after 72 hours. . 2. Pump: Has an EF of 55% by ECHO. Decreased cardiac index probably due to tamponade with good recovery post-drainage. Did not require diuresis after pericardial drainage. . 3. Acute on Chronic Renal Insufficiency: Likely pre-renal secondary to poor cardiac output due to tamponade physiology. Baseline creatnine is ~1.3, improved on this hospital stay to 1.4-1.6. . 4 Normocytic Anemia: Has prior history of anemia and GI bleeds, hematocrit is 34.1,which is around his baseline with no obvious source of bleeding. iron studies consistent with mixed anemia of chronic disease and iron deficiency. . 5 Diabetes: Has a history of NIDDM, possibly on glyburide in the past, blood glucose monitored here and <150, no sliding scale was needed so discharged off medication. . 6 Code: FULL Medications on Admission: asa 81 mg qd lasix 40 mg qd Folate/B12 glyburide ? . Allergies: NKDA Discharge Medications: 1. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). Disp:*30 Tablet, Chewable(s)* Refills:*2* 2. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*90 Tablet, Delayed Release (E.C.)(s)* Refills:*3* 3. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Cyanocobalamin 100 mcg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Pericardial effusion. Discharge Condition: Good. Discharge Instructions: Please take all medications as prescribed. Please keep all follow-up appointments. Please notify your primary care doctor, Dr. [**First Name8 (NamePattern2) **] [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 42160**] ([**Telephone/Fax (1) 42161**], or your cardiologist, Dr. [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) 437**], or return to the Emergency Department if you experience fevers, chills, shortness of breath, chest pain or pressure, light-headedness, feeling faint, nausea, vomitting, diarrhea, or any symptoms that concern you. Followup Instructions: Please follow-up with your primary care doctor, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] [**Last Name (NamePattern1) 42160**] within 1-2 weeks of discharge. Please call [**Telephone/Fax (1) 42162**] for this appointment. . Please follow-up with Dr. [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) 437**] of cardiology within 1 week of discharge. Please call [**Telephone/Fax (1) 4451**] to schedule this appointment. ICD9 Codes: 5849, 5859, 2859
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Medical Text: Admission Date: [**2145-2-20**] Discharge Date: [**2145-2-23**] Date of Birth: [**2070-2-11**] Sex: F Service: [**Hospital Unit Name 196**] CHIEF COMPLAINT: Chest pain. HISTORY OF PRESENT ILLNESS: Ms. [**Known lastname 34521**] is a 75-year-old female without any prior cardiac history who presented with 10/10 chest pain. The patient first noted exertional chest pain over the last week. The patient was seen at her primary care physician's office for evaluation of upcoming rectocele surgery and was noted to have electrocardiographic changes from prior EKGs two years ago. The patient underwent an exercise stress test on Friday which was reported as positive with ischemic changes shortly after initiation of the study. The patient reported that she received sublingual Nitroglycerin and had plans for cardiac catheterization early next week. The patient states that at 5:30 p.m., she suddenly developed 10/10 chest pain while at rest. She took sublingual Nitroglycerin without relief and went to the Emergency Room. She was started on aspirin, Heparin, nitrates, and 2B3A inhibitor without relief of pain. Electrocardiogram showed anterior T wave inversion, poor R wave progression, and she was transferred to [**Hospital6 1760**] for cardiac catheterization. At cardiac catheterization, she was found to have 100% occlusion of the proximal left anterior descending artery. The patient received percutaneous transluminal coronary angioplasty with stent to the proximal left anterior descending artery and percutaneous transluminal coronary angioplasty to the D-1 where the thrombus extended. Apparently the patient was noted to have a small amount of coffee ground emesis while down in the catheterization laboratory. She was continued on 2B3A inhibitor and transferred to the Coronary Care Unit. PAST MEDICAL HISTORY: The past medical history revealed hypertension and anxiety/depression. MEDICATIONS: Verapamil SR 100 mg q. day, Spironolactone, Hydrochlorothiazide, aspirin, Selenium, Zoloft. ALLERGIES: Ceclor. FAMILY HISTORY: There is no coronary artery disease in the family. SOCIAL HISTORY: There is a remote tobacco history. The patient has occasional alcohol use. PHYSICAL EXAMINATION: Vital signs revealed blood pressure 130/80, pulse 76, respirations 20, pulse oximetry 98% on 2 liters nasal cannula. In general, the patient was resting in bed in no apparent distress. HEENT examination revealed clear oropharynx, anicteric sclerae, moist mucous membranes. The neck revealed no jugular venous distention. The carotids were 2+, no bruits. Cardiac examination revealed regular rate and rhythm, normal S1 and S2, no murmurs, gallops, or rub. The abdomen was soft, nontender, and nondistended with positive bowel sounds. The extremities revealed no pedal edema. There were 2+ dorsalis pedis and posterior tibialis pulses bilaterally. The extremities were warm. LABORATORY DATA: Laboratory studies from the outside hospital revealed white blood cell count 5.9, hematocrit 39, platelets 267,000, sodium 137, potassium 3.5, chloride 95, bicarbonate 27, BUN 15, creatinine 1, glucose 125, INR 1, troponin 0.09. Electrocardiogram per report from the outside hospital revealed up-sloping ST segments with T wave inversions in V2 through V3. There was poor R wave progression. The electrocardiogram after catheterization revealed resolution of up-sloping ST segments. T wave inversions were present in V1 through V4 with possible biphasic T wave in V4. Chest x-ray from the outside hospital revealed no effusion, no infiltrate, and no evidence of congestive heart failure or cardiomegaly. Catheterization revealed moderate anterior lateral hypokinesis with an ejection fraction of 50%. There was a 100% proximal LAD with thrombus filling. LAD filling was via collaterals right to left. There was 40% right coronary artery stenosis. The left anterior descending artery was 0% status post stent placement. The D-1 revealed 30% after percutaneous transluminal coronary angioplasty. SUMMARY OF HOSPITAL COURSE Coronary artery disease: The patient tolerated catheterization well. She remained on Integrelin for 18 hours and was started on Plavix. The patient's antihypertensive medications were changed from Verapamil and Hydrochlorothiazide to Lopressor and Captopril which were titrated up as tolerated. The patient was started on a daily aspirin and continued on Plavix. The patient had no further episodes of chest pain. She was seen by physical therapy and found to have good exercise tolerance. The patient had a mild elevation of her troponin to 4.3 post catheterization. Her CKs peaked at 180. Arrhythmia: The patient had a 7-8 beat episode of ventricular tachycardia within 24 hours of the revascularization. The patient was noted to have an ejection fraction of 50% on ventriculography. The patient remained on telemetry for another 24-36 hours with no further episodes of prolonged ventricular tachycardia. Gastrointestinal: The patient was noted to have a small amount of coffee ground emesis in the catheterization laboratory and had nausea on admission to the Coronary Care Unit. The patient had nasogastric lavage with a small amount of coffee ground emesis that cleared after 100 cc of normal saline lavage. The patient's hematocrit was 39 at the outside hospital and was 34 post catheterization. The patient remained on Prilosec 40 mg b.i.d. and her hematocrit remained stable. The patient was discharged on Prilosec 40 mg q. day and was told to follow up with her primary care physician. DISCHARGE MEDICATIONS: Lisinopril 5 mg p.o. q. day, Atenolol 25 mg p.o. q. day, Lipitor 10 mg p.o. q. day, Plavix 75 mg p.o. q. day, aspirin 325 mg p.o. q. day, Zoloft 50 mg p.o. q. day, Prilosec 40 mg p.o. q. day. DISCHARGE STATUS: To home. DISCHARGE CONDITION: Stable. DISCHARGE DIAGNOSIS: Non-Q wave myocardial infarction. [**First Name11 (Name Pattern1) **] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 4786**] Dictated By:[**Last Name (NamePattern1) 16516**] MEDQUIST36 D: [**2145-2-23**] 20:23 T: [**2145-2-24**] 19:50 JOB#: [**Job Number 34522**] cc:[**Numeric Identifier 34523**] ICD9 Codes: 4271, 4019, 311
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Medical Text: Admission Date: [**2113-2-15**] Discharge Date: [**2113-2-19**] Date of Birth: [**2044-5-8**] Sex: M Service: MEDICINE Allergies: Sulfa (Sulfonamides) Attending:[**Doctor Last Name 10493**] Chief Complaint: altered mental status, hypotension Major Surgical or Invasive Procedure: R IJ central line History of Present Illness: 68 y/o M with SLE who p/w 1d hx of dysuria, polyuria, chills, mental status changes. Driving with wife and drove onto grass [**Street Address(1) 29525**]. States urine was "bright red" with increasing urgency, called PCP and was told to go to hospital. En route, had episodes of n/v, worsening mental status. Denies pain. In ED, initially given ASA, lopressor, then MUST protocol started. Got 4.5L IVFs, started on levophed/vasopressin. Lactate=4.4; Given dose of levo/flagyl. T 101.3 HR 115 BP 129/63 RR 18 96% on RA. Dirty urine. In MICU, weaned off pressors. Switched to GENT for empiric coverage of GNR bacteremia. Started on Fluconazole emperically for yeast in the blood. Hydrated with IVF and remained hemodynamically stable. Transferred to Medicine on [**2112-2-17**]. Past Medical History: SLE- on plaquenil Social History: doesn't smoke, [**4-14**] glasses wine/night Married, no children, retired writer Family History: non-contributory Physical Exam: On admission [**2113-2-15**] vitals: T 101.3, BP 129/63, HR 115, RR 18, 96% RA Gen: ashen appearing, cachectic, but NAD HEENT: PERRLA/EOMI; MMM; OP Clear PUlM: CTA b/l. no r/r/w CV: Normal S1/S2. tachycardic. no m/r/g ABD: BS present, soft, NT/ND EXT: no edema, warm Neuro: A&O x 3. downgoing toes b/l. 5/5 strength skin: no rash/lesions Neck: R neck hematoma, RIJ in place * On transfer from MICU [**2113-2-17**] vitals: 97.9, BP 122/70, HR 47, RR 20 , 95% on RA Gen- well appearing, sitting up in bed, communicating appropriately HEENT- PERRLA/EOMI. no scleral injection. OP w/ mild posterior pharyngeal erythema. Neck- supple. R IJ central line in place PULM- CTA b/l. no r/r/w CV- RRR. no m/r/g. normal s1/s2 ABD- soft, NT/ND. NABS EXT- 2+ pedal edema b/l. No joint swelling or redness. NEURO- A&O x 3. CN II-XII intact. SKin- no diaphoresis, no rash Pertinent Results: Admission labs: * WBC-2.0* RBC-4.29* Hgb-13.5* Hct-39.7* MCV-93 MCH-31.4 MCHC-33.9 RDW-13.6 Plt Ct-151 Neuts-78* Bands-7* Lymphs-13* Monos-2 Gran Ct-1680* Glucose-125* UreaN-20 Creat-0.9 Na-138 K-3.3 Cl-105 HCO3-23 AnGap-13 BLOOD ALT-15 AST-18 AlkPhos-42 Amylase-32 TotBili-0.3 Albumin-2.7* Calcium-6.8* Phos-0.8* Mg-1.3* BLOOD Cortsol-36.6* BLOOD Genta-0.8* BLOOD Type-[**Last Name (un) **] pO2-35* pCO2-37 pH-7.40 calHCO3-24 BLOOD Lactate-4.4* * Micro: Blood Cx [**2-14**]: Enterobacter (4/4 bottles) pansensitive, Yeast Urine Cx [**2-15**]: Negative Blood Cx [**2-17**]: no growth to date Blood Cx [**2-18**]: no growth to date * Radiologic Studies: CXR [**2113-2-15**]: negative for failure/infiltrate CT abdomen [**2113-2-18**]: gallstones w/ gallbladder wall edema, moderate bilateral pleural effusions, normal colon with no evidence of diverticulosis/diverticulitis * Transthoracic ECHO [**2113-2-15**]: The left atrium is elongated. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets are mildly thickened. There is no aortic valve stenosis. The mitral valve leaflets are mildly thickened. Mild to moderate ([**2-12**]+) mitral regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. Brief Hospital Course: Brief [**Hospital **] Hospital Course is outlined below: 1) Enterobacter bacteremia: The patient was initially admitted to the ICU on the MUST protocol based on a lactate of 4.4. He was mildly hypotensive and febrile to 101.4. He was aggressively hydrated with IVF and empirically initiated on amp/gent. He was briefly placed on levophed/vasopressin pressors but was able to be weaned off by his second hospital day. Blood cultures from admission grew enterobacter in [**5-15**] bottles, pan sensitive. In addition cultures were positive for yeast, unspeciated upon discharge. Fluconazole was added to his regimen and ampicillin was discontinued. The source of his infection was unclear, although urine source was suspected given dirty urine on admission. Admission urinalysis showed >50 RBCs, >50 WBC's and moderate leukocytes, although urine cultures were negative. The patient was transferred to the medicine service on [**2-17**], hospital day #3. ID was consulted and recommended a switch to levaquin based on culture sensitivities. Flagyl was also added for empiric GI coverage pending further evaluation. CT abdomen was performed and demonstrated no evidence of abscess or bowel pathology. There was mention of gallstones and gallbladder wall thickening suspicious for cholecystitis. However the patient remained afebrile with no abdominal pains and normal liver function tests. Given his clinical stability with maintenance of his blood pressure off IVF, tolerance of PO intake, and absence of fever, he was discharged to home on [**2-19**]. He was discharged home on PO levaquin and PO fluconazole for a 14 day course based on ID recommendations. Flagyl was discontinued. He will follow-up with his PCP [**Last Name (NamePattern4) **] [**2-12**] weeks. 2) Rheumatoid arthritis- previoiusly on plaquenil, so relatively immunosuppressed. Granulocyte count on admission= 1680, so he was not neutropenic. He was re-started on plaquenil after he was clinically stable. 3) Anemia: secondary to SLE likely. Goal HCT>27. Hct remained >30 through his hospital course. Initital decrease in hematocrit was likely secondary to IVF hydration. 4) Edema: Noted peripheral edema following IVF hydration. He was also noted to have bilateral pleural effusions by CT scan, also likely secondary to aggressive fluid resuscitation. He was not started on lasix since he was able to autodiurese well, with >2 liters off over the last 24 hours prior to discharge. 5) Mental status change: Initially delirious on admission, likely secondary to his underlying infection. Once infection cleared his mental status improved back to baseline. No further evaluation was performed. Medications on Admission: home meds: plaquenil 200mg/400mg alternating days Discharge Medications: 1. Hydroxychloroquine Sulfate 200 mg Tablet Sig: One (1) Tablet PO EVERY OTHER DAY (Every Other Day). 2. Hydroxychloroquine Sulfate 200 mg Tablet Sig: Two (2) Tablet PO EVERY OTHER DAY (Every Other Day): alternate days with 200mg dose. 3. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 10 days. Disp:*10 Tablet(s)* Refills:*0* 4. Fluconazole 200 mg Tablet Sig: Two (2) Tablet PO Q24H (every 24 hours) for 10 days. Disp:*20 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Primary Diagnosis: 1. Enterobacter bacteremia (pan-sensitive) Secondary Diagnosis: 1. SLE 2. Rheumatoid arthritis Discharge Condition: good. hemodynamically stable. afebrile. Discharge Instructions: Report fever, chills, lightheadedness, stomach pains or bleeding to your PCP. Please complete your antibiotic regimen as prescribed below. Stay well-hydrated. Drink at least [**4-14**] 8oz glasses of water each day. Followup Instructions: Please follow-up with Dr. [**Last Name (STitle) 1007**] in [**2-12**] weeks at phone # [**Telephone/Fax (1) 10492**]. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 10491**] MD, [**MD Number(3) 10495**] ICD9 Codes: 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7919 }
Medical Text: Admission Date: [**2154-2-1**] Discharge Date: [**2154-2-7**] Date of Birth: [**2079-6-23**] Sex: F Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 613**] Chief Complaint: AMS, intubated Major Surgical or Invasive Procedure: Extubation History of Present Illness: Patient is a 66 yo F with a history of CVA, HTN, HLD who was transferred from an OSH with altered mental status. Per report, the patient had a fall 2 days ago after slipping on ice after the snowstorm and falling on her right side. She was diagnosed with R sided rib fractures during an urgent care visit at the [**Hospital 6598**] [**Hospital **] Clinic the next day. She was prescribed vicodin and asked to come back for CT scan. Family states the patient took [**1-20**] a tablet of vicodin last night, but did not become altered until this morning. When they came to see her at home, they found she was more altered; she was lying on the couch, more lethargic, not taking good POs or any of her medications, and complaining of a headache. She was brought into the OSH ([**Hospital1 **]/[**Hospital1 6136**]) for further evaluation. There, the patient was given Narcan without good effect. She was reportedly intubated for a GCS of 6 and for airway protection in the setting of vomiting. Labs at the OSH significant for Hct of 42.9, Plts 221, INR of 1.0, Na 139 K 3.9, Cre: 1.3, negative EtOH, tylenol, and ASA levels . Pt was guaiac negative, and gastric occult negative. Head CT at OSH was also negative for acute new infarct. Received Zosyn 3.25 mg IV x1. She was placed on propofol for sedation, but subsequently noted post-intubation to become hypotensive, required 1 L IVFs and was started on peripheral dopamine and transferred to [**Hospital1 18**] for further evaluaton. . In the ED, admission VS were 88 141/78 (dopa) 20 100% (PS [**10-28**] PEEP of 5). Pt received a fentanyl boluses with midazolam gtt. Her dopamine was quickly weaned with 2 L of IVFs. Labs sig for Cre of 1.3, WBC of 15.8, Hct of 32.9, and urine toxicology screen positive for benzos and methadone. Vancomycin 1 gram IV x1 given. Patient noted to be interacting appropriately on minimal sedation. Trauma series was performed (CT Head, CT C-spine, CT Torso) which showed a LLL consolidation and rib fractures but no obvious bleed or C-spine fractures. Head CT negative for acute intracranial process but does show old MCA-PCA watershed infarct. C-collar was placed. Trauma Surgery was consulted and will be following for tertiary survey in AM and clearance of C-spine in AM. . On the floor, patient was alert and interactive. Able to indicate pain from her rib fractures. REVIEW OF SYSTEMS: (+)ve: (-)ve: fever, chills, night sweats, loss of appetite, fatigue, chest pain, palpitations, rhinorrhea, nasal congestion, cough, sputum production, hemoptysis, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, nausea, vomiting, diarrhea, constipation, hematochezia, melena, dysuria, urinary frequency, urinary urgency, focal numbness, focal weakness, myalgias, arthralgias Past Medical History: PAST MEDICAL HISTORY: h/o CVA in [**2151**] Hypertension Hyperlipidemia . Past Surgical History: s/p hysterectomy s/p carotid endarterectomy Social History: Lives alone. Ambulates independently without a walker but has had some difficulty walking recently after her stroke. +tobacco (1 ppd); occasional EtOH use; no illegal drugs or IVDU (per sister) Family History: unknown Physical Exam: Exam: 97.6, HR 73, BP 126/55, 94% (88-94%) on 4Lnc GEN: elderly F looking younger than stated age HEENT: PERRLA. pinpoint pupils, ~ 1 mm in diameter, MMM. NECK: neck supple PULM: bibasilar rales CARD: RRR S1/S2 present. no m/g/r. ABD: soft NT +BS EXT: wwp no edema NEURO: AAOX3 but in and out of responsiveness, could not say months of year backwards Pertinent Results: [**2154-2-1**] 08:41PM TYPE-ART PO2-86 PCO2-49* PH-7.32* TOTAL CO2-26 BASE XS--1 [**2154-2-1**] 08:41PM LACTATE-0.8 [**2154-2-1**] 08:19PM TYPE-[**Last Name (un) **] TEMP-36.7 PEEP-5 PO2-35* PCO2-57* PH-7.28* TOTAL CO2-28 BASE XS--1 INTUBATED-INTUBATED [**2154-2-1**] 07:49PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]->1.050* [**2154-2-1**] 07:49PM URINE BLOOD-TR NITRITE-NEG PROTEIN-30 GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.5 LEUK-NEG [**2154-2-1**] 07:49PM URINE RBC-3* WBC-<1 BACTERIA-FEW YEAST-NONE EPI-0 [**2154-2-1**] 07:48PM GLUCOSE-122* UREA N-26* CREAT-1.2* SODIUM-138 POTASSIUM-3.8 CHLORIDE-103 TOTAL CO2-27 ANION GAP-12 [**2154-2-1**] 07:48PM CK(CPK)-291* [**2154-2-1**] 07:48PM CK-MB-5 cTropnT-0.04* [**2154-2-1**] 07:48PM CALCIUM-7.7* PHOSPHATE-4.1 MAGNESIUM-1.9 IRON-14* [**2154-2-1**] 07:48PM calTIBC-278 VIT B12-516 FOLATE-GREATER TH FERRITIN-170* TRF-214 [**2154-2-1**] 07:48PM WBC-ERROR DISR RBC-ERROR DISR HGB-ERROR DISR HCT-ERROR DISR MCV-ERROR DISR MCH-ERROR DISR MCHC-ERROR DISR RDW-ERROR DISR [**2154-2-1**] 02:30PM UREA N-30* CREAT-1.3* [**2154-2-1**] 02:30PM estGFR-Using this [**2154-2-1**] 02:30PM LIPASE-22 [**2154-2-1**] 02:30PM URINE HOURS-RANDOM [**2154-2-1**] 02:30PM URINE HOURS-RANDOM [**2154-2-1**] 02:30PM URINE GR HOLD-HOLD [**2154-2-1**] 02:30PM URINE bnzodzpn-POS barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-POS [**2154-2-1**] 02:30PM WBC-15.8* RBC-3.73* HGB-11.6* HCT-32.9* MCV-88 MCH-31.2 MCHC-35.5* RDW-14.1 [**2154-2-1**] 02:30PM PLT COUNT-195 [**2154-2-1**] 02:30PM PT-12.9 PTT-23.1 INR(PT)-1.1 [**2154-2-1**] 02:30PM FIBRINOGE-512* [**2154-2-1**] 02:30PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.016 [**2154-2-1**] 02:30PM URINE BLOOD-MOD NITRITE-NEG PROTEIN-75 GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2154-2-1**] 02:30PM URINE RBC-0-2 WBC-0-2 BACTERIA-FEW YEAST-NONE EPI-[**12-8**] [**2154-2-1**] 02:30PM URINE GRANULAR-0-2 HYALINE-[**6-28**]* [**2154-2-1**] 02:30PM URINE AMORPH-FEW Brief Hospital Course: #. Altered mental status: Patient was initially found to have altered mental status after slip and fall on ice. She sustained R sided rib fractures which were treated with vicodin. She was found by family to be altered and brought to OSH where she was intubated for GCS 6. She had also had a URI prior to OSH presentation. Initial AMS was likely multifactorial due to infection (pneumonia, likely acquired in setting of splinting from rib pain [**2-20**] fractures), medication induced from narcotics (received vicodin for pain control) but urine toxicology screen also positive for methadone, and ABG showed an acute respiratory acidosis concerning for respiratory depression. Toxicology screen negative at OSH for EtOH, APAP, and ASA. No evidence of new ICH or stroke on head CT. No evidence of UTI on urine analysis. Cardiac etiology was ruled out with cardiac enzymes negative x 2. Patient was extubated with good mental status but subsequently became increasingly altered, thought to be associated with morphine use for pain control. This delirium resolved upon avoiding opioid medications such as morphine and oxycodone. . # Respiratory Failure: Pt initially hypoxic with pna and splinting from pain, intubated [**2-20**] altered mental status. The pt was extubated after transfer from [**Hospital1 18**], with decreasing O2 requirement. She was found to have a pneumonia and was started on Levaquin for presumed CAP. However, patient continued spiking despite abx. Given sputum cx stained 2+ GPC in pairs and chains, 2+ [**Name (NI) **], pt was broadened to Vanc/Zosyn (pt is allergic to penicillins but has tolerated zosyn in the past). Abx were continued for an eight day course (last day [**2-9**]). She was also encouraged to use incentive spirometer and pain was controlled as below. . # [**Last Name (un) **], prerenal, hypovolemic: pt??????s cr increased from nadir 1.0 to 1.5. Cr improved with ivf hydration. Cr was 1.2 by next day. . # normocytic anemia: Hct down to 32.9 from 42 at OSH. HCT slowly trending down. No evidence of intra-abdominal bleed on CT scans. Iron studies [**Location (un) 381**] levels, showing element of iron deficiency, likely mixed with anemia of chronic disease. no colonoscopy in system. B12 and folate nl. . #. Rib fractures: s/p fall with R sided rib fractures from T3-T7. Pain control with standing tylenol, lidocaine patch x3 for rib fractures, oxycodone prn pain. Patient initially treated with morphine however it was felt to contribute to here AMS. Patient's pain controlled with around the clock Tylenol and lidocaine patches. . # Mediastinal Lymphadenopathy: CT scan showed areas of mediastinal lymphadenopathy thought to be less consistent with reactive process. Could be sarcoid vs. malignancy. Should be followed up with an outpatient biopsy to assess for malignancy. Patient scheduled for Interventional Pulmonology clinic on [**2-18**] at noon. MD made aware at facility. . # Adrenal nodule: Incompletely visualized. Should be followed up outpt with a dedicated adrenal MR [**First Name (Titles) **] [**Last Name (Titles) **]. . #. Clearing C-spine: clinically cleared per trauma . #. Hypertension: home antihypertensives . #. Hyperlipidemia: continue statin . # Anxiety: held ativan for protection of respiratory status Medications on Admission: (per [**Hospital3 **] Records and confirmed with pt's pharmacy (Stop and Shop in [**Location (un) 6598**] #([**Telephone/Fax (1) 88247**]) Folic Acid Aspirin 81 mg PO daily Amlodipine 5 mg PO daiy Metoprolol Tartrate 50 mg PO BID Vicodin 5-500 mg 1 tablet prn:pain HCTZ 12.5 mg PO daily Ativan 0.5 mg PO QHS Trazadone 150 mg [**1-20**] tablet PO QHS Mevacor 20 mg PO daily . OLD MEDS: Buspirone (old, filled last back in [**2152**]) Combivent Inhaler (filled last back in [**2152-3-19**]) Discharge Medications: 1. acetaminophen 500 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours). 2. heparin (porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 3. simvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily) as needed for pain. Disp:*30 Adhesive Patch, Medicated(s)* Refills:*1* 6. metoprolol tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 8. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 9. nicotine 14 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). 10. tramadol 50 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. Disp:*30 Tablet(s)* Refills:*1* 11. vancomycin in D5W 1 gram/200 mL Piggyback Sig: One (1) Intravenous Q 24H (Every 24 Hours): Please complete on [**2154-2-9**]. 12. piperacillin-tazobactam 2.25 gram Recon Soln Sig: One (1) Recon Soln Intravenous Q6H (every 6 hours): Please complete on [**2154-2-9**]. 13. hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 14. amlodipine 5 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Hospital3 **] ([**Hospital **] Hospital of [**Location (un) **] and Islands) Discharge Diagnosis: metabolic encephalopathy community-acquired pneumonia Rib fractures Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear Ms. [**Known lastname 88248**], You were transferred to our hospital to care for a pneumonia that was the result of a probable aspiration event during a state of altered mental status. We believe the pain medications in the opioid class (including morphine, vicodin, codeine) worsen your mental status and make you delirious. Please AVOID TAKING THESE MEDICATIONS. We treated your probable pneumonia with antibiotics, that should be completed on [**2154-2-9**]. We placed a special i.v. into your arm that can be used for these medications. Also of note, a CAT scan at the beginning of your visit here showed a left lower lobe infiltrate consistent with pneumonia. However, it also showed a couple abnormalities that will require followup. This includes: 1) Mediastinal lymphadenopathy - size is less compatible with reactive nodes, and may be compatible with metastatic nodes or sarcoidosis. 2) Left adrenal nodule, incompletely characterized - a dedicated adrenal CT Please follow up with our pulmonologists and your primary doctor to set up these examinations to further evaluate these findings. We controlled your pain from your rib fractures with Tylenol and lidocaine patches, since other medications worsened your mental state. Please continue to take these as needed for your pain. Followup Instructions: Please follow up with your primary care physician as soon as you can after discharge Please also follow up with our pulmonary clinic to follow up on the abnormal CAT scan findings. You have an appointment with the interventional pulmonology clinic here at [**Hospital1 18**] [**Hospital Ward Name **] at 12 PM on [**2154-2-18**]. [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 617**] ICD9 Codes: 5070, 2762, 5849, 4019, 2724, 3051, 496
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7920 }
Medical Text: Admission Date: [**2193-7-1**] Discharge Date: [**2193-7-5**] Date of Birth: [**2146-2-16**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1283**] Chief Complaint: Asymptomatic Major Surgical or Invasive Procedure: Ascending aorta replacement (valve-sparing [**Doctor Last Name **] procedure)[**2193-7-1**] History of Present Illness: 47 yo male with known dilated aorta. Referred to Dr. [**Last Name (STitle) 1290**] for surgical repair. Cath done [**5-21**] showed no CAD, right dominant system, aortic aneurysm. Echo [**4-20**] showed aortic root 4.9cm, ascending 5.2 cm, 1+ MR, trivial TR, no AI, EF 55%. Prior CT done [**6-/2187**] showed no dissection, and aortic root size 4.7cm x 5.0cm indicating further aneurysmal dilation. Past Medical History: ? pericarditis [**2186**] s/p childhood tonsillectomy Social History: lives with partner self employed in real estate/antique sales occasional ETOH quit smoking 20 years ago Family History: mother with ? MR Physical Exam: Hr 74 RR 18 right 114/74, left 110/70 6'6" 220# NAD skin/HEENT unremarkable neck supple with full ROM and no carotid bruits CTAB RRR no murmur abd soft/NT/ND +BS warm, well-perfused, no edema or varicosities neuro grossly intact 2+ bilat. fem/DP/PT/radials Pertinent Results: Echo [**7-1**]: Prebypass: A patent foramen ovale is present. There is a bidirectional shunt across the interatrial septum at rest. Left ventricular wall thickness, cavity size, and systolic function are normal (LVEF>55%). Regional left ventricular wall motion is normal. The aortic root is moderately dilated. The sinuses of Valsalva are dilated. The ascending aorta is moderately dilated. There are three aortic valve leaflets. There is no aortic valve stenosis. Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are structurally normal. Mild (1+) mitral regurgitation is seen. Post Bypass: Biventricular systolic function is unchanged. Mild aortic insufficiency present. Trace to mild mitral regurgitation present. Graft material seen in the ascending aorta. CXR [**7-3**]: The patient is status post median sternotomy and CABG. A tiny left apical pneumothorax is present. Chest tubes, mediastinal drains, and Swan-Ganz catheter have been removed. Heart is normal in size. Mediastinal and hilar contours are unchanged. Left lower lobe atelectasis is improving. Tiny right pleural effusion is present. Pulmonary vascularity is within normal limits. [**2193-7-1**] 05:10PM BLOOD WBC-7.7# RBC-2.06*# Hgb-6.7*# Hct-18.1*# MCV-88 MCH-32.3* MCHC-36.9* RDW-13.3 Plt Ct-167 [**2193-7-3**] 07:45AM BLOOD WBC-13.0* RBC-3.11* Hgb-9.7* Hct-27.9* MCV-90 MCH-31.2 MCHC-34.7 RDW-13.1 Plt Ct-181 [**2193-7-5**] 07:05AM BLOOD Hct-24.6* [**2193-7-1**] 05:10PM BLOOD PT-16.9* PTT-59.1* INR(PT)-1.6* [**2193-7-2**] 03:08AM BLOOD PT-12.5 PTT-28.8 INR(PT)-1.1 [**2193-7-1**] 06:58PM BLOOD UreaN-16 Creat-0.9 Cl-106 HCO3-27 [**2193-7-3**] 07:45AM BLOOD Glucose-123* UreaN-17 Creat-0.9 Na-135 K-3.9 Cl-97 HCO3-33* AnGap-9 [**2193-7-5**] 07:05AM BLOOD K-4.3 Brief Hospital Course: Mr. [**Known lastname 19568**] was a same day admit after undergoing all pre-operative work-up as an outpatient. On [**7-1**] he was brought directly to the operating room where he underwent a ascending aorta replacement. Please see operative report for surgical details. Following surgery he was transferred to the CSRU for invasive monitoring in stable condition on a titrated propofol drip. Later on op day he was weaned from sedation, awoke neurologically intact and extubated. That evening he was off all drips and then transferred to the floor on post-op day one. Beta blockers and diuretics were initiated and he was gently diuresed towards pre-op wt. Foley and chest tubes were removed on post-op day two. Pacing wires removed on post-op day three and beta blockade titrated for HR/BP management. Physical therapy followed him throughout post-op course for strength and mobility. He continued to improve quite rapidly without any post-op complications. He was discharged to home with VNA services and the appropriate follow-up appointments on post-op day four. Medications on Admission: wellbutrin 200 mg [**Hospital1 **] prilosec 20 mg daily metoprolol 25 mg [**Hospital1 **] ambien prn alprazolam prn Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 2. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 4. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 5. Bupropion 75 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 6. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 7. Furosemide 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 2 weeks. Disp:*28 Tablet(s)* Refills:*0* 8. Potassium Chloride 20 mEq Packet Sig: One (1) Packet PO Q12H (every 12 hours) for 2 weeks. Disp:*28 Packet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital3 **] VNA Discharge Diagnosis: Ascending Aortic Aneurysm s/p valve-sparing ascending aorta replacement ([**Doctor Last Name **] procedure) PMH: ? h/o pericarditis [**2186**], s/p tonsillectomy Discharge Condition: stable Discharge Instructions: no lotions, creams or powders on any incision no driving for one month call for fever greater than 100, rednes or drainage no lfting greater than 10 pounds for 10 weeks may shower over incisions and pat dry Followup Instructions: follow up with Dr.[**Doctor Last Name 19569**] in [**12-17**] weeks follow up with Dr. [**Last Name (STitle) **] in [**1-18**] weeks follow up with Dr. [**Last Name (STitle) 1290**] in 4 weeks [**Telephone/Fax (1) 170**] Completed by:[**2193-7-24**] ICD9 Codes: 4240
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7921 }
Medical Text: Admission Date: [**2146-12-25**] Discharge Date: [**2147-4-4**] Date of Birth: [**2146-12-25**] Sex: Service: HISTORY OF PRESENT ILLNESS: This patient's post discharge name will be [**Name (NI) 76463**] [**Name (NI) 76464**]. Baby [**Name (NI) **] [**Known lastname 76463**] [**Known lastname **] delivered at 28 and 4/7 weeks gestation and was admitted to the newborn intensive care unit for management of respiratory distress and prematurity. Birth weight 1060 (25th percentile). Length 37 cm (25 to 50th percentile). Head circumference 24 cm (10th percentile). Mother is a 39 year-old, gravida 3, para 0, now 1 mother with estimated date of delivery of [**2147-3-15**]. Prenatal screens included blood type A positive, antibody negative, RPR nonreactive, Rubella immune, hepatitis B surface antigen negative and group beta strep status unknown. The mother presented to [**Hospital1 69**] from Bermuda for continued management of preterm labor on [**2146-11-24**] at 24 and 1/7 weeks gestation. The mother received a complete course of betamethasone on [**2146-11-25**]. Preterm labor was managed by Terbutaline and vaginal progesterone suppositories. The mother was stable on antepartum floor until day of delivery when her membranes spontaneously ruptured and she had a fever to 100.4. Labor was allowed to progress. The delivery was by spontaneous vaginal delivery. Membranes had been ruptured 7 hours prior to delivery. The infant initially emerged with good activity and spontaneous respiratory effort. He received routine dry and suctioning and stimulation but his respiratory effort became poor with poor color, requiring positive pressure ventilation and then intubation with slow but steady improvement. His heart rate was always greater than 100. His Apgar scores were 4 at 1 minute, 6 at 5 minutes and 8 at 10 minutes. PHYSICAL EXAM AT DISCHARGE: Weight 3695 grams (75 to 90th percentile). Length 52 cm (75 to 90th percentile). Head circumference 36 cm (75 to 90th percentile). In general, a well-appearing, alert infant. Head sutures approximated. Eyes clear red reflex bilaterally. Nose patent. No cleft. Vigorous cry. Chest: Breath sounds bilaterally equal, clear. Mild subcostal retracting. Heart: Normal S1 and S2, no murmur, normal pulses and perfusion. Abdomen: Soft, no hepatosplenomegaly, no masses. Active bowel sounds. Skin: Pale, pink, nevus flammeus on eyelids and forehead. A 3.5 x 3.5 cm raised papillary hemangioma on back. Genitalia: Normal male. External genitalia: Uncircumcised, testes descended bilaterally. Skeletal: Spine straight and intact, no dimple. Hips stable. No clicks or clunks. Moves all extremities equally. Neuro: Tone appropriate for gestational age. Able to elicit suck, grasp. HOSPITAL COURSE BY SYSTEMS: Placed on conventional ventilation on admission. Received 2 doses of Surfactant, due to 100% oxygen requirement, was changed to high frequency oscillatory ventilation with a mean airway pressure of 13, Delta P of 28 with a good response. His oxygen requirement slowly came down and he weaned back to conventional ventilation on day of life 4. He was extubated to continuous positive airway pressure (CPAP) on day of life 6. He successfully transitioned off CPAP on day of life 46 to nasal cannula oxygen. He remains on nasal cannula oxygen 25 cc flow. He started Lasix on day of life 57 for chronic lung disease. He continues on Lasix around 2 mg/kg once every Monday, Wednesday and Friday. His respiratory rates range in the 30's to 60's with mild subcostal retracting. He will be discharged home on nasal cannula with home oxygen and a saturation monitor which the mother has received teaching for. Respiratory: [**Known lastname 76463**] started caffeine on day of life 4 and it was discontinued on day of life 60. His last apnea and bradycardia episode, which was associated with a feed, was on day of life 86 ([**2147-3-21**]). Cardiovascular: He received normal saline on admission for hypotension. He has remained hemodynamically stable since. Received Indocin on day of life 4 for patent ductus arteriosus that was diagnosed by echocardiogram. A follow-up echocardiogram on day of life 8 showed no patent ductus arteriosus and a left peripheral pulmonic stenosis, mild. Intermittently, a murmur is heard which is probably related to the PPS. His heart rate ranges in the 120's to 170's. A recent blood pressure was 63 over 44 with a mean of 48. Fluids, electrolytes and nutrition: He was n.p.o. on admission, receiving total parenteral nutrition. Enteral feeds were started on day of life 6 and he was gradually advanced to full volume feeds by day of life 14 without problems. The caloric density was increased gradually to a total of 30 calories per ounce with added BeneProtein. We started weaning the calories on day of life 52. At discharge, he is receiving breast milk mixed with Enfamil powder to equal 24 calories per ounce or does breast feed also. His electrolytes have been followed on Lasix. He did receive potassium chloride supplements that were discontinued on [**2147-3-27**]. With electrolytes followed after the potassium chloride was discontinued, his electrolytes have been stable. His most recent set was on [**2147-4-3**] and showed a sodium of 138, potassium of 5.8, chloride 102, C02 of 30. Gastrointestinal: Received 12 days of phototherapy for indirect hyperbilirubinemia. His peak bili was on day of life 2, total of 5.8, direct of 0.3. Hematology: His blood type is A negative. The direct Coombs was negative. He received a total of 2 packed red blood cell transfusions with the last one on day of life 22. His most recent hematocrit was on [**2147-3-20**], 31.4% with a reticulocyte count of 2.1%. Infectious disease: He received 21 days of ampicillin and gentamycin for suspicion for sepsis and meningitis. We were unable to rule out meningitis with a lumbar puncture secondary to the intraventricular hemorrhages. His blood culture was negative. He received 48 hour rule out of Vancomycin and gentamycin, due to increased apnea and bradycardia episodes on day of life 33. The CBC was benign and the blood culture was negative. Neurology: He was followed closely with frequent ultrasounds due to the initial ultrasound showing bilateral intraventricular hemorrhage with mild ventriculomegaly. The most recent head ultrasound was on [**2147-2-17**] on day of life 54 and it showed resolved intraventricular hemorrhages and a left caudal thalamic cyst. His ventricular size was the upper size of normal. Skin: [**Known lastname 76463**] has a large 3.5 x 3.5 cm strawberry hemangioma on his back. It was initially small and has increased in size as he has grown. Sensory: Audiology hearing was performed with automated auditory brain stem responses. He passed both ears. Ophthalmology: Eyes were examined most recently on [**2147-3-6**] revealing mature retinal vessels. A follow-up examination is recommended at 9 months of age. CONDITION ON DISCHARGE: 100 day old, now 42 and 6/7 weeks post menstrual age infant with chronic lung disease, stable in nasal cannula oxygen. DISCHARGE DISPOSITION: Baby will be discharged with mother to her apartment in [**Name (NI) 86**] for one day, with the plan to fly to [**State 108**] the following day on [**2147-4-5**] and stay in [**State 108**] for about 2 weeks and then return to Bermuda. Portable oxygen has been arranged for discharge and the airline flights and for [**State 108**]. PEDIATRICIAN: Pediatrician in [**State 108**] will be Dr. [**Last Name (STitle) 76465**] [**Name (STitle) **], telephone number [**Telephone/Fax (1) 76466**]. The pediatrician in Bermuda will be Dr. [**Last Name (STitle) **] at [**Doctor Last Name **] Care Pediatrics, telephone number 1-[**Telephone/Fax (1) 76467**]. Fax #1-[**Telephone/Fax (1) 76468**]. CARE AND RECOMMENDATIONS: Feeds: Ad lib feeds with breast milk mixed with Enfamil powder to equal 24 calories per ounce. Mother may breast feed as desired but will give several bottles per day for the calories. Medications: Lasix 7 mg once every Monday, Wednesday and Friday. Goldline baby vitamins 1 ml daily. Ferrous sulfate 0.6 ml daily. Iron and vitamin D supplementation: Iron supplementation is recommended for preterm and low birth weight infants until 12 months corrected age. All infants fed predominantly breast milk should receive Vitamin D supplementation at 200 i.u. (may be provided as a multi-vitamin preparation) daily until 12 months corrected age. Car seat position screening test done and passed. State newborn screens were followed and are within range. Immunizations received: Received hepatitis B immunization on [**2147-1-26**]. Received 2 month immunizations on [**2147-2-28**] which consisted of PediaRx, Hib and Pneumococcal 7-Falent conjugate vaccine. Received Synagis on [**2147-4-2**]. Immunizations recommended: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following four criteria: (1) Born at less than 32 weeks; (2) Born between 32 weeks and 35 weeks with two of the following: Day care during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities or school age siblings; (3) chronic lung disease or (4) hemodynamically significant congenital heart disease. Influenza immunization is recommended annually in the Fall for all infants once they reach 6 months of age. Before this age, and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out-of-home caregivers. This infant has not received ROTA virus vaccine. The American Academy of Pediatrics recommends initial vaccination of preterm infants at or following discharge from the hospital if they are clinically stable or at least 6 weeks but fewer than 12 weeks of age. FOLLOWUP: Recommended: Follow-up appointment with Dr. [**First Name (STitle) **] in [**State 108**] is scheduled for [**2147-4-7**]. Dr. [**First Name (STitle) **] to arrange VNA visits in [**State 108**]. Pulmonology follow-up with Dr. [**First Name4 (NamePattern1) 4468**] [**Last Name (NamePattern1) 37305**]. This will be done by phone as he is in [**Location (un) 86**]. Early intervention to be arranged by pediatrician in Bermuda. A follow-up eye appointment with Pediatric ophthalmology recommended at 9 months of age. DISCHARGE DIAGNOSES: 1. Prematurity at 28 and 4/7 weeks. 2. Respiratory distress syndrome. 3. Patent ductus arteriosus resolved. 4. Presumed sepsis meningitis resolved. 5. Indirect hyperbilirubinemia. 6. Strawberry hemangioma. 7. Retinopathy of prematurity resolved. 8. Hypertension at birth, resolved. 9. Bilateral intraventricular hemorrhages, resolved. 10.Anemia. 11.Apnea of prematurity resolved. 12.Chronic lung disease. [**Doctor First Name **] [**Name6 (MD) **] [**Name8 (MD) **], [**MD Number(1) 62348**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2147-4-4**] 01:29:56 T: [**2147-4-4**] 05:25:13 Job#: [**Job Number 76469**] ICD9 Codes: 769, 7742, V053
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Medical Text: Admission Date: [**2112-10-5**] Discharge Date: [**2112-10-8**] Date of Birth: [**2056-9-18**] Sex: M Service: ADMISSION DIAGNOSIS: Morbid obesity. DISCHARGE DIAGNOSIS: Morbid obesity, status post open gastric bypass with roux-en-y reconstruction. HISTORY OF PRESENT ILLNESS: The patient is a 56 year old man with morbid obesity and multiple comorbidities from his obesity. These comorbidities include sleep apnea, osteoarthritis, lymphedema, congestive heart failure, and ventral hernia. The patient weighs 500 pounds and a BMI of 60. He has been on multiple weight loss regimens in the past without any significant long term success. The patient presents for elective gastric bypass surgery. PHYSICAL EXAMINATION: In general, the patient is in no acute distress, morbidly obese. Vital signs are stable, afebrile. Chest is clear. Cardiovascular is regular rate and rhythm without murmurs, rubs or gallops. The abdomen is obese, soft, nontender, nondistended. Extremities - venous stasis disease without active ulcers, 1+ pitting edema bilaterally in the lower extremities. Neurologically, the patient is alert and oriented times three. No gross deficits. PAST MEDICAL HISTORY: 1. Atrial fibrillation, status post pacemaker. 2. Congestive heart failure. 3. Sleep apnea. 4. Osteoarthritis. 5. Lymphedema in pannus and right groin. 6. Ventral hernia repair [**2102**]. MEDICATIONS ON ADMISSION: 1. Lasix 80 mg once daily. 2. Zoloft 50 mg once daily. 3. Toprol 50 mg once daily. 4. Coumadin 10 mg once daily. 5. Lovenox 45 mg once daily. 6. Cozaar 50 mg once daily. 7. Tylenol p.r.n. HOSPITAL COURSE: The patient was admitted for elective open gastric bypass surgery. The surgery proceeded without complication. The patient was left intubated and sent to the Intensive Care Unit for closer monitoring and ventilatory support. This is due to his cardiac status. The patient did have a known ejection fraction of 30 to 35% documented on echocardiogram. Postoperatively the patient did well and was extubated on postoperative day number one without complication. The patient was also advanced to Stage I diet. On postoperative day two, the patient was transferred to the floor and advanced to Stage II diet. The patient did complain of a little bit of chest pressure. An electrocardiogram was obtained which was unchanged from his preoperative electrocardiogram. The patient described his chest pressure as feeling as if he had eaten too much. Decision was made not to cycle cardiac enzymes. The patient did well otherwise. On postoperative day three, the patient was advanced to a Stage III diet. The patient was subsequently discharged to home tolerating a Stage III diet. CONDITION ON DISCHARGE: Good. DISPOSITION: To home. DIET: Stage III diet per gastric bypass protocol. MEDICATIONS ON DISCHARGE: 1. Roxicet Elixir one to two teaspoons q4hours p.r.n. 2. Actigall 300 mg p.o. twice a day. 3. Zantac Liquid 150 mg p.o. twice a day. 4. Vitamin B12 1000 mcg once daily. 5. Lasix 80 mg once daily. 6. Zoloft 50 mg once daily. 7. Toprol 50 mg once daily. 8. Coumadin 10 mg once daily. 9. Lovenox 45 mg once daily. 10. Cozaar 50 mg once daily. 11. Tylenol p.r.n. FOLLOW-UP: The patient is to follow-up with the Surgical [**Hospital **] Clinic in two weeks time. He is to maintained a Stage III diet until that time. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3799**], M.D. [**MD Number(1) 3800**] Dictated By:[**Last Name (NamePattern1) 5745**] MEDQUIST36 D: [**2112-10-8**] 09:28 T: [**2112-10-9**] 09:12 JOB#: [**Job Number 37816**] ICD9 Codes: 4280
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Medical Text: Admission Date: [**2135-12-19**] Discharge Date: [**2135-12-31**] Date of Birth: [**2078-1-25**] Sex: F HISTORY OF PRESENT ILLNESS: This is a 51-year-old woman with a history of a recent stroke, asthma, insulin-dependent diabetes, and renal disease who was at Stone Hinge Convalescent Center and noted to have changes in her behavior On the day of admission at 2:25 p.m. she had an episode of unresponsiveness and then she developed status epilepticus at [**Hospital 882**] Hospital. She received 6 mg of Ativan and Versed as well loaded on Dilantin intravenously. At that time she was intubated and then transferred to the Neurology Intensive Care Unit. Congestive heart failure, stroke, lupus, asthma, insulin-dependent diabetes, renal disease. MEDICATIONS ON ADMISSION: Synthroid 0.1, Catapres transdermal patch 2 every week, Novolin NPH 24 units, Serevent 2 puffs b.i.d., Zantac 150 mg p.o. b.i.d., [**Doctor First Name 233**] Ciel, hydralazine, furosemide, Flovent, calcium, Milk of Magnesia. PHYSICAL EXAMINATION ON PRESENTATION: Blood pressure 217/97, heart rate 119, 100% on room air. Rectal temperature of 100. Cardiovascular revealed tachycardia with a 2/6 systolic murmur. Chest revealed bilateral crackles, low breath sounds (left compared to right). The abdomen was soft, nontender, and nondistended. Extremities revealed no clubbing, cyanosis or edema. Neurologically, intubated and sedated, positive tongue abrasion. Held her right hand in fist with eyes contracted. Right leg flexed spontaneously. Did not follow commands. Pupils revealed left 4 mm to 5 mm, right 3.5 mm, reactive to light bilaterally. No blink to visual threat. Extraocular movements appeared conjugate. Left side had decreased abduction with dolls. Positive occasional right nystagmus with dolls. No obvious facial asymmetry which was difficult to tell with a tube in place. Positive gag. Positive cough. Motor revealed spontaneously moved the right side more than the left. Spontaneous movement in the right upper and lower extremities. Positive withdrawal to pain on the left lower extremity. Positive extension to pain in the left upper extremity. Her reflexes were symmetric bilaterally with upgoing toes bilaterally, 4+ on the right ankle, 1+ on the left ankle. PERTINENT LABORATORY DATA ON PRESENTATION: The patient had basic laboratories with a white blood cell count of 15.8, a hematocrit of 32.2. Normal electrolytes except for her blood glucose which was 336. PT, PTT, and INR were normal. Her urinalysis showed 0 to 2 white blood cells, and rare bacteria. RADIOLOGY/IMAGING: Head CT done at the time showed only chronic microvascular changes. No infarct. No axillar hemorrhage. Chest x-ray showed left lower lobe opacity, a question of atelectasis. HOSPITAL COURSE: The patient was admitted to the Neurolgy Intensive Care Unit and followed. Blood pressure was controlled. She was moving all extremities to pain, left greater than right. Slight increased tone on the right side. She was started on a maintenance dose of Dilantin. Acute coronary artery syndrome was r/o with serial EKGs, creatine kinases and troponin. Magnetic resonance imaging showed extensive encephalomalacia change in atrophy from multiple old infarct. No acute infarct. MRA at the same time was read as motion artifact, severely aluminated the Circle of [**Location (un) 431**], visualized internal carotid arteries were likely vertebrobasilar system patent; however, the patient after extubation had new left arm weakness which was not at her baseline. When the stroke team reviewed her MRA they felt that she could possibly have basilar artery stenosis; and, therefore, she was started on a heparin drip. Prior to that a workup for the seizure included a lumbar puncture which was unrevealing with 1 white blood cell, no red blood cells, and a differential of 65% lymphocytes, 30% monocytes, and 5% polys. Glucose was 126. No protein was sent. She was continued on Synthroid. Her serum glucose was controlled. She did require an insulin drip at one point until she started eating again. In addition, she had an electroencephalogram on [**12-20**] which showed very low voltage background with beta in most areas, not epileptiform. She was transferred out from the NICU to the Neurologyfloor on [**2135-12-22**] and remained stable on a heparin drip. Her PTT was kept between 60 and 80. Her blood pressure was watched carefully. At the time she was transferred she was alert and oriented times hospital. She felt well, and she was consistently following commands. She moved her right arm and had some difficulty moving her left arm. Her Dilantin levels were followed and on [**12-22**] it was 9.3. She was bolused with Dilantin with subsequent repeat being 10.9, and her chronic dose was increased. During her stay, her hematocrit fell to 28. Because of her diabetes and risk factors for coronary artery disease, she was transfused 2 units with a repeat hematocrit of 34 on [**2135-12-25**]. We continued to follow her hematocrit, and again it dipped down to 28, and she needed to receive another transfusion. Her Dilantin was continued, and her mental status improved. She was started on Levaquin for a possible aspiration pneumonia and then found to have urinary tract infection, and thus the Levaquin was continued. Her urine grew out Staphylococcus aureus and group B strep. She was started on vancomycin and continued on the levofloxacin. The sensitivities studies showed methicillin-resistant Staphylococcus aureus, and a peripherally inserted central catheter line was placed for a prolonged course of vancomycin. Vancomycin peak and trough was checked on [**2135-12-29**] which showed a peak of 22 and a trough of 10.9, which seemed adequate and continued on the vancomycin dose 500 mg q.24h. The patient's neurologic examination improved with her able to have antigravity movement with her left hand. Her heparin was discontinued after the second hematocrit drop, and Gastrointestinal was consulted. They had originally planned to take her for upper and lower endoscopy; however, her daughter did not want any intervention unless the patient had life threatening problems, and after the discontinuation of the heparin, her hematocrit remained stable. The patient was then started on Plavix for stroke prophylaxis since she had an aspirin allergy. Her stools were consistent guaiac-positive through the hematocrit drops, and thus we thought that the source was gastrointestinal. MEDICATIONS ON DISCHARGE: 1. Dilantin 100 mg p.o. t.i.d. 2. Nitroglycerin patch 0.4 mg q.d. 3. Catapres 0.2 mg transdermal patch every week. 4. Serevent meter-dosed inhaler 2 puffs b.i.d. 5. Flovent meter-dosed inhaler 2 puffs b.i.d. 6. Vancomycin 500 mg intravenously q.24h. 7. Protonix 40 mg p.o. q.d. 8. Plavix 75 mg p.o. q.d. 9. Zantac 150 mg p.o. q.d. 10. Regular insulin sliding-scale. 11. NPH 12 units q.a.m. and 4 units q.p.m. 12. Labetalol 100 mg p.o. b.i.d. (hold for a blood pressure of less than 160 and heart rate less than 40). 13. Synthroid 100 mcg p.o. q.d. 14. Colace 100 mg p.o. b.i.d. DISCHARGE DIAGNOSES: 1. Seizure and question stroke. 2. Diabetes. 3. Gastrointestinal bleed. DISCHARGE FOLLOWUP: Follow up with stroke team. [**Name6 (MD) 725**] [**Name8 (MD) 726**], M.D. [**MD Number(1) 727**] Dictated By:[**Last Name (NamePattern1) 8853**] MEDQUIST36 D: [**2135-12-29**] 16:41 T: [**2135-12-29**] 18:06 JOB#: [**Job Number 37481**] ICD9 Codes: 5990, 4280, 2760, 4019
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Medical Text: Admission Date: [**2185-9-3**] Discharge Date: [**2185-9-5**] Date of Birth: [**2153-12-1**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 9454**] Chief Complaint: Vomiting blood Major Surgical or Invasive Procedure: Esophagogastroduodenoscopy (EGD) History of Present Illness: This is a 31 y.o male w/ past medical history of GERD and alcohol abuse who reports being in his normal state of health until last night when he developed nausea and went to the bathroom where he vomited [**11-26**] tablespoons of red blood mixed w/ emesis. He had previously had symptoms similar to this so he wasn't particularly concerned and then went back to bed. He went on to have two further episodes of bloody emesis during which he filled up the sink and then the toilet with what appeared to be pure blood by his report. This led him to seek care at [**Hospital 1562**] Hospital. There, he was hemodynamically stable by report but nevertheless received two units of blood and was started on octreotide and PPI drips and was trensferred here. Over the course of these symptoms he reports that he developed mild to moderate epigastric pain. No chest pain or shortness of breath. He reports he did develop some dizziness as he was riding to [**Hospital1 1562**] but has had none since. No syncope. . In the ED, initial VS were T 97.2, P 83, BP 139/80, RR 16, O2 Sat 97 % on RA. He was placed on PPI drip and an NG lavage was done that yielded red blood which then failed to clear. His PPI and octreotide drips were continued and he was admited to the ICU. . Currently, he reports mild abdominal discomfort and nausea but no other symptoms at this time. . Review of systems: No fevers, chills, weight loss, night sweats. Reports . Past Medical History: Past Medical History: -MVA in [**2173**] with multiple fractures, now takes chronic narcotics for chronic pain -History of GSW to right leg -GERD Social History: EtOH abuse in the past, currently 1ppd, has wife and 2 children Family History: Mother reportedly died of "untreated ulcer" Physical Exam: Afebrile 142/75 p80 96%RA Large M sitting in unit bed without shirt on, wife in chair next to bed, watching Pats game on TV. Nice, alert, oriented, no distress. CTAB no w/c/r/r S1 S2 are clear, light 1-2/6 systolic murmur noted, with heart sounds and murmur decreasing in intensity moving towards the apex. Radial pulses are 2+ bilaterally. Abd with prominent midline scar from ex lap, per pt. No TTP in any quadrant. BS+. RUE has 2 PIV's well placed. No c/c/e. RLE with scar tissue on anterior aspect of shin, LLE with prominent scar tissue and deformity near ankle. DP's are 2+. There is no LE edema. Pertinent Results: WBC 11.4 --> 4.5 on discharge Hct 38.1 --> 32.0 Plts 289 Chems BUN/Cr 21/0.8 on admission but otherwise all normal through admission LFT's normal Lipase 37 H. pylori serology positive [**2185-9-3**] EKG Sinus rhythm. Normal tracing. No previous tracing available for comparison. EGD [**2185-9-3**] Findings: Esophagus: Mucosa: Several areas of ulceration with erythema and evidence of prior bleeding were noted in the gastroesophageal junction and cardia. There was no active bleeding or visible vessel, and due to patient intolerance after repeated procedure attempts, no intervention was performed. Stomach: Normal stomach. Duodenum: Normal duodenum. Impression: Erythema and ulceration in the gastroesophageal junction and cardia Otherwise normal EGD to second part of the duodenum Recommendations: Routine post procedure orders Serial HCTs. IV PPI gtt. NPO with sips. If stable overnight can advance to clears tomorrow. Will need 6-8 weeks of [**Hospital1 **] PPI therapy and repeat endoscopy to assess for healing. Brief Hospital Course: 31yo healthy M with sujective h/o severe GERD admit for hematemesis, found to have multiple GE junction ulcerations not actively intervened upon, to be treated with medical therapy. 1. GI bleed--Admitted to MICU hemodynamically stable and was stable through admission. Had received 2U PRBC's at OSH but did not require any blood products at [**Hospital1 18**]. Had EGD without any active bleeding or varices and only old blood and multiple ulcers with clot. Had difficult tolerating procedure so no electrocautery employed or clipping done, GI recommended [**5-2**] wks of PPI therapy and reassessment with repeat EGD in future. Serial Hct's post procedure was stable and rest of hospital course uncomplicated. Pt was hemodynamically stable through admission and on discharge. 2. History of alcohol abuse--Pt with h/o considerable alcohol consumption in the past, but less so currently by history. Had h/o mild withdrawal symptoms (tremulous and anxious) but no seizures or complicated withdrawal. Kept on CIWA scale, no complications this admission. 3. PUD, H. pylori positive--Given prescription for triple therapy with Clarithromycin, Amoxicillin, and Omeprazole. N.b. Discharge worksheet showing Rx for 2wks Omeprazole, with GI recs for 6-8wks PPI Tx --> Called both pt's PCP and pt to make them aware and give 6-8wks of Tx. Stressed importance of ABx compliance. Will need repeat EGD in future after medical therapy complete. Medications on Admission: Oxycodone/APAP PRN Discharge Medications: 1. Omeprazole 20 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO twice a day for 2 weeks. Disp:*28 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 2. Amoxicillin 500 mg Capsule Sig: Two (2) Capsule PO twice a day for 2 weeks. Disp:*56 Capsule(s)* Refills:*0* 3. Clarithromycin 500 mg Tablet Sig: One (1) Tablet PO twice a day for 2 weeks. Disp:*28 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: 1. Upper GI tract bleed 2. Ulcers at gastoesophageal junction, H. Pylori positive Discharge Condition: By the time of discharge, the pt's hematocrit was stable, vital signs were stable, the pt was taking good PO food and liquids, and was medically clear for discharge. Discharge Instructions: You were admitted to [**Hospital1 18**] after you vomited a large amount of blood. You were given 2 units of blood at an outside hospital and transferred to [**Hospital1 18**], where you were admitted to the intensive care unit. You had a procedure to visualize your esophagus and stomach and were found to have bleeding ulcers at the junction of your stomach and esophagus. It was not actively bleeding and no interventions were taken because you were not tolerating the procedure well. You will need to treat these ulcers with medical therapy for several weeks. You will need to be treated for a bacterial infection of your stomach that contributes to ulcers. You will need to take this medicine regimen for two weeks: 1. Omeprazole 20mg twice daily 2. Amoxicillin 1g twice daily 3. Clarithromycin 500mg twice daily Please note that if you do not complete the course of antibiotics for two weeks, you risk recurrence of the ulcers. Please seek immediate medical attention if you experience further vomiting of blood, blood in your stool, dizziness or lightheadedness, signs of bleeding from anywhere in your body, abdominal pain that does not spontaneously resolve, or any other concerns. Followup Instructions: Please follow up with your primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 84672**], at [**Street Address(2) 84673**], [**Location (un) **],MA, sometime THIS WEEK to have your hematocrit checked. The clinic has already been called, at [**Telephone/Fax (1) 14916**], and they will contact you sometime this week to set up this appointment. This is VERY important and it is important that you keep this appointment. You will also need a repeat EGD (a procedure to visualize your esophagus and stomach) in [**5-2**] weeks to assess your ulcers. You can arrange this by calling the Department of Gastroenterology at [**Hospital1 18**] at([**Telephone/Fax (1) 2233**] and telling them that you were seen while an inpatient and need to set up a follow up appointment. Or, you can ask your primary care doctor to arrange this for you. Completed by:[**2185-9-11**] ICD9 Codes: 2851, 4019
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Medical Text: Admission Date: [**2126-5-8**] Discharge Date: [**2126-7-1**] Date of Birth: [**2060-8-27**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3984**] Chief Complaint: Weakness, rash Major Surgical or Invasive Procedure: catheter exchange [**5-10**] and [**2126-5-17**] ultrasound-guided percutaneous cholecystostomy History of Present Illness: Mr. [**Known lastname 13275**] is a 65 yo M who presented on day +27 status post non-myeloblative matched unrelated donor stem cell transplant for myelofibrosis with weakness and a rash. He reports that he had been feeling well at the time of discharge on [**2126-4-29**] but had become progressively weaker in the interval. Three days prior to presentation the patient first noted a decrease in his energy, and over the previous two days he was so weak he could not even stand for a few minutes. This was associated with some dizziness with standing, which was without sensation of movement or vertiginous features. He also reported that his rash had worsened despite an increase in prednisone with mild pruritus. Cough had also developed on the day of presentation, which was productive of clear phlegm. He denied dysuria, fevers, chills, diarrhea, nausea or abdominal pain. At presentation he did endorse a mild [**1-12**] headache that was dull and not associated with photophobia, nausea or neck stiffness. He denied palpitations or dyspnea. His chronic low back pain is at baseline, dull, [**3-12**], and not associated with leg weakness, saddle anesthesia or bowel/bladder incontinence. He did report constipation x 4 days. He had noted some decrease in appetite but was unsure regarding weight loss. On the day of presentation the patient was seen in clinic and found to be orthostatic from 141/93 to 119/80 with symptoms. He received 2 L NS, and had labs drawn including cultures. He was admitted to the BMT sertvice to further work up his weakness and rash. His dizziness improved after IVF. ROS: Positive per HPI and otherwise essentially negative. The pt denied recent fevers, night sweats, chills, changes in hearing or vision, including amaurosis fugax, neck stiffness, lymphadenopathy, hematemesis, coffee-ground emesis, dysphagia, odynophagia, heartburn, nausea, vomiting, diarrhea, steatorrhea, melena, hematochezia, cough, hemoptysis, wheezing, shortness of breath, chest pain, palpitations, dyspnea on exertion, increasing lower extremity swelling, orthpnea, paroxysmal nocturnal dyspnea, leg pain while walking, joint pain. Past Medical History: ONCOLOGIC HISTORY ==================== Diagnosed with primary myelofibrosis (w/ JAK2 mutation) in [**8-/2125**] with progressively declining platelet count. -Matched unrelated donor non-myeloablative allogeneic stem cell transplant with Fludarabine/Busulphan/ATG conditioning - day 0 was [**2126-4-11**] complicated by grade 2 acute cutaneous GVHD for which he was started on steroids and hadn his cyclosporine dose increased OTHER PAST MEDICAL HISTORY ============================= - Epistaxis - TIAs (3 episodes in past 5 years) - Coronary Artery Disease (asymptomatic, diagnosied by positive stress test 8 yrs ago; stress test with imaging in [**2123**] showed a small area of mild distal inferior apical ischemia. He had a radionucleotide stress test recently, however, that stratified him to low risk.) - Hypertension - Chronic Low Back Pain, found by MRI to have spinal stenosis and disc disease - History of leg edema of unclear etiology - heterozygote for the C282Y gene mutation (hemochromotosis gene; His baseline ferritin in [**1-11**] was 970) Social History: He is married with four children and 10 grandchildren. He works as a cement finisher and also ploughs snow in the winter. He has an 80 pkyr smoking history, having quit 11 years prior to admission. He drinks 2-3 alcoholic beverages per week. Family History: No history of cancer, marrow disorders. Physical Exam: Vitals: T:96.7 BP: 138/81 P: 81 R: 20 SaO2: 99 RA General: Awake, alert, NAD, pleasant, appropriate, cooperative. HEENT: NCAT, PERRL, EOMI, no scleral icterus, MMM, no lesions noted in OP Neck: supple, no significant JVD or carotid bruits appreciated Pulmonary: Lungs CTA bilaterally, no wheezes, ronchi or rales Cardiac: RR, nl S1 S2, no murmurs, rubs or gallops appreciated Abdomen: soft, NT, ND, normoactive bowel sounds, no masses or organomegaly noted Extremities: No edema, 2+ radial, DP pulses b/l Lymphatics: No cervical, supraclavicular, axillary or inguinal lymphadenopathy noted Skin: Blanching erythema noted on face, chest and abdomen. No open sores or lesions. Some flaking noted on face. Neurologic: Alert, oriented x 3. Able to relate history without difficulty. Cranial nerves II-XII intact. Normal bulk, strength and tone throughout. Finger to nose normal on RIGHT but some difficult with passing finger on LEFT. Patient unable to spell WORLD backwards. Patient forgets [**2-5**] words at 2 minutes but rememebers [**2-5**] with prompting. No deficits to light touch throughout. No nystagmus, dysarthria, intention or action tremor. 2+ biceps, triceps, brachioradialis, 2+ ankle jerks bilaterally. Plantar response was flexor bilaterally. Pertinent Results: LABORATORY RESULTS ================== On Admission: WBC-4.1 RBC-3.46* Hgb-9.6* Hct-26.4* MCV-76* RDW-19.1* Plt Ct-20* --Neuts-42* Bands-3 Lymphs-22 Monos-22* Eos-5* Baso-1 Atyps-2* Metas-1* Myelos-1* Promyel-1* NRBC-11* Glucose-151* UreaN-28* Creat-0.8 Na-128* K-4.1 Cl-95* HCO3-24 AnGap-13 ALT-44* AST-30 LD(LDH)-597* AlkPhos-186* TotBili-1.1 On Discharge: WBC 20.9 RBC 3.62 Hgb 11.1 Hc2 33.0 Na 119 K 5.0 Cl 91 HC03 16 Creat 1.8 BUN 59 ALT 3458 AST 7528 AP 636 Tot Bili 5.4 Ca 7.4 Mg 2.2 Phos 6.9 ABG: 7.05/50/80 MICROBIOLOGY ============== Blood Cultures on [**5-10**], [**5-17**], [**5-23**]: No Growth Urine Cultures: All negative CMV Viral Load [**5-13**], [**5-20**], [**5-25**], [**6-3**]: Not detected Stool Toxin Assay for C Diff [**5-12**], [**5-13**], [**5-14**], [**5-23**], [**5-30**], [**5-31**]: Negative Parainfluenza postive respiratory culture PCR of Adenovirus with [**Numeric Identifier 81563**] copies Sputum [**6-20**] GNR Mini BAL [**6-21**] GNR PATHOLOGY ========= Skin Biopsy [**2126-5-10**]: DIAGNOSIS: 1. Skin, right lateral eyebrow (A,B): Squamous cell carcinoma, well to moderately differentiated and invasive; extends to the peripheral and to the deep specimen margins. 2. Skin, left medial canthus (C,D): Basal cell carcinoma, superficial and nodular types with superficial excoriation and squamous differentiation; extends to the peripheral and to the deep specimen margins. Skin Biopsy [**2126-5-13**]: DIAGNOSIS: Skin, left abdomen, punch biopsy (A): Vacuolar interface dermatitis with satellite cell necrosis and scattered eosinophils (see note). Note: The findings raise a histologic differential diagnosis that includes acute graft versus host disease and a drug eruption. Clinical correlation is required. GI Biopsies [**2126-5-15**]: DIAGNOSIS: Colonic mucosal biopsies: A. Descending: 1. Features consistent with involvement by acute graft vs. host disease; see note. 2. No viral inclusions identified on immunostain for CMV. B. Sigmoid: 1. Features consistent with involvement by acute graft vs. host disease; see note. 2. No viral inclusions identified on immunostain for CMV. C. Rectum: 1. Features consistent with involvement by acute graft vs. host disease; see note. 2. No viral inclusions identified on immunostain for CMV. Note: The biopsies demonstrate focally prominent crypt apoptoses, rare crypt abscess, and focal cryptitis with only a mild associated mixed inflammatory infiltrate, consistent with involvement by acute GVHD. Foci of crypt drop-out are identified. While CMV immunostains are negative for viral inclusions, a concomitant infectious process cannot be entirely excluded. Radiology ========== Chest Radiograph [**2126-5-8**]: IMPRESSION: PA and lateral chest. Lungs are fully expanded and clear. Cardiac silhouette exaggerated by a mild pectus deformity is top normal size. There is no pulmonary edema, pleural effusion, or evidence of central adenopathy. Dual-channel central venous catheter has backed out to the junction of the brachiocephalic veins. This may have no clinical significance but is sometimes seen when thrombus develops at the tip of the catheter. Unilateral Upper Extremity U/S [**2126-5-8**]: Within this limitation, the right internal jugular vein, axillary vein, brachial veins x 2 and basilic veins were all patent. Limited views of the right subclavian vein were obtained due to patient's bandage. The vein appears to be patent but the useful assessment for clot cannot be made. Chest radiograph from [**2126-5-8**] showed the tip to lie over the region of the brachiocephalic confluence or proximal SVC. The report at that time is noted. It would be not be possible on ultrasound to interrogate the tip of the catheter, as this is essentially a retrosternal location. A contrast-enhanced study is recommended to further evaluate for clot. RIGHT Venogram 1. Venogram demonstrating no clot in the inferior portion of the right brachiocephalic vein and in the SVC. 2. Existing catheter exchanged with a longer triple-lumen tunneled Hickman catheter with tip in the SVC. CT Torso W/Contrast [**2126-5-11**]: 1. Wall thickening and inflammatory fat stranding of the terminal ileum, ascending colon and transverse colon. Differential diagnosis includes inflammatory, infectious and ischemic etiology. SMA/SMV are patent. No evidence of free fluid, free air or pneumatosis. Colonoscopy after treatment/resolution is recommended. 2. Splenomegaly. 3. Bilateral renal hypodensities. 4. 1.5-cm pericardial effusion. MRI Head W and W/O Contrast [**2126-5-11**]: FINDINGS: There are scattered areas of white matter hyperintensity on the FLAIR images in both the deep and subcortical white matter. These suggest chronic small vessel ischemia. The remainder of the brain appears normal with no evidence of hemorrhage, edema, masses, mass effect, or infarction. The ventricles and sulci are within the range of normal for a patient of this age. There are no diffusion abnormalities. There is no abnormal enhancement after contrast administration. CONCLUSION: Findings suggesting chronic small vessel ischemia. No evidence of hemorrhage, infarction, or infection. Chest Radiograph [**2126-5-13**]: IMPRESSION: No change or evidence of acute pneumonia. Chest Radiograph [**2126-5-17**]: INDICATION: Line change. Right internal jugular vascular catheter terminates in the mid superior vena cava, with no evidence of pneumothorax. New widespread interstitial opacities are likely due to acute interstitial edema. CT Head W/O Contrast [**2126-5-17**]: IMPRESSION: No acute intracranial process. Liver/GB Ultrasound [**2126-5-18**]: IMPRESSION: No evidence of biliary obstruction. Transthoracic Echocardiogram [**2126-6-3**]: Conclusions The left atrium is elongated. No atrial septal defect is seen by 2D or color Doppler. The estimated right atrial pressure is 0-5 mmHg. There is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (LVEF>55%). There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic root is moderately dilated at the sinus level. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. Mild (1+) aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. The tricuspid valve leaflets are mildly thickened. There is mild pulmonary artery systolic hypertension. There is a small pericardial effusion. There are no echocardiographic signs of tamponade. Compared with the prior study (images reviewed) of [**2126-3-26**], the pericardial effusion is slightly larger (still small). CXR [**2126-6-14**]: The Hickman catheter tip is at the level of mid SVC. The cardiomediastinal silhouette is stable. There is interval development of left lower lobe opacity that is concerning for infectious process. Evaluation with PA and lateral radiographs is recommended for precise characterization of this worrisome for infectious process abnormalities. Cardiomegaly is unchanged, moderate compared to the prior study RUQ US [**2126-6-19**]: 1. New extra-hepatic biliary ductal dictation. No evidence of choledocholithiasis in the visualized portions, however the head of the pancreas and distal common bile duct are not well visualized. MRCP is recommended. 2. Normal gallbladder. MRCP [**2126-6-16**]: 1. Limited exam. The extrahepatic common duct is dilated, new from [**2126-5-3**]. It is seen to the level of the ampulla, with no definite stone. Some internal signal in the distal CBD could represent sludge. However, artifacts significantly limit the images obtained. 2. Hemosiderosis. 3. Abnormal appearance of small bowel loops in the right lower quadrant and distention of the splenic flexure of the colon. These findings may be related to graft versus host disease. CTA [**2126-6-17**]: 1. No central pulmonary embolus. Severe respiratory motion limits evaluation of the segmental and subsegmental pulmonary arteries, especially in the lower lobes. 2. Multifocal pulmonary opacities, predominently ground glass, with areas of consolidation in the bases. While these findings are consistent with given history of pneumonia, drug toxicity or cryptogenic organizing pneumonia could have a similar appearance CXR [**2126-6-18**]: FINDINGS: In comparison with the study of [**6-14**], there is increasing opacification at the left base in the retrocardiac area, as well as some increasing opacification at the right base. This is consistent with the clinical diagnosis of a developing pneumonia [**6-23**] RENAL U.S. PORT; DUPLEX DOP ABD/PEL LIMITED IMPRESSION: No evidence of hydronephrosis. Markedly limited Doppler examination, probable gross venous patency although if renal vein thrombus were of significant clinical concern then CT or MR would better evaluate. Echo [**2126-6-24**]: There is mild symmetric left ventricular hypertrophy. The left ventricular cavity is unusually small. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF>55%). The right ventricular cavity is mildly dilated with mild global free wall hypokinesis. The number of aortic valve leaflets cannot be determined. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. The tricuspid valve leaflets are mildly thickened. The pulmonary artery systolic pressure could not be determined. There is a small pericardial effusion. The effusion appears circumferential. The effusion is echo dense, consistent with blood, inflammation or other cellular elements. There is brief right atrial diastolic collapse. There is significant, accentuated respiratory variation in mitral/tricuspid valve inflows, consistent with impaired ventricular filling. Compared with the prior study (images reviewed) of [**2126-6-3**], the pericardial effusion is slightly larger, especially posterior to the heart. There is now evidence of impaired ventricular filling. The left ventricle is smaller and the right ventricle (although not well seen) is probably milldy dilated and hypokinetic. However, the patient is now ventilated with a high PEEP which may explain these findings. Gallbladder US IMPRESSION: 1. Increasing intrahepatic and extrahepatic biliary ductal dilatation. No cholelithiasis or stone seen within the proximal or mid CBD, but visualization of distal CBD is limited. 2. Distended gallbladder with interval appearance of sludge and questionable gallbladder wall edema. The findings are nonspecific given hypoproteinemia and biliary distention but acute cholecystitis cannot be excluded; HIDA scan could be performed for further evaluation of biliary tract function. [**6-29**] Echo Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF>55%). The right ventricular cavity is mildly dilated with moderate global free wall hypokinesis. There is a small circumferential pericardial effusion. There is very brief right atrial invagination, but no echocardiographic signs of tamponade. IMPRESSION: Limited study. Small pericardial effusion without signs of tamponade. Right ventricular dilation and systolic dysfunction. [**6-30**] CXR FINDINGS: Comparison is made to the prior studies from [**2126-6-29**]. Right-sided central venous catheter, nasogastric tube, left IJ central venous catheter, and nasogastric tube are unchanged in position. There are again seen diffuse airspace opacities throughout both lung fields which are unchanged. Brief Hospital Course: 65 year old male who presented on D+27 of matched unrelated donor non-myeloblative allogeneic stem cell transplant with worsening GVHD and weakness found to have worsening acute GVHD. . # Acute Graft Versus Host Disease: The patient presented with worsening rash but no diarrhea and normal bilirubin and transaminases. As his rash had not improved on prednisone and he was having primarily weakness and some mental status changes at presentation concern for severe, acute GVHD was low and concern for infection was much higher. Therefore prednisone was stopped on [**2126-5-12**]. Unfortunately, within the first five days of presentation the patient developed severe diarrhea with >1500 ml of stool per day. This led to strong suspicion of acute GVHD being the primary cause of his presentation and symptoms and the patient was put on 1 mg/kg methyprednisolone on [**2126-5-13**] and made NPO. GI biopsies were performed on [**2126-5-15**] with flexible sigmoidoscopy, which were consistent with GVHD and negative for CMV while skin biopsies of his rash from [**5-13**] were non-dignostic. On [**2126-5-19**] there was an attempt made to wean this steroids back in the context of potential improvement but his diarrhea once again worsened and bilirubin started to climb so that by [**2126-5-22**] he was back on 1mg/kg methylprednisolone per day. On [**2126-5-23**] the patient was advanced to 2mg/kg IV methylprednisolone per day divided into two doses and on [**2126-5-24**] he was started on mycophenolate motefil for what was now considered steroid refractory acute GVHD. Methylprednisolone dosing was was dropped back to 1mg/kg on [**5-26**] as there was minimal improvement and considerable concern about the risk of this high of a steroid dose. Bilirubin peaked at 7.3 on [**5-25**] but then began to fall along with the patient having decreased volume of diarrhea and improving rash. The patient was allowed rice once again on [**2126-6-2**] as his stool output had dropped below 500 cc per day and bilirubin was back to less than 4. However, his stool output continued then increased the first week of [**Month (only) **]. PO diet was stopped and he was continued on TPN for nutrition. His symptoms continued to worsen, along with increasing of his LFTs. RUQ US was done which showed sludge in the common bile duct. ERCP was held off secondary to respiratory issues. Stools stopped once intubated (started on sedation and narcotics). On [**6-26**], in the ICU, IR placed percutaneous cholecystostomy with pigtail. . # Weakness/Cough: At presentation the outpatient oncologist was quite concerned these symptoms could indicate occult infection given the patient was less than 1 month post transplant. Culture data remained unrevealing and UA and chest radiograph were benign and and respiratory viral screen was unremarkable. When CT torso revealed colitis the patient was empirically started on ciprofloxacin/metronidazole on [**2126-5-12**] though C diff assay was negative. On [**2126-5-17**] the patient was briefly febrile and had rigors so cipro/metronidazole was discontinued and vancomycin/ pipercillin-tazobactam were started for empiric coverage of a possible enteric infection. His hickman was also changed over a wire as the cuff was noted to be protruding from the skin though culture of the tip remained negative. All cultures remained negative and vancomycin stopped on [**5-21**], pipercillin-tazobactam stopped [**5-22**]. These were briefly restarted after another fever on [**5-23**] but weaned off by [**5-26**] as once again cultures remained negative and no source of fevers were found. The patient remained afebrile thereafter, until [**2126-6-15**] when he spiked a temp and was started on cefepime and vancomycin for suspected pulmonary source. The patient's respiratory symptoms quickly progressed. A CT of the chest was performed on [**2126-6-17**] which showed bilateral infiltrates. Pulmonary was consulted for possible bronchoscopy, however the patient became more hypoxic on [**2126-6-18**] and required transfer to the [**Hospital Unit Name 153**] for monitoring. Was intubated due to hypoxia and SOB. Found to have parainfluenza on viral culture. Started on Tamiflu. Also found to have highly positive PCR in blood for adenovirus, and was started on cidofovir on [**6-21**] with pretreatement of renal protection with probenicid. Also had sputum and mini-BAL from [**6-20**] and [**6-21**] showing GNRs identified as STENOTROPHOMONAS (XANTHOMONAS) MALTOPHILIA sensitive to SMX TMP. ID followed pt and also had changed micafungin to voirconazole on transfer to [**Hospital Unit Name 153**], continued cefepime and discontinued Vancomycin. BMT decreased steriods, cellcept and cyclosporine due to infection. . # Respiratory Distress: On the evening of [**2126-5-17**] while having his hickman changed the patient developed acute shortness of breath during the procedure associated with an anxiety attack. The patient is quite claustrophobic and reacted poorly to being placed for the procedure but also developed brief hypoxia that resolved with supplementary O2. Chest radiograph from the time of the procedure showed interstitial edema and it seems likely the patient had flash pulmonary edema in the context of volume overload and being placed flat. He was gently diuresed over the ensuing two days and did well thereafter. The patient had another episode of respiratory distress on [**2126-6-17**] after being diagnosed with bilateral multifocal pneumonia. He became acutely hypoxic and was transferred to the medical ICU ([**Hospital Ward Name 332**]) as above on [**2126-6-18**]. Due to TPN and required medications patient was 21 L positive in the [**Hospital Unit Name 153**] and difficult to diuresis. Eventually required Lasix drip with pressor support. While he was able to be weaned from pressors during his ICU stay, on [**6-29**] his requirements increased and phenylepherine and vasopressin were added. On [**6-30**], his respiratory status declined and he had worsening acidosis and hypoxia. Pt gradually became bradycardic. Family was called to come to bedside. Family arrived to be with the patient in his last moments. Pt was noted to be asystolic on telemetry. Mechanical ventilation was discontinued. On exam, pt had no pupillary reflexes, breath sounds, or heart tones. Pt was pronouced dead at 4:28 AM. . # Hypotension: During ICU stay patient developed hypotension. All outpatient HTN medications were stopped. Patient was started on Levophed for support, which was transitioned over to Phenylephrine due to tachycardia. Later in his stay vasopression was added. Etiology of hypotension most likely sepsis from infections as described above. Patient was weaned off pressors but then became hypotensive and pressors were restarted. . # Acute Renal Failure: Patient developed renal failure following cidovir dose which is a known nephrotoxin. Renal ultrasound was preformed which demonstrated no obstruction. CVVHD started on [**6-25**]. Renal failure did not improve significantly throughout his ICU stay, . # Confusion: On presentation the patient's wife was concerned about mild deficites in memory and concern about his mental status. These were never particularly obvious to the treating team. Imaging of the head (CT and MRI) were benign and these deficits resolved over his first 3-4 days in the hospital so no further work up was pursued. Most likely this represented delirium in the setting of acute illness. . # Cardiac status: The patient intermittently complained of dyspnea, particularly when standing up though he had no problems with laying flat. ECG remained stable, CXR remained benign, and he was never hypoxic except as described above. Echocardiogram was also completely stable. His BB was weaned down over concern his dyspnea could have been due to difficulty augmenting his cardiac output in the context of standing with beta blockade but this wasn't particularly helpful. Ultimately, there was suspciion his shortness of breath was primarily due to deconditioning/anxiety once other pernicious etiologies were excluded. In the ICU, pt had afib with RVR, tx with amiodarone. . # Myelofibrosis s/p BMT: The patient's counts remained relatively stable throughout his hospitalization with low platelets and relatively stable anemia but no leukopenia or neutropenia. There continued to be abnormal forms in his peripheral smear presumed due to his myelophthisic process (despite this GVHD and resolution of his previous splenomegaly both suggest significant graft versus tumor effect). He was supported with transfusions and cyclosporine was continued with addition of mycophenolate and prednisone as described. . # Hematochezia: After his flexible sigmoidoscopy with biopsies the patient had hematochezia for the following two days. He remained hemodynamically stable and anemia did not worsen during his hematochezia. This stopped without further intervention. During [**Hospital Unit Name 153**] course GI continued to follow, however patient was felt unstable for flex sigmoidoscopy. . # Hypertension: The patient initially required increased nifedipine dosing in the context of his increased steroid dosing and secondary worsening of hypertension. Eventually, beta blocker was decreased due to concern of worsening his dyspnea. During [**Hospital Unit Name 153**] stay patient became hypotensive and all outpatient HTN medications were held. . # Pain: The patient has chronic low back pain secondary to degenerative joint disease. This was well controlled with PO oxycodone in the hospital. . # Prophylaxis: On presentation the patient was on voriconazole for fungal prophylaxis as there was concern fluconazole had worsened his rash. This was changed to micafungin out of concern the vori was contributing to his mental status changes. Later in [**Hospital Unit Name 153**] changed back to vori due to unclear cause of PNA. Acyclovir was briefly stopped out of concern it contributed to rash but he remained on this throughout most of his hospitalization for viral prophylaxis. He never demonstrated signs or symptoms of herpes reactivation. He remained on ursodiol for VOD prophylaxis. . # Hypernatremia: had Na up to 155 in [**Name (NI) 153**], unclear cause. Given D5W and sodium improved. . # FEN: The patient was NPO from [**Date range (1) 81564**] and supplemented with TPN. Lytes were repleted per standing scales. Medications on Admission: ACYCLOVIR 400 mg po TID CYCLOSPORINE MODIFIED 200 mg po BID FOLIC ACID 1 mg po LORAZEPAM - 0.5 - 1 mg po QHS METOPROLOL SUCCINATE 200 mg po daily NIFEDIPINE CR 60 mg po daily OXYCODONE 5 -10 mg po Q4H prn OXYCONTIN 10 mg po BID PENTAMIDINE [NEBUPENT] - (given in clinic on [**5-1**]) - 300 mg Recon Soln - 1 inh po monthly given in clinic [**5-1**] PREDNISONE 40 mg po BID RANITIDINE HCL - 150 mg po BID SULFACETAMIDE SODIUM - 10 % Drops - 2 gtts ou four times a day for 7 days for eye infection ([**2126-5-7**] - [**2126-5-14**]) URSODIOL 300 mg po BID VORICONAZOLE 200 mg po BID ZOLPIDEM - 10 mg Tablet po QHS Medications - OTC DOCUSATE SODIUM 100 mg prn MVI SENNA WHITE PETROLATUM-MINERAL OIL [DERMACERIN] - (discharge med) - Cream - apply to face as needed for for dry, flaky, or itchy skin Discharge Medications: n/a Discharge Disposition: Expired Discharge Diagnosis: Graft vs host disease, cardiorespiratory failure Discharge Condition: deceased Discharge Instructions: n/a Followup Instructions: n/a [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2437**] MD [**MD Number(1) 2438**] ICD9 Codes: 5849, 2760, 0389, 4019
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Medical Text: Admission Date: [**2199-9-20**] Discharge Date: [**2199-9-22**] Date of Birth: [**2117-3-20**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2736**] Chief Complaint: Hypotension Major Surgical or Invasive Procedure: Cardiac Catheterization History of Present Illness: The patient is an 82-year-old male with history of CAD, s/p MI in [**2187**], CHF w/ EF 10-15% who had a recent admission to [**Hospital 16843**] hospital for CHF exacerbation. He was discharged 1 week prior to this admission on [**2199-9-22**]. The patient has been complaining of shortness of breath since his last hospitalization. He reports new exertional dyspnea after walking just "10 feet" and he has [**1-13**] pillow orthopnea and needs to sleep upright on occasion. No new lower extremity swelling and he reports weight loss of 15lbs over the last 2-3 months. Has has a "constant cough" with white/green phlegm but no blood. No sick contacts. [**Name (NI) **] recent travel. By report from family patient's lasix dose was recently decreased by his home visiting nurses/CNAs due to low blood pressures. Previously had been taking 60mg [**Hospital1 **] and now was taking 40-60mg daily (unclear, patient limited historian and daughter uncertain). Patient was admitted to [**Hospital3 7571**]Hospital a week ago where he was treated for a CHF exacerbation. 2D Echo done at [**Hospital **]demonstrated an EF of 10% w/ severe global LV hypokinesis, pulmonary HTN, and severe aortic stenosis. BNP was elevated to 5,000, Troponin I of 0.05. Mr. [**Name14 (STitle) 75012**] was diuresed 1.5L but fluid removal was limited by hypotension. The [**Hospital 228**] hospital course was further complicated by acute on chronic renal failure with Cr 1.7, and by recurrent NSVT. He was started on amiodarone infusion at OSH. Impression from cardiology was for re-stenosis of stents placed in [**2199-2-9**] and he was transferred to [**Hospital1 18**] for cardiac catheterization and EP consult for discussion of possible upgrade of ICD to BivPM. . In the cath lab, RHC demonstrated CI 1.78, PCWP 28, RA pressure of 5, PAP of 34. LHC demonstrated LM w/ obstruction, LCX with proximal TO, RCA and LAD with minimal disease. Were unable to cross the LCx w/ wire. Felt to be a CTO. Post-procedure patient was hypotensive to upper 70's low 80's. Baseline BP 80-90's. Also with brief episode of chest pain post procedure (no EKG changes). Transferred to CCU for further management. . On arrival in CCU, patient was chest pain free and otherwise had complaints of mild dyspnea. No complaints of dizziness, back pain, groin pain, or leg pain. . Past Medical History: CAD with MI in [**2187**], underwent angiogram at [**Hospital1 498**] (no stent placed) ICD placement in [**2193**] at [**Hospital6 15083**] Prostate Cancer, no intervention, "slow growing" per patient HTN Nephrolithiasis Gout h/o pancreatic duct obstruction Borderline Diabetes, diet controlled Acute on Chronic Kidney Disease Social History: Social history is significant for the absence of current tobacco use. Past tobacco use over 50years ago. There is no history of alcohol abuse or drug abuse per patient. Patient is a retired firefighter and is currently still very active working with lumber. He ambulates 2 flights of stairs easily. Family History: There is no family history of premature coronary artery disease or sudden death. Father lived to be [**Age over 90 **] years old. Physical Exam: T 98.3 F, HR 103, NBP 82/62, ABP 95/61, RR 15-20, O2 sat 98 % 2L NC. Gen: Well appearing elderly man resting supine in bed, NAD, very pleasant affect HEENT: NCAT, pupils constricted, reactive b/l symmetric, Neck: supple, fully recumbent and unable to appreciate JVD. Lungs: rales at bases bilaterally L>R Heart: RRR, systolic murmur at apex, S3 noted, weak carotid upstrokes bilaterally Abd: soft, nontender and nondistended, no abdominal bruits, Ext: cold LE bilaterally, dopplerable DP/PT pulses, no LE edema, 1+ left femoral pulse, 1+ radial pulses b/l Neuro: AOx3, CN II-XII grossly intact, full strength upper and lower extremities and no focal moror or sensory deficits on exam. Skin: Warm but pale comlexion Pertinent Results: [**2199-9-20**] 08:04PM TYPE-ART PO2-132* PCO2-32* PH-7.51* TOTAL CO2-26 BASE XS-3 INTUBATED-NOT INTUBA [**2199-9-20**] 08:04PM LACTATE-2.3* [**2199-9-20**] 07:32PM GLUCOSE-158* UREA N-40* CREAT-1.4* SODIUM-140 POTASSIUM-4.3 CHLORIDE-100 TOTAL CO2-26 ANION GAP-18 [**2199-9-20**] 07:32PM estGFR-Using this [**2199-9-20**] 07:32PM ALT(SGPT)-30 AST(SGOT)-24 LD(LDH)-251* CK(CPK)-91 ALK PHOS-113 TOT BILI-0.9 [**2199-9-20**] 07:32PM CK-MB-NotDone cTropnT-0.04* proBNP-[**Numeric Identifier **]* [**2199-9-20**] 07:32PM CALCIUM-9.4 PHOSPHATE-4.8*# MAGNESIUM-2.2 [**2199-9-20**] 07:32PM WBC-8.1 RBC-4.30* HGB-13.5* HCT-39.7* MCV-92 MCH-31.4 MCHC-34.1 RDW-16.8* [**2199-9-20**] 07:32PM PLT COUNT-251# [**2199-9-20**] 07:32PM PT-22.3* PTT-62.4* INR(PT)-2.1* [**2199-9-20**] 04:36PM TYPE-ART RATES-/34 O2 FLOW-2 PO2-124* PCO2-46* PH-7.44 TOTAL CO2-32* BASE XS-6 INTUBATED-NOT INTUBA COMMENTS-NASAL [**Last Name (un) 154**] [**2199-9-20**] Admission EKGs: Several for review, baseline rhythm is Sinus with LBBB, occasional PVC's, 1st degree AV conduction delay, no ST T changes. One EKG with no discernable p-waves and atrial fibrillation . . TELEMETRY: Several runs of polymorphic NSVT on arrival to floor on [**2199-9-20**] and on [**2199-9-21**]. . [**2199-9-21**] 2D-ECHOCARDIOGRAM: The left atrium is moderately dilated. Left ventricular wall thicknesses are normal. The left ventricular cavity is mildly dilated. No masses or thrombi are seen in the left ventricle. Overall left ventricular systolic function is severely depressed (LVEF= 15-20 %) with global hypokinesis. The inferior and infero-lateral walls are thinned and akinetic. There is no ventricular septal defect. Right ventricular chamber size is normal. There is mild global right ventricular free wall hypokinesis. The aortic valve leaflets are moderately thickened. Significant aortic stenosis is present (not quantified). Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild to moderate ([**12-12**]+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. . CARDIAC CATH [**2199-9-21**]: RHC demonstrated CI 1.78, PCWP 28, RA pressure of 5, PAP of 34. LHC demonstrated LM w/ obstruction, LCX with proximal TO, RCA and LAD with minimal disease. Were unable to cross the LCX w/ wire. Felt to be a CTO. [**2199-9-21**] 04:06AM BLOOD WBC-9.2 RBC-4.36* Hgb-13.6* Hct-40.6 MCV-93 MCH-31.3 MCHC-33.6 RDW-16.0* Plt Ct-256 [**2199-9-21**] 04:06AM BLOOD Glucose-194* UreaN-45* Creat-1.9* Na-141 K-4.8 Cl-99 HCO3-29 AnGap-18 [**2199-9-21**] 04:06AM BLOOD CK-MB-162* MB Indx-22.3* cTropnT-1.47* Brief Hospital Course: In summary, the patient is an 82yo male with longstanding history of CHF with poor EF of [**9-25**]%, severe aortic stenosis and CAD who was transferred from OSH for evaluation of progression of CHF and question of in-stent re-stenosis. He underwent cardiac catheterization which showed CTO of LCX and no other acute lesions. He had complication post-procedure for hypotension and he was transferred to the CCU. . CORONARY ARTERY DISEASE /NSTEMI: The patient had a prior CABG, an MI in [**2187**] and a PCI 6 months ago at OSH. He also has advanced COPD and he has had several CHF episodes in the recent past. The patient had CTO of LCX but otherwise no obstructive disease was noted on his cardiac catheterization. He initially had no elevation in his CK level and a mild increase in his troponin which was attributed to his worsening renal function. Unfortunately, however, his CK trended up from 469 to 726 post-catheterization and MB-I went up to 22.3 from 19.8 and troponins increased from .75 to 1.47 on [**2199-9-21**]. He had some T-wave changes suggesting ischemia and a possible NSTEMI on EKG. Follow-up EKG later in the evening after admission showed left axis deviation, evidence of old inferior wall myocardial infarction with q-waves and old anteroseptal myocardial infarction. He also had marked intraventricular conduction delay and continuing ST-T wave changes which were non-specific and difficult to interpret amongst his LBBB. For NSTEMI management, hHe was continued on his ASA 325 mg daily, Plavix 75 mg, Atorvastatin 80mg daily and a heparin drip was started. He continued to have intermittent mild to moderate chest pains during his hospital stay which were relieved with low doses of IV Morphine. Beta blockers were held given the concern for cardiogenic shock and his extremely low EF. . CHF: The patient had decompensated heart failure with elevated PCWP and low CI. He had an EF of [**9-25**]% on most recent ECHO and his blood pressures began to worsen throughout his CCU stay. He entered the CCU with systolic BPs in the 80-90 range which worsened to SBP in the 70s and diastolic pressures in the mid-40s. An arterial line was placed for better monitoring of his hemodynamics and his non-invasive BP was noted to be approximately 10mmHg less then arterial measurement. He was given some gentle diuresis as tolerated by SBP and his Spironolactone was held due to his low BPs. Unfortunately, the patient continued to required increasing amounts of supplemental oxygen to maintain oxygen saturations above 90%. ECHO done (TTE) on [**2199-9-21**] showed a dilated LA and LV and severely depressed LV function (LVEF= 15 %) with global hypokinesis. The inferior and infero-lateral walls were notably thinned and akinetic and there was global right ventricular free wall hypokinesis as well. . HYPOTENSION: The patient's SBPs of 80-90s declined to the low 70s and his MAP by arterial line measure dropped into the mid-40s to low 50s range so the patient was started on a Dopamine drip. . AORTIC STENOSIS: On physical exam the patient had a prominent mid-systolic ejection murmur best heard at the right second intercostal space, with radiation into the right neck. TTE also noted severe aortic stenosis. The patient's valvular disease further contributed to Mr. [**Last Name (Titles) 75103**] poor cardiac output and worsening heart failure. . RHYTHM: The patient was in normal sinus rhythm initially but began to have multiple episodes of short NSVT, PACs and progressive tachycardia into the 160s. He had started on Amiodarone at an OSH just prior to admission but this was held in the setting of his severe hypotension. He was monitored via continuous telemetry. . RENAL FAILURE : The patient's renal dysfunction and climbing creatinine were felt to be secondary to his poor forward flow and faltering cardiac index in the setting of his advanced heart failure and overnight NSTEMI. . PULMONARY EDEMA/ RESPIRATORY DISTRESS: Mr. [**Name14 (STitle) 75012**] was hypoxic from accumulating pulmonary edema from his worsening CHF. He remained difficult to wean off of oxygen and diuresis was limited because of extreme renal failure and inability to dose large amounts of lasix in the setting of his extreme hypotension with SBPs in the 70s. Moreover, the patient had underlying risk factors for interstitial lung disease and COPD history per records which also negatively impacted his pulmonary reserve. . PRE-DIABETES: The patient was placed on sliding scale insulin for glycemic control in the setting of ACS. He had a poor appetite during his stay and was unable to take in oral food over the last day of his CCU stay prior to his death as he was in fulminant CHF with respiratory distress. . ADDITIONAL CARE / PROPHYLAXIS: -In terms of wound care, the patient was given a Duoderm for additional care of his buttock ulcer during his hospital course. A bowel regimen was given with Colace and Senna tablets and Heparin drip per ACS protocol covered the DVT prophylaxis concerns. . As the patient's clinical status rapidly declined Mr. [**Name14 (STitle) 75012**] and his family were counseled and a family meeting was held to discuss the patient's goals of care and end of life wishes. The patient expressed his desire to be DNR/DNI status and he expressed his desire to be made as comfortable as possible in the closing hours of his rapidly failing heart. The EP team was called to deactivate the patient's pacemaker and he was given IV Morphine for comfort and IV Lasix drip for additional relief of his gross fluid overloaded state and pulmonary edema. He became hypotensive and bradycardic and went into respiratory arrest. Unfortunately, the patient passed away after respiratory arrest and was pronounced on [**2199-9-22**]. Medications on Admission: - lasix 40mg daily (?60mg [**Hospital1 **]) - Potassium 10 meq [**Hospital1 **] - Metoprolol 12.5 daily - Allopurinol 300mg daily - ASA 325mg daily - Plavix 75mg daily - Fish Oil 1000mg daily - Vitamin D 1000 units daily - Spironolactone [**12-12**] pill daily - MVI daily Discharge Medications: patient deceased, pronounced on [**2199-9-22**] Discharge Disposition: Expired Discharge Diagnosis: patient deceased, pronounced on [**2199-9-22**] Discharge Condition: patient deceased, pronounced on [**2199-9-22**] Discharge Instructions: patient deceased, pronounced on [**2199-9-22**] Followup Instructions: patient deceased, pronounced on [**2199-9-22**] Completed by:[**2199-9-26**] ICD9 Codes: 4280, 5849, 5859, 2749, 496
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Medical Text: Admission Date: [**2174-5-11**] Discharge Date: [**2174-6-7**] Date of Birth: Sex: M Service: [**Last Name (un) **] HISTORY OF PRESENTING ILLNESS: Mr. [**Known lastname 174**] is a 43-year-old Caucasian gentleman who is status post liver re- transplantation for hepatitis C cirrhosis. This was complicated amongst other things by pancreatic pseudocyst development requiring surgical drainage. He was admitted with tachycardia and altered mental status with fever. PAST MEDICAL HISTORY: Remarkable for end-stage liver disease secondary to hepatitis C and alcohol-related cirrhosis. He had a failure of his first transplant with subsequent re- transplant. Liver failure was due to hepatic artery stenosis. MEDICATIONS ON ADMISSION: 1. Bactrim. 2. Epogen. 3. Ribavirin. 4. Protonix. 5. Ursodiol. 6. Interferon. 7. Olanzapine. 8. Insulin. 9. Imodium. 10. Lasix. 11. Reglan. 12. Atenolol. 13. Miconazole. 14. Tacrolimus. 15. Cortisone. He has recently been treated for hepatitis C recurrence. He also has a history of profound depression. PHYSICAL EXAMINATION: On exam, he was awake but somewhat disoriented. He had a temperature to 103 degrees, heart rate of 130, and blood pressure of 110/65. He had crackles on his chest, on the left side. Heart sounds were normal. His abdomen was soft and nondistended. His extremities were normal. LABORATORY DATA: His LFTs showed a bilirubin of 18, and he had a white cell count of 12.2. HOSPITAL COURSE: He was admitted to the intensive care unit, and an extensive workup was done, including CAT scan, ultrasound, and he was started on broad-spectrum antibiotics consisting of linezolid and Zosyn. He was kept n.p.o. on TPN, and supportive care was provided. Subsequent liver biopsy was consistent with fibrosing cholestatic hepatitis. Over the next 2 weeks, he had a progressively deteriorating course of worsening cholestasis and then proceeded to develop multiple organ failure requiring intubation and pressor support. In light of the poor prognosis of the underlying condition and after extensive discussion with the family, it was decided to withdraw support, subsequent to which the patient rapidly expired. DISCHARGE DIAGNOSES: Fibrosing cholestatic hepatitis, liver failure subsequent to liver transplant, and multiple organ failure. [**Name6 (MD) **] [**Name8 (MD) **], [**MD Number(1) 4841**] Dictated By:[**Name8 (MD) 32797**] MEDQUIST36 D: [**2174-9-27**] 14:23:28 T: [**2174-9-28**] 07:07:20 Job#: [**Job Number 45122**] ICD9 Codes: 2765, 0389
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Medical Text: Admission Date: [**2138-12-3**] Discharge Date: [**2112-2-8**] Date of Birth: [**2070-1-22**] Sex: M Service: NOTE: This is a Discharge Summary Addendum to the previous Addendum from [**2139-1-12**]. HOSPITAL COURSE CONTINUED: The patient had a question of a right middle lobe infiltrate on chest x-ray noted on [**2139-1-11**]. The patient was started on ceftazidime for presumed Medical Intensive Care Unit associated pneumonia. On [**1-12**], the patient underwent a bronchoscopy to further elucidate the question of a right middle lobe infiltrate. It was noted that there was no purulent discharge or tracheoesophageal fistula on bronchoscopy. The patient has remained clinically without pneumonia since his bronchoscopy. On [**2139-1-13**], it was decided that the patient most likely did not have pneumonia and ceftazidime was stopped. The patient had also been on vancomycin for presumed tracheal cuff cellulitis. The area around the cuff was erythematous; however, it was not warm nor was it indurated. It most likely was a result of inflammatory and/or irritative changes to the skin. The patient did not have clinical cellulitis around the tracheal pallor. The patient's vancomycin was stopped. The patient has been weaned off CPAP to a tracheal mask for durations of up to 16 hours on [**1-12**] and on [**1-13**]. The patient has been tolerating these weanings appropriately. The patient was started on Mucomyst for secretion to help decrease the thickness of his secretions. The patient was tolerating his current respiratory support well. The patient was ready for discharge to rehabilitation when rehabilitation is available. [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 98036**] Dictated By:[**Last Name (NamePattern1) 98037**] MEDQUIST36 D: [**2139-1-13**] 14:14 T: [**2139-1-13**] 14:28 JOB#: [**Job Number **] ICD9 Codes: 4280, 5119, 2851
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Medical Text: Admission Date: [**2123-10-6**] Discharge Date: [**2123-10-10**] Date of Birth: [**2123-10-6**] Sex: M Service: NB HISTORY OF PRESENT ILLNESS: Baby boy, [**Known lastname 449**] [**Last Name (NamePattern1) **] [**Known lastname **] or "[**Doctor First Name **]" as his parents call him, was [**Doctor First Name **] at 34 and 1/7 weeks and admitted to the newborn intensive care unit for issues related to prematurity. He was [**Doctor First Name **] to a 34 year old gravida 2, P1-2-3 mom with [**Name2 (NI) **] type O positive, antibody negative, hepatitis B surface antigen negative, rubella immune, RPR nonreactive, group B strep unknown. This was IUI pregnancy with twin gestation. Pregnancy was uncomplicated until mother presented in preterm labor. This baby was [**Name2 (NI) **] by vaginal delivery and had Apgars of 8 and 9 at 1 and 5 minutes. He was given blow-by oxygen and transported to the newborn intensive care unit for further management. PHYSICAL EXAMINATION: Birth weight of 1.965 kg, just under the 50th percentile; length 44.5 cm, 50th percentile; head circumference 30.5 cm, 50th percentile. On examination he was pink and well perfused, active and vigorous. His skin was clear with no rashes or birth marks. HEENT: Anterior fontanel was open and flat. Eyes were clear. Nares intact. Palate intact. Mucous membranes moist and pink. Neck supple. No masses. Clavicles intact. Chest symmetric. Clear and equal breath sounds. Comfortable respiratory pattern. CARDIOVASCULAR: Regular rate and rhythm. No murmurs. Pulses +2 and equal. ABDOMEN: No hepatosplenomegaly. Active bowel sounds. Cord clamped. GENITALIA: Normal external male genitalia with testicles descending. Patent anus. Spine smooth. Hips stable. Symmetric reflexes. SUMMARY OF HOSPITAL COURSE BY SYSTEMS: RESPIRATORY: [**Doctor First Name **] has remained in room air breathing between 30 and 40 with oxygen saturations greater than 96%. He has had no periodic breathing or evidence of apnea of prematurity to date. CARDIOVASCULAR: Apical pulse 130 to 150s. [**Doctor First Name **] pressure 53/30 with a mean of 46. He has remained hemodynamically stable. FLUIDS, ELECTROLYTES AND NUTRITION: Access was via peripheral IV. Total fluids were initiated at 80 per kg and advanced to currently at 120 per kg. He initially had IV fluids running and was euglycemic with an initial D-stick of 81. He transitioned from IV fluids to enteral feeds by day of life 2. Currently he is taking breast milk or PE-20 at 120 per kg with some breast feeding, minimal PO feeding and the rest by gavage. He has tolerated this well with no issues. He is voiding and stooling meconium. His electrolytes were followed and were noted to be in the normal range. TF increased to 140 cc/k/d this am. GASTROINTESTINAL: Bilirubin was checked at 24 hours and was 5.2/0.3. Phototherapy was started on day of life 3 for bilirubin of 9.3/0.2. Currently the baby remains under phototherapy. Bili on the morning of transfer is 7.4/0.3. HEMATOLOGY: Initial CBC upon admission revealed white [**Doctor First Name **] cell count of 19.5, with 53 polys, and 6 bands, hematocrit of 48.5% and platelet count 296,000. [**Doctor First Name **] culture was also obtained and remains sterile. The baby received 48 hours of ampicillin and gentamycin and has remained clinically well off antibiotics. NEUROLOGIC: Appropriate for gestational age. SENSORY: Hearing screen has not yet been performed on Zed. OPHTHALMOLOGY: An eye examination is not indicated at this gestational age. PSYCHOSOCIAL: Parents have been present, involved in care and mother is being discharged on [**2123-10-10**], and desires the baby to be transferred to [**Hospital3 3765**] at that time for continued care and feeding maturity. They have another small child at home and have good supports. CONDITION ON DISCHARGE: Good. DISCHARGE DISPOSITION: Level II nursery at [**Hospital3 3765**]. NAME OF PRIMARY PEDIATRICIAN: Dr. [**Last Name (STitle) 53161**] [**Name (STitle) 10351**]. CARE RECOMMENDATIONS: 1. Feedings at the time of discharge are breast feeding as tolerated, PO feedings with feeding cues at 140 ml/kg of breast milk or PE-20. 2. Medications - none at this time. CAR SEAT POSITION SCREEN: Car seat position screening has not been performed, but is recommended prior to ultimate discharge home. HEARING SCREENs have not yet been performed, but are recommeneded prior to ultimte discharge home. THE STATE NEWBORN SCREEN: The last State Newborn Screen was sent on [**2123-10-9**], and results are pending. IMMUNIZATIONS RECOMMENDED: 1. Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following three criteria. 1. [**Month (only) **] at less than 32 weeks. 2. [**Month (only) **] between 32 and 35 weeks with two of the following: 2. daycare during the RSV season. 3. a smoker in the household, neuromuscular disease, airway abnormalities, or school age siblings. 4. infants with chronic lung disease. 1. Influenza immunization is recommended annually in the Fall for all infants once they reach 6 months of age. Before this age and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out of home caregivers. DISCHARGE DIAGNOSES: 1. Prematurity at 34 and 1/7 weeks, twin No. 1. 2. Sepsis ruled out with antibiotics. 3. Physiologic jaundice. [**Known lastname 449**] [**Last Name (NamePattern1) **], [**MD Number(1) 54604**] Dictated By:[**Last Name (NamePattern1) 62536**] MEDQUIST36 D: [**2123-10-9**] 23:44:14 T: [**2123-10-10**] 00:40:47 Job#: [**Job Number 62695**] ICD9 Codes: 7742
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Medical Text: Admission Date: [**2153-12-19**] Discharge Date: [**2153-12-28**] Date of Birth: [**2084-5-16**] Sex: M Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1835**] Chief Complaint: Reason for consult: R frontal hemorrhage Major Surgical or Invasive Procedure: stereotactic R frontal mass biopsy History of Present Illness: HPI: 69 yo RH male with MS, DM, HTN, HL, s/p CABG ("quintuple") in [**2147**], defribillator placement who presents with 2 days of worsening dysarthria and L sided weakness (baseline - flaccid paralysis of LE bilaterally). Pt awoke with symptoms and with worsening function, he presented to OSH - [**Location (un) **]/[**Location (un) 1459**]. There, CT demonstrated 2x3 cm hemorrhage lesion concerning for underlying mass. pt was then transferred to [**Hospital1 18**]. Past Medical History: PAST MEDICAL HISTORY: DM, HTN, HL, CAD MS: dx 10 yrs ago by Dr. [**Last Name (STitle) 76767**] in [**Location (un) **]. has not followed up 2/2 insurance reasons. baseline wheel chair bound hx of trigeminal neuralgia on left Social History: SOCIAL HISTORY: lives with wife in [**Name (NI) **]. >10 PPD tob hx (stopped in [**2114**]). no EtOH, no IVDA. used to be attendent for handicapped individual before MS diagnosis Family History: FAMILY HISTORY: no HTN, no CA Physical Exam: EXAM VS: T 97 HR 88 BP 153/92 RR 16 Sat 95 % on 2L NC PE: General NAD HEENT AT/NC, MMM no lesions Neck Supple, no bruits Chest CTA B CVS RRR, no m/r/g ABD soft, NTND, + BS EXT no C/C/E, no rashes or petechiae NEUROLOGICAL MS: waxes/wanes with intermittent confusion most likely from decadron, cooperative, following commands. General: alert,interactive Orientation: waxes/wanes, mostly oriented to person, place, date, situation Speech/[**Doctor Last Name **]: fluent w/o paraphasic errors but with slow responses; simple and complex command-following w/o L/R confusion. Repetition, naming intact. perseverative "i don't want to talk to psychiatry" Calculations: 7 quarters = $1.75 CN: II,III: difficulty keeping eyes open, VFFTC, pupils 4-2 mm bilaterally to light, optics discs sharp and flat III,IV,V: EOMI, eyelids half mast. Normal saccades/pursuits V: sensation decreased on left VII: Facial strength decreased on left, decreased nasolabial fold VIII: hears finger rub bilaterally IX,X: voice slightly thickened, palate elevates symmetrically [**Doctor First Name 81**]: SCM/trapezeii [**5-5**] bilaterally XII: tongue protrudes midline without atrophy or fasciculation Motor: Normal bulk and tone in UE. decreased tone in LE. occasional faciculations of LE bilaterally Delt [**Hospital1 **] Tri WE FE Grip IO C5 C6 C7 C6 C7 C8/T1 T1 R 5 5 5 5 5 5 5 IP Quad Hamst DF [**Last Name (un) 938**] PF L2 L3 L4-S1 L4 L5 S1/S2 2 4- 4- 4 4 5- Reflex: [**Hospital1 **] Tri Bra Pat An Plantar C5 C7 C6 L4 S1 CST L 2 2 2 2 4+/clonus Extensor R 2 2 2 2 4+ clonus Extensor Sensation: No extinction of DSS. Coordination: Finger-nose-finger without dysmetria on R Gait: not testing Pertinent Results: Color Yellow Appear Clear SpecGr 1.020 pH 6.5 Urobil 1 Bili Neg Leuk Sm Bld Lg Nitr Neg Prot Tr Glu Neg Ket Tr RBC [**11-20**] WBC 21-50 Bact Many Yeast None Epi 0 CTA w/wo contrast [**2153-12-19**] IMPRESSION: 1. Unchanged 3-cm right frontal intraparenchymal hematoma with surrounding vasogenic edema, without evidence of feeding artery or draining veins suggestive of AVM or AVS. 2. No significant abnormality in intracranial anterior and posterior circulation. 3. Atherosclerotic disease of the bilateral carotid arteries and right vertebral artery. 4. Small left vertebral artery with no flow in V3 and V4 segment, suggestive of prior dissection or occlusion . Further evaluation by MRA or CTA of the neck is recommended on outpatient basis. 5. Extensive sinus disease with prior endoscopic surgery and sinus-nasal polyposis. IMAGING: CT brain: 1. 2.9-cm right frontal intracranial hemorrhage, likely related to underlying mass lesion with small component of subarachnoid hemorrhage. There is moderate surrounding edema and minimal mass effect. 2. Evidence of prior infarction in the left occipital lobe. 3. Moderate cranial atrophy. 4. Evidence of prior left occipital craniotomy. 5. Extensive sinonasal polyposis. CTA with contrast: Hemorrhagic mass in right high frontal lobe is unchanged in appearance - no tangle of vessels to suggest an AVM. Major vessels of COW patent. [**12-26**] IMPRESSION: No pathologic ehnacement with stable right frontal parenchymal hemorrhage and decreased right subarachnoid hemorrhage since [**2153-12-20**]. [**2153-12-28**] 06:20AM BLOOD WBC-7.6 RBC-4.19* Hgb-13.6* Hct-39.8* MCV-95 MCH-32.5* MCHC-34.2 RDW-13.6 Plt Ct-297 [**2153-12-28**] 06:20AM BLOOD WBC-7.6 RBC-4.19* Hgb-13.6* Hct-39.8* MCV-95 MCH-32.5* MCHC-34.2 RDW-13.6 Plt Ct-297 [**2153-12-28**] 06:20AM BLOOD PT-13.8* PTT-26.1 INR(PT)-1.2* [**2153-12-28**] 06:20AM BLOOD Plt Ct-297 [**2153-12-28**] 06:20AM BLOOD Glucose-116* UreaN-22* Creat-1.1 Na-142 K-3.6 Cl-108 HCO3-23 AnGap-15 [**2153-12-28**] 06:20AM BLOOD Calcium-8.8 Phos-3.2 Mg-2.0 [**2153-12-28**] 06:20AM BLOOD Carbamz-4.3 [**2153-12-28**] 06:20AM BLOOD Phenyto-9.0* Brief Hospital Course: 69 yo male with MS, HTN, DM, HL who presents with R frontal hemorrhage, with concern for underlying mass. He was admitted to the ICU for 72 hours followed with serial head CTs and CTA that did not show any source for the bleed. On [**2153-12-21**] patient underwent a R frontal mass biopsy, pathology prelimary showed reactive tissue no tumor however at this writing the pathology is not completely confirmed. Post-operatively he had slight confusion, which improved over a couple of days. On [**2153-12-28**] he is alert and oriented x 3, reports leg pain with prolonged sitting in one position. Pain is controlled when repositioned and also with oral pain meds Mr. [**Known lastname **] diet was advanced and pt tolerated diet well, he is voiding without any difficulties. His exam remains stable - his right upper extremity motor is full, [**5-5**]; he does not have any movement in left upper extremity, and no movement in bilateral lower extremities. His dysarthia is slowly improving. His staples were removed on discharge the site was clean and dry no redness. Mr. [**Known lastname 4223**] will follow up with Dr. [**Last Name (STitle) **] in two weeks. Pt and significant other agrees with plan. Medications on Admission: MEDICATIONS: metformin 1000 [**Hospital1 **] simvastatin 20 QD amiodarone 200 QD metoprolol 50 [**Hospital1 **] neurontin 300 QID tegretol 200 QID avandia 8 mg QD lisinopril 10 QD lasix 20 QD flovent 110 mcg [**Hospital1 **] Discharge Medications: 1. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 2. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO QID (4 times a day). 5. Carbamazepine 200 mg Tablet Sig: One (1) Tablet PO QID (4 times a day). 6. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation [**Hospital1 **] (2 times a day). 8. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 9. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 10. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain: Please use stool softeners as long as you use pain meds. Disp:*60 Tablet(s)* Refills:*0* 11. Albuterol Sulfate 0.083 % (0.83 mg/mL) Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed. 12. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed. 13. Phenytoin Sodium Extended 100 mg Capsule Sig: Two (2) Capsule PO BID (2 times a day). 14. Dexamethasone 1 mg Tablet Sig: Three (3) Tablet PO every eight (8) hours for 1 days: three tablests every eight hours on [**2153-12-28**]; use two tablest every eight hours [**Date range (3) 76768**]; use 1 tablet every eight hours [**2153-12-31**] - [**2154-1-1**], then stop. Disp:*18 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital1 3894**] Health VNA Discharge Diagnosis: R frontal hemorrhage Discharge Condition: neurologically stable Discharge Instructions: DISCHARGE INSTRUCTIONS FOR CRANIOTOMY/HEAD INJURY ?????? Have a family member check your incision daily for signs of infection ?????? Take your pain medicine as prescribed ?????? Exercise should be limited to walking; no lifting, straining, excessive bending ?????? You may wash your hair only after sutures and/or staples have been removed ?????? You may shower before this time with assistance and use of a shower cap ?????? Increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? Unless directed by your doctor, do not take any anti-inflammatory medicines such as Motrin, aspirin, Advil, Ibuprofen etc. ?????? If you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered ?????? Clearance to drive and return to work will be addressed at your post-operative office visit CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING: ?????? New onset of tremors or seizures ?????? Any confusion or change in mental status ?????? Any numbness, tingling, weakness in your extremities ?????? Pain or headache that is continually increasing or not relieved by pain medication ?????? Any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? Fever greater than or equal to 101?????? F Followup Instructions: PLEASE CALL [**Telephone/Fax (1) **] TO SCHEDULE AN APPOINTMENT WITH DR. [**Last Name (STitle) **] TO BE SEEN IN 2 WEEKS. YOU WILL NEED A CAT SCAN OF THE BRAIN WITH CONTRAST Completed by:[**2153-12-28**] ICD9 Codes: 431, 5990, 2724, 4019
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Medical Text: Admission Date: [**2103-10-26**] Discharge Date: [**2103-10-31**] Date of Birth: [**2054-2-20**] Sex: M Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 165**] Chief Complaint: Fatigue, palpitations Major Surgical or Invasive Procedure: [**2103-10-26**] Aortic Valve Replacement(25mm St. [**Male First Name (un) 923**] mechanical valve), with Maze Procedure and Ligation of Left Atrial Appendage History of Present Illness: This is a 49 year old gentleman with longstanding history of heart murmur who has been followed with serial echocardiograms for aortic insufficiency. Recent echocardiograms revealed that his aortic insufficiency has now become severe. He also has atrial fibrillation which he has had since [**2102-5-18**]. His symptoms include palpitations and fatigue. Past Medical History: Aortic insufficiency Atrial fibrillation Non-ischemic cardiomyopathy Hypertension Hyperlipidemia s/p Right wrist surgery following MVA 30 yrs. ago Social History: Last Dental Exam: 2 years ago Lives with: alone Occupation: manufacturing- industrial floors and plastics Cigarettes: Smoked no [X] yes [] Hx: Other Tobacco use: ETOH: < 1 drink/week [] [**12-25**] drinks/week [] >8 drinks/week [X] 30 pack of beer per week Illicit drug use: Denies Family History: Denies premature coronary artery disease. Father died at 69 with renal failure and hypertension. Mother died at 69 with Rheumatoid Arthritis Physical Exam: General: NAD, anxious, slightly slow to respond Skin: Dry [X] intact [X] numerous tattoos HEENT: PERRLA [] EOMI [X] left round and reactive, right is sluggish Neck: Supple [X] Full ROM [X] Chest: Lungs clear bilaterally [X] Heart: RRR [] Irregular [X] Murmur [] grade - not appreciated Abdomen: Soft [X] non-distended [X] non-tender [X] bowel sounds + [X] Extremities: Warm [X], well-perfused [X] Edema/Varicosities: None Neuro: Grossly intact [X] Pulses: Femoral Right: 2+ Left:2+ DP Right: 2+ Left:2+ PT [**Name (NI) 167**]: 2+ Left:2+ Radial Right: 2+ Left:2+ Carotid Bruit: none Pertinent Results: [**2103-10-26**] Intraop TEE PRE-CPB: 1. The left atrium is moderately dilated. The left atrial appendage emptying velocity is depressed (<0.2m/s). No thrombus is seen in the left atrial appendage. 2. No atrial septal defect is seen by 2D or color Doppler. 3. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity is mildly dilated. Overall left ventricular systolic function is moderately depressed (LVEF= 30 %). 4. Right ventricular chamber size and free wall motion are normal. 5. The aortic root is mildly dilated at the sinus level. The ascending aorta is mildly dilated. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. 6. There are three aortic valve leaflets. The aortic valve leaflets are moderately thickened. There is a possible vegetation on the RCC. There is no valvular aortic stenosis. The increased transaortic velocity is likely related to high cardiac output. Moderate to severe (3+) aortic regurgitation is seen. 7. Mild (1+) mitral regurgitation is seen. POST-CPB: On infusion of epi, phenylephrine. AV pacing for sinus bradycardia. Well-seated mechanical valve in the aortic position with trivial paravalvular leak, most likely representing suture gaps and most of which resolving post protamine dose. Preserved biventricular systolic function on inotropic support. LVEF is now 40%. MR remains 1+. Aortic contour is normal post decannulation. [**2103-10-31**] 05:38 Hematocrit 27.3* 40 - 52 % [**2103-10-31**] 05:38 PT/INR: 27.7*1 2.7* [**2103-10-30**] 06:56AM BLOOD WBC-8.3 RBC-3.02* Hgb-9.5* Hct-28.2* MCV-93 MCH-31.7 MCHC-33.9 RDW-15.1 Plt Ct-164# [**2103-10-29**] 05:15AM BLOOD WBC-8.9 RBC-2.93*# Hgb-9.3*# Hct-27.0* MCV-92 MCH-31.8 MCHC-34.6 RDW-15.2 Plt Ct-91* [**2103-10-28**] 06:10AM BLOOD WBC-7.6 RBC-2.31* Hgb-7.3* Hct-21.9* MCV-95 MCH-31.5 MCHC-33.2 RDW-14.5 Plt Ct-61* [**2103-10-30**] 08:40AM BLOOD PT-19.7* PTT-63.5* INR(PT)-1.9* [**2103-10-30**] 06:56AM BLOOD PT-19.8* PTT-61.9* INR(PT)-1.9* [**2103-10-29**] 05:15AM BLOOD PT-16.7* INR(PT)-1.6* [**2103-10-28**] 06:10AM BLOOD PT-18.0* INR(PT)-1.7* [**2103-10-27**] 01:10AM BLOOD PT-14.6* PTT-31.1 INR(PT)-1.4* [**2103-10-26**] 01:11PM BLOOD PT-14.5* PTT-32.8 INR(PT)-1.4* [**2103-10-26**] 12:03PM BLOOD PT-18.6* PTT-32.2 INR(PT)-1.8* Brief Hospital Course: Mr. [**Known lastname 10010**] was admitted and underwent a mechanical aortic valve replacement along with Maze procedure and ligation of left atrial appendage. For surgical details, please see operative note. Following the operation, he was brought to the CVICU for invasive monitoring. Within 24 hours, he awoke neurologically intact and was extubated without incident. He maintained stable hemodynamics and transferred to the SDU on postoperative day one. He was transfused with packed red blood cells to maintain hematocrit near 30%. Chest tubes and pacing wires were removed per protocol without complication. Warfarin anticoagulation was started for mechanical aortic valve replacement and atrial fibrillation. Warfrin was dosed daily and titrated for goal INR between 2.5 to 3.5. He went into a rapid atrial fibrillation to the 160's on POD3. His Lopressor was increased, boluses with Amiodarone and placed on a drip. Lisinopril was added for hypertension management. His rhythm at the time of discharge was his basline afib. He did have some minimal sternal drainage but WBC was normal and he was afebrile so no antibiotics were started. Prior to discharge, arrangements were made with [**Hospital1 **] [**Hospital 197**] Clinic to monitor his PT/INR as an outpatient. Again, his goal INR is between 2.5 to 3.5. (Fax [**Telephone/Fax (1) 91209**]On POD #5 his INR was therapuetic, he was ambulating without difficulty, tolerating a full oral diet and his incision was drainging very scant amounts of old bloody drainage. He was discharged home with VNA services and all follow up arrangements were arranged. Medications on Admission: ATENOLOL 100 mg once a day DIGOXIN 125 mcg once a day DILTIAZEM HCL 120 mg once a day FUROSEMIDE 40 mg once a day LISINOPRIL 20 mg once a day SIMVASTATIN 20 mg once a day bedtime ASPIRIN 325 mg once a day Discharge Medications: 1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 4. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 5. simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*2* 6. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 2 weeks. Disp:*28 Tablet(s)* Refills:*0* 7. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*65 Tablet(s)* Refills:*0* 8. amiodarone 200 mg Tablet Sig: Two (2) Tablet PO once a day: take 400mg for 7 days then change to 200mg daily until advised to stop. Disp:*60 Tablet(s)* Refills:*2* 9. lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 10. furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 7 days. Disp:*7 Tablet(s)* Refills:*0* 11. potassium chloride 10 mEq Tablet Extended Release Sig: Two (2) Tablet Extended Release PO DAILY (Daily) for 7 days. Disp:*14 Tablet Extended Release(s)* Refills:*0* 12. metoprolol tartrate 25 mg Tablet Sig: Three (3) Tablet PO TID (3 times a day). Disp:*270 Tablet(s)* Refills:*2* 13. warfarin 2 mg Tablet Sig: Two (2) Tablet PO once a day: dose based on INR goal 2.5-3.5. Disp:*60 Tablet(s)* Refills:*2* 14. Outpatient Lab Work Labs: PT/INR for Coumadin ?????? indication Mechanical AVR Goal INR 2.5-3.5 First draw [**2103-11-1**] Results to [**Hospital3 **] [**Hospital 197**] Clinic Fax [**Telephone/Fax (1) 91209**] Discharge Disposition: Home With Service Facility: [**Company 1519**] Discharge Diagnosis: Aortic Insufficiency Atrial Fibrillation Non-ischemic Cardiomyopathy Hypertension Dyslipidemia Discharge Condition: Alert and oriented x3 nonfocal Ambulating with steady gait Incisional pain managed with Percocet Incisions: Sternal - healing well, no erythema and scant bloody drainage Edema trace Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. Look at your incisions daily for redness or drainage Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Followup Instructions: You are scheduled for the following appointments Surgeon: Dr. [**First Name (STitle) **] on [**2102-12-4**] at 1:00 PM in the [**Hospital **] medical office building , [**Doctor First Name **] [**Hospital Unit Name **] Cardiologist: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] on [**2102-12-3**] at 2:00 PM Please call to schedule appointments with your Primary Care Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 3373**] in [**2-20**] weeks **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Labs: PT/INR for Coumadin ?????? indication Mechanical AVR Goal INR 2.5-3.5 First draw [**2103-11-1**] Results to [**Hospital3 **] [**Hospital 197**] Clinic Fax [**Telephone/Fax (1) 91209**] [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2103-11-2**] ICD9 Codes: 4241, 4254, 4019, 2724
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Medical Text: Admission Date: [**2169-9-25**] Discharge Date: [**2169-9-28**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2901**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: none History of Present Illness: 88 year old female with questioned history of renal artery stenosis and hypertension, presents with shortness of breath. The patient went to the bathroom this morning and felt short of breath. It seemed to improve with rest, but then occurred again soon after, and she called 911. She denies any chest pain or pressure, dizziness, or changes in vision during that time. In the ED her blood pressure was found to be 206/107, HR of 120, with O2Sa of 88% on RA. She was placed on Bipap with good results. Lasix 80mg IV was given, morphine 2mg x2 and a nitro drip was started. There were questioned ST depressions in V4-V6; cardiology was consulted and believed they were rate related changes. Troponin was 0.05 and CK-MB of 3. . Patient was brought to the CCU with a BP of 135/57 and O2Sa of 97% on 4L NC. In the CCU, patient stated much improved shortness of breath and denied chest pain. She had no vision changes or lightheadedness. She denies any recent changes in her medications, has been taking them as prescribed except for her clonidine patch which she has not had since Thursday [**2169-9-21**] but has supplemented with clonidine PO. Denies recent change in her diet. She denies nausea, vomiting, change in appetite, fevers, chills, or dysuria. . Patient was admitted in [**Month (only) **] at [**Hospital1 2025**] for similar symptoms. Patient had very elevated BP while at a physicians office, became dyspnic and was admitted to the ICU with flash pulmonary edema. She was intubated for 2 days during that stay. Patient also has history of renal artery stenosis diagnosed approximately one year ago, although ultrasound done in [**Month (only) **] did not show any evidence of stenosis. . Cardiac review of systems is notable for absence of chest pain, paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. Patient does have baseline level of edema on her lower extremities R>L, and there has been no change recently. Past Medical History: PAST MEDICAL HISTORY: 1. CARDIAC RISK FACTORS: Hypertension 2. CARDIAC HISTORY: No history of MI 3. OTHER PAST MEDICAL HISTORY: Hypertension (up to SBP211 on clinic visit on CRI (baseline 1.5-1.7) ?Renal Artery Stenosis (L 60-90%) Hypothyroidism, s/p thyroidectomy Hip dislocation as child with subsquent growth defect in effected leg Thrombocytosis Admission in [**2169-8-1**] at [**Hospital1 2025**] for hypertensive urgency with pulmonary edema and respiratory distress requiring intubation Social History: Occupation: Retired Drugs: na Tobacco: distant history Alcohol: na Other: Lives in [**Location **], manages all ADLs, retired secretary, widowed. Family History: No known family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. Physical Exam: GENERAL: WDWN ** in NAD. Oriented x3. Mood, affect appropriate. HEENT: Sclera anicteric. PERRL, EOMI. No evidence of flame hemorrhage. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of 10 cm. Right external jugular vein line CARDIAC: PMI located in 5th intercostal space, lateral clavicular line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: Resp were unlabored, no accessory muscle use. Diffuse wheezes with rales at the bases. Decreased breath sounds particularly at the bases bilaterally. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: 1+ pedal on the left, 2+ on the right. Left leg shorter than the right. No femoral bruits. SKIN: Some mild erythematous change on the right shin, no change per patient PULSES: Right: Carotid 2+ Femoral 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ DP 2+ PT 2+ Neuro: CNII-XII intact, stregnth equal bilaterally, no gross sensory deficits Pertinent Results: [**2169-9-25**] 09:30AM BLOOD WBC-13.9* RBC-3.15* Hgb-8.7* Hct-28.1* MCV-89 MCH-27.8 MCHC-31.1 RDW-17.8* Plt Ct-417 [**2169-9-26**] 02:14AM BLOOD WBC-6.7# RBC-2.94* Hgb-8.3* Hct-25.3* MCV-86 MCH-28.1 MCHC-32.7 RDW-17.8* Plt Ct-323 [**2169-9-27**] 06:15AM BLOOD WBC-5.4 RBC-2.82* Hgb-8.1* Hct-24.3* MCV-86 MCH-28.8 MCHC-33.4 RDW-17.3* Plt Ct-301 [**2169-9-28**] 06:45AM BLOOD WBC-3.8* RBC-2.53* Hgb-7.1* Hct-21.9* MCV-86 MCH-28.1 MCHC-32.5 RDW-17.4* Plt Ct-364 . [**2169-9-25**] 09:30AM BLOOD Neuts-84.9* Lymphs-7.3* Monos-6.8 Eos-0.4 Baso-0.6 [**2169-9-26**] 12:50PM BLOOD Hypochr-NORMAL Anisocy-1+ Poiklo-NORMAL Macrocy-NORMAL Microcy-NORMAL Polychr-OCCASIONAL . [**2169-9-25**] 09:30AM BLOOD PT-11.9 PTT-22.2 INR(PT)-1.0 [**2169-9-26**] 12:20PM BLOOD Fibrino-613* [**2169-9-26**] 12:50PM BLOOD Ret Aut-2.4 . [**2169-9-25**] 09:30AM BLOOD Glucose-267* UreaN-58* Creat-1.8* Na-135 K-6.6* Cl-96 HCO3-27 AnGap-19 [**2169-9-25**] 04:38PM BLOOD Glucose-109* UreaN-60* Creat-2.1* Na-139 K-5.3* Cl-98 HCO3-30 AnGap-16 [**2169-9-26**] 02:14AM BLOOD Glucose-101* UreaN-61* Creat-2.0* Na-139 K-4.4 Cl-97 HCO3-29 AnGap-17 [**2169-9-27**] 06:15AM BLOOD Glucose-95 UreaN-65* Creat-1.7* Na-138 K-4.1 Cl-98 HCO3-33* AnGap-11 [**2169-9-28**] 06:45AM BLOOD Glucose-96 UreaN-72* Creat-1.9* Na-139 K-4.3 Cl-100 HCO3-33* AnGap-10 . [**2169-9-25**] 04:38PM BLOOD CK(CPK)-99 [**2169-9-26**] 02:14AM BLOOD CK(CPK)-95 [**2169-9-25**] 09:30AM BLOOD CK-MB-3 proBNP-[**Numeric Identifier 19353**]* [**2169-9-25**] 09:30AM BLOOD cTropnT-0.05* [**2169-9-25**] 04:38PM BLOOD CK-MB-5 cTropnT-0.10* [**2169-9-26**] 02:14AM BLOOD CK-MB-4 cTropnT-0.06* . [**2169-9-25**] 09:30AM BLOOD Calcium-8.0* Phos-6.0* Mg-2.7* [**2169-9-25**] 04:38PM BLOOD Calcium-8.4 Phos-5.1* Mg-2.7* [**2169-9-26**] 02:14AM BLOOD Calcium-8.3* Phos-5.3* Mg-2.6 [**2169-9-26**] 12:20PM BLOOD Iron-13* [**2169-9-27**] 06:15AM BLOOD Calcium-8.1* Phos-4.6* Mg-2.6 [**2169-9-28**] 06:45AM BLOOD Calcium-7.6* Phos-4.6* Mg-2.5 . [**2169-9-26**] 12:20PM BLOOD calTIBC-230* Hapto-154 Ferritn-135 TRF-177* [**2169-9-25**] 09:30AM BLOOD %HbA1c-6.3* eAG-134* . [**2169-9-25**] 09:30AM BLOOD TSH-0.77 [**2169-9-25**] 09:56AM BLOOD Glucose-254* K-4.8 . [**2169-9-25**] 1:35 pm MRSA SCREEN Source: Nasal swab. **FINAL REPORT [**2169-9-28**]** MRSA SCREEN (Final [**2169-9-28**]): No MRSA isolated. . [**2169-9-25**] 08:15AM URINE RBC-[**4-14**]* WBC-0-2 Bacteri-0 Yeast-NONE Epi-0-2 TransE-0-2 [**2169-9-25**] 08:15AM URINE Blood-TR Nitrite-NEG Protein-25 Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-8.0 Leuks-NEG [**2169-9-25**] 08:15AM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.009 . ECG [**9-25**] 0739 Sinus tachycardia. Left atrial abnormality. Left ventricular hypertrophy. Non-specific QRS widening and diffuse non-diagnostic repolarization abnormalities. No previous tracing available for comparison. TRACING #1 Read by: [**Last Name (LF) **],[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 975**] Intervals Axes Rate PR QRS QT/QTc P QRS T 131 118 112 296/420 74 0 116 . ECG [**9-25**] 1300 Sinus rhythm. Compared to the previous tracing deep T wave inversion in the anterior precordial leads is now present. Heart rate is now reduced. TRACING #3 Read by: [**Last Name (LF) **],[**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 975**] Intervals Axes Rate PR QRS QT/QTc P QRS T 73 148 108 426/448 48 -3 5 . Chest Xray [**9-26**] 0745 AP UPRIGHT RADIOGRAPH OF THE CHEST: There has been marked interval improvement in the parenchymal aeration suggesting improving pulmonary edema. There is mild residual, right greater than left. Retrocardiac consolidation is either atelectasis or pneumonia. There are small bilateral pleural effusions. Marked kyphoscoliosis of the thoracolumbar spine and related DJD is noted. There is a moderate-sized cardiac enlargement with dense atherosclerotic aortic calcifications. Surgical clips are seen in the neck. IMPRESSION: 1. Improving parenchymal aeration with mild residual pulmonary edema and small bilateral pleural effusions. 2. LLL atelectasis and/or pneumonia. Brief Hospital Course: #Hypertensive Urgency: Patient had similar episode in [**Month (only) **] or [**Month (only) 205**] with hypertensive urgency and flash pulmonary edema, but little support for RAS. Likely similar etiology to current shortness of breath and pulmonary edema. BP responded quickly to nitro drip. Will maintain blood pressure at 140s, as patient's baseline is in 170s and if decreased too quickly may get decreased perfusion. Patient shows no obvious end organ damage of the hypertension. No change in mental status, no vision changes or neurologic deficits, creatinine close to baseline. Patient has history of hypertension with evidence of LVH. Likely etiology of exacerbation of essential hypertension appears to be transition from clonidine patch to po. Unknown if PO dose was adequate or if pt was taking medication properly. Possible rebound hypertension in setting of inappropriate clonidine dosing. No recent change in diet. Pt has a questionable history of renal artery stenosis per OSH records, however ultrasound in [**Month (only) **] was negative and per nephrologist, he does not believe she has RAS. Given conflicting record, would prefer not to start an ACEi. TSH was normal. BPs well controlled morning after admission with home medication regimen, no longer requiring nitro gtt. She was started on Amlodipine, metoprolol succinate, and continued on the clonidine patch. Hydralazine was discontinued for lack of ease of administration. . #Pulmonary Edema: Acute elevation of BP decreasing forward flow, likely caused flash pulmonary edema; similar to previous episode in [**Month (only) **]. Denies chest pain, cardiac enzymes negative (troponin minimally elevated in setting of CRI), perfusion scan on [**2169-8-7**] was normal. Does have some EKG changes possibly suggestive of ischemia, although more likely related to LV strain. Symptoms of SOB have improved and patient appears less volume overloaded than on admission after over 2L negative. O2Sa stable on 3L NC. CXR questioned possible pneumonia in right lobe on [**2169-9-25**], but afebrile and no history of cough, leukocytosis has resolved. CXR this morning does not show opacity in RUL and improved vascular congestion. Clinical picture appears to coincide with pulmonary edema secondary CHF and proBNP elevated to [**Numeric Identifier 19353**]; however, will monitor for signs of infection. No further diuresis will be done today as patient had good response yesterday, is a petite women, and will begin to mobilize fluid into her vasculature. . # CRI - Baseline creatinine of 1.5-1.7. Mildly elevated to 1.8 upon admission and up to 2.1 today. Will continue to monitor and should improve with improved forward flow. Also has proteinuria on UA. Could be secondary to hypertensive nephropathy, HbA1c at 6.3%. Pt will follow with her outpatient nephrologist who was contact[**Name (NI) **] during her admission. . # Anemia - Patient has baseline Hct in high 20s, however did decrease to 23.8 this AM. No obvious source of bleeding, guiac negative, no abdominal complaints, no hematuria. Patient had similar decrease in Hct during previous admission for similar episode. [**Month (only) 116**] be secondary to dilution as increase mobilization of fluid into vasculature. Microangiopathic hemolytic anemia can be seen with hypertensive urgency, however less likely. Anemia will be followed as outpatient by heme. . #Hypothyroidism: If over treated with medication, could cause hypertensive urgency. Will continue current synthroid dose. TSH normal. . # Thrombocytosis - has been treated with anagrelide. Will continue anagrelide . #Diabetes Mellitus: questioned history of DM with previous HbA1c at 7, it is 6.5% here. Monitor as an outpatient. Medications on Admission: Metoprolol 75mg PO BID Vit D 800 daily Hydralazine 10mg PO QID Anagrelide 1mg PO BID Clonidine Patch 0.3mg/24hrs transdermal qweek Lasix 20mg daily Synthroid 88mcg daily Metronidazole cream. 0.75% [**Hospital1 **] to affected area Discharge Medications: 1. Clonidine 0.3 mg/24 hr Patch Weekly Sig: One (1) Patch Weekly Transdermal QMON (every Monday). Disp:*4 Patch Weekly(s)* Refills:*2* 2. Outpatient Lab Work Please check chem 7 and CBC on [**2169-10-2**] and call results to [**First Name8 (NamePattern2) 717**] [**Last Name (NamePattern1) **] or Dr. [**Last Name (STitle) 19354**] at [**Telephone/Fax (1) 19355**] 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 4. Senna 8.6 mg Tablet Sig: One (1) Tablet PO HS (at bedtime): Hold for loose stools. 5. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 6. Levothyroxine 88 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Metoprolol Succinate 200 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*2* 8. Ferrous Sulfate 300 mg (60 mg Iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 9. Amlodipine 10 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 10. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day. 11. Vitamin D-3 400 unit Tablet Sig: Two (2) Tablet PO once a day. 12. Metronidazole 0.75 % Cream Sig: One (1) application Topical as directed. 13. Anagrelide 1 mg Capsule Sig: One (1) Capsule PO twice a day: Please check with the previously prescipbing physician for [**Name Initial (PRE) **] refill. Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: Hypertensive urgency Flash Pulmonary Edema Chronic Renal Insufficiency Anemia Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You had another episode of hypertensive urgency that led to fluid backing up into your lungs. We think this is because you had trouble with your medicines at home. We have now simplified your medicine regimin after talking with Dr. [**Last Name (STitle) 19356**]. Medication changes: 1. Stop taking Hydralazine 2. start taking Amlodipine (Norvasc) to treat your high blood pressure 3. Continue taking your clonidine patch, you have a new prescription for this. 4. Increase the Metoprolol to 200 mg once a day (NOT twice a day) 5. Start taking Iron (ferrous sulfate) to treat your anemia with colace to prevent constipation 6. The visiting nurses can check labs on [**10-3**] so that [**First Name8 (NamePattern2) 717**] [**Last Name (NamePattern1) **] NP has the information when she sees you on [**10-4**]. 7. Start aspirin daily (take chewable baby aspirin) . Weigh yourself every morning, call Dr. [**Last Name (STitle) 19354**] if weight goes up more than 3 lbs in 1 day or 6 pounds in 3 days. Followup Instructions: Name: NP[**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] Location: [**Hospital3 **] [**Hospital3 **] Address: [**Age over 90 19357**], [**Location (un) **],[**Numeric Identifier 19358**] Phone: [**Telephone/Fax (1) 19355**] Appointment: Wednesday [**2169-10-4**] 11:20am We are working on a follow up appointment in Nephrology with Dr. [**First Name8 (NamePattern2) 1692**] [**Last Name (NamePattern1) 19356**] within 16-30 days. The office will contact you at home with an appointment. If you have not heard or have any questions please call [**Telephone/Fax (1) 10574**]. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2908**] MD, [**MD Number(3) 2909**] ICD9 Codes: 5859, 4280
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Medical Text: Admission Date: [**2177-4-2**] Discharge Date: [**2177-4-7**] Service: CCU HISTORY OF PRESENT ILLNESS: This is an 81-year-old woman with a history of AFib that has been difficult to rate control, who is scheduled for elective pacemaker placement and AVJ ablation on day of admission. After completion of pacemaker placement, patient's blood pressure dropped to 50/palpable. Volume resuscitation was begun and echocardiogram showed a large effusion with tamponade. Emergent pericardiocentesis was 300 cc of frank blood and improved blood pressure. Blood pressure decreased again and another 400 cc blood was pulled off. Pacing wire was repositioned successfully in the right ventricle and pacer was set at DDD at 90. PAST MEDICAL HISTORY: 1. Hypertension. 2. Hypothyroidism. 3. Hypercholesterolemia. 4. Atrial fibrillation. 5. Atrial flutter. 6. Status post right atrial isthmus ablation in summer of [**2175**]. Was on amiodarone, but discontinued secondary to nausea and headache. Status post several admissions with AFib with RVR with rates in the 160s. Referred for pacer and AVJ ablation. Stress echocardiogram in [**2175-4-17**] showed an ejection fraction of 65%, mild AS and AI, mild MR [**First Name (Titles) **] [**Last Name (Titles) **]. ALLERGIES: Amiodarone causes headache and nausea. MEDICATIONS ON ADMISSION: 1. Atenolol 25 b.i.d. 2. Univasc 15 mg q.d. 3. Lescol 80 mg p.o. q.d. 4. Cartia 120 mg p.o. b.i.d. 5. Coumadin. 6. Levoxyl 75 mg p.o. q.d. 7. Vitamin E. 8. Vitamin C. 9. Calcium. 10. Magnesium citrate. 11. Calcium citrate. FAMILY HISTORY: Negative for diabetes and otherwise noncontributory. SOCIAL HISTORY: Denies drugs, tobacco, and alcohol. Lives in [**Location **] with friend. PHYSICAL EXAM ON ADMISSION: Temperature 97.3, blood pressure 120/59, heart rate 90, respiratory rate 16, and sats 100% on room air. Height is 5'5.5", weight 128 pounds. HEENT was moist mucous membranes. Clear oropharynx. Neck was supple. Jugular venous pressure is 6 cm. Cardiovascularly: S1, S2 with a 2/6 systolic ejection murmur at the right upper sternal border, and pericardial drain that was clean, dry, and intact. Lungs were clear to auscultation bilaterally. Abdomen was soft, nontender, and nondistended, positive bowel sounds. Extremities: No cyanosis, clubbing, or edema. Neurologic examination: Awake, alert, and oriented times three. Cranial nerves II through XII are grossly intact. Intact strength and motor function, normal sensation. Skin: No rashes or lesions. LABORATORIES ON ADMISSION: White count 16.1, hematocrit 30.4, platelets 222. Potassium 4.2, creatinine 0.7, INR 1.3, PTT 25.1. Echocardiogram at 11:18 on day of admission showed moderate-to-large sized pericardial effusion with RV diastolic collapse. This is impaired filling and tamponade physiology. At 11:21 a.m. status post pericardiocentesis, just trivial physiologic pericardial effusion. HOSPITAL COURSE: This was an 81-year-old woman with a history of atrial fibrillation, atrial flutter, status post right atrial isthmus ablation in the summer of [**2175**] admitted for pacer placement. Procedure complicated by RV perforation requiring pericardiocentesis with removal of 700 cc of blood. 1. Hemorrhagic pericardial effusion with tamponade: Patient's drain output continued to decline and patient's drain was eventually removed with good results. Patient remained hemodynamically stable. She got 2 units of packed red blood cells in the Cath Lab, but was otherwise stable. Patient had follow-up echocardiogram with no recurrence of the effusion even after Coumadin was removed. Plans were to stay off Coumadin for at least one month secondary to this bleed. Otherwise, patient was started on Ancef 1 gram q.8 initially and then titrated off. 2. Atrial fibrillation: Patient continued to have episodes of tachycardia. Patient was continued on her outpatient regimen eventually and titrated up as tolerated. Patient's diltiazem dose was titrated up to 180 b.i.d. at time of discharge. Her atenolol at her home b.i.d. dose regimen was titrated up to 50 mg b.i.d. Patient was started on aspirin to which she is to continue especially while she is off Coumadin. Otherwise, patient was doing well and was planned for EP study as an outpatient. Patient will follow up with [**Hospital **] Clinic, on [**4-9**] for Device Clinic and then will return on [**4-29**] for AVJ ablation. 3. Pneumothorax: Patient had a small pneumothorax after her pacer placement. Leads were in place and pneumothorax had resolved by the time of dischar ge on follow-up chest x-ray. 3. Hypothyroidism: The patient was continued on her home dose of Levoxyl. Patient's TSH was elevated, but her free T4 was in the normal range, and this was likely secondary to subacute hypothyroid picture. No changes were made during this acute setting. DISCHARGE DIAGNOSES: 1. Right ventricle perforation. 2. Atrial fibrillation. 3. Atrial flutter. 4. Hypertension. 5. Hypothyroidism. 6. Pericardial effusion and tamponade. 7. Pneumothorax. DISCHARGE MEDICATIONS: 1. Aspirin 325 mg p.o. once a day. 2. Atenolol 50 mg p.o. b.i.d. 3. Diltiazem extended release 180 mg p.o. b.i.d. 4. Ascorbic acid 500 mg p.o. b.i.d. 5. Vitamin E 400 units p.o. q.d. 6. Levothyroxine 75 mcg p.o. q.d. DISCHARGE CONDITION: Good. Patient is ambulating without difficulty. Chest pain free at present, no oxygen requirement. DISCHARGE STATUS: Discharged to home with followup. FOLLOW-UP INSTRUCTIONS: The patient is to see her PCP [**Last Name (NamePattern4) **] [**1-17**] weeks. Patient is to followup in Device Clinic on [**4-9**] at 9:30 and then for return on [**2177-4-29**] for an AVJ ablation. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 8227**] Dictated By:[**Name8 (MD) 264**] MEDQUIST36 D: [**2177-4-7**] 13:50 T: [**2177-4-8**] 08:58 JOB#: [**Job Number 26913**] ICD9 Codes: 9971, 4019, 2449, 2720
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Medical Text: Admission Date: [**2120-12-11**] Discharge Date: [**2120-12-17**] Date of Birth: [**2045-6-11**] Sex: F Service: CARDIOTHOR HISTORY OF THE PRESENT ILLNESS: This is a 75-year-old Portuguese-speaking female with known history of aortic stenosis seen by the primary care practitioner [**First Name (Titles) **] [**Last Name (Titles) 37566**]. TTE was consistent with critical aortic stenosis. The patient denies angina, TIAs, syncope, or claudication. There is no history of orthopnea, paroxysmal nocturnal dyspnea, or lower extremity edema. Cardiac catheterization revealed critical aortic stenosis with atrial valve area of .4-cm squared and mild three-vessel coronary artery disease. PAST MEDICAL HISTORY: 1. Hypertension. 2. Hyperlipidemia. 3. Hiatal hernia. ALLERGIES: The patient is allergic to FLU SHOTS. PHYSICAL EXAMINATION: Examination revealed the patient to be afebrile, vital signs were stable. LUNGS: Lungs were clear. HEART: Regular rate and rhythm, 3/6 systolic murmur. ABDOMEN: Soft, nontender, nondistended. EXTREMITIES: No edema; palpable pulses. SUMMARY OF HOSPITAL COURSE: The patient was brought to the operating room on [**2120-12-12**]. The procedure performed was an AVR and CABG times three. A 19-mm pericardial CE valve was placed. The saphenous vein graft went to LAD, PDA, and OM. CVP was 189 minutes, XCL 150 minutes. The pericardium was left open. A Swan-Ganz catheter was placed. Two atrial and ventricular wires along with two mediastinal and one pleural tube were also placed. The patient had an episode of ventricular fibrillation coming off pump and, therefore, an amioardone drip was started. In the ICU the patient was rapidly extubated and the Levo drip was weaned. On postoperative day #1 the patient was observed in the ICU and stable. On postoperative day #2, she was transferred to the floor. On postoperative day #3, due to a low hematocrit, two units of packed red blood cells were given. She also had a run of atrial fibrillation on postoperative day #3 for which she was started on oral Amiodarone. Due to a low output from the pleural and mediastinal tubes, they were removed. On postoperative day #4, the patient was tolerating p.o. diet well. The Foley catheter was removed. On postoperative day #5, the patient was stable for discharge to rehabilitation. Wires were also removed. LABS ON DISCHARGE: Laboratory data revealed the following: White count 176, hematocrit 28.7, platelet count 172,000, sodium 139, potassium 4.6, chloride 105, bicarbonate 27, BUN 20, creatinine .8, glucose 103, calcium 1.11, magnesium 2.0, and phosphorus 3.1. CONDITION ON DISCHARGE: Stable. DISCHARGE MEDICATIONS: 1. Lasix 20 mg b.i.d. times seven days. 2. [**First Name5 (NamePattern1) 233**] [**Last Name (NamePattern1) 1002**] 20 mg b.i.d. times seven days. 3. Enteric coated Aspirin 325 mg q.d. 4. Captopril 50 mg t.i.d. 5. Lipitor 10 mg q.d. 6. Lopressor 25 mg b.i.d. 7. Amiodarone 400 mg t.i.d. times two days; 400 mg b.i.d. times seven days; 400 mg q.d. times 14 days. 8. Percocet one to two tablets, q. 4 to 6h.p.r.n. 9. Colace 100 mg b.i.d. DISCHARGE STATUS: The patient is discharged to a rehabilitation facility. FOLLOW-UP CARE: The patient will follow up with the primary care provider or cardiologist in three weeks. The patient will followup with Dr. [**Last Name (STitle) 1537**] in four weeks. DIAGNOSIS: Status post coronary artery bypass graft times three/AVR. [**First Name11 (Name Pattern1) 275**] [**Last Name (NamePattern4) 1539**], M.D. [**MD Number(1) 1540**] Dictated By:[**Name8 (MD) 1308**] MEDQUIST36 D: [**2120-12-17**] 10:13 T: [**2120-12-17**] 10:16 JOB#: [**Job Number 37567**] ICD9 Codes: 4241, 9971, 4019, 2720
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Medical Text: Admission Date: [**2163-2-14**] Discharge Date: [**2163-2-16**] Date of Birth: [**2111-11-5**] Sex: F Service: NEUROSURGERY Allergies: Sulfa (Sulfonamides) / Tape / Ativan / Aloe / Dilantin Attending:[**First Name3 (LF) 3227**] Chief Complaint: Headache and Visual Disturbance Major Surgical or Invasive Procedure: None History of Present Illness: This is a 51 year old female with metastatic melanoma to brain well known to our service who presented [**Hospital3 3583**] with headache and visual disturbance but otherwise GCS 15. She had a Head CT which was consistent with large right parietal intraparencymal hemorhage and 7 mm midline shift. She was intubated for transfer and transferred here for further care. Past Medical History: - Malignant melanoma w/ metastases to brain s/p ICH evacuation and IP shunt placement for hydrocephalus - Graves' disease s/p Tapazole treatment 13yrs ago - cervical dysplasia s/p LEEP - s/p resection of melanoma from left lower back - s/p resection of intradermal melanocytic nevus from left lateral chest wall Social History: Previous smoker 28 pack years, recently quit. Social alcohol. Denies illicit drug use. No pets, currently living with her mother and working as a buyer for [**Name (NI) 9400**] NY. Never married. Family History: Father with carotid stenosis and history of CVA x2, age 78. Mother age 68 and healthy. Brother, age 50, healthy. No known early CAD or cancer history. Physical Exam: On Admission: O: T: 97.7 BP: 107/63 HR:119 R: 19 O2Sats100% on ventilator assist control BASIC COAGULATION ( PT, PTT, PLT, INR) [**2163-2-14**] 12.2 26 387 1 Gen: intubated and sedated HEENT: Pupils: 3.5-3 EOMs:pt unable to perform Neck: Supple. Extrem: Warm and well-perfused. Neuro: Mental status/Orientation: GCS 10T/eyes-3,motor-6 verbal-1T Recall: pt intubated Language:pt intubated Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, 3.5 to 3 mm bilaterally. Visual fields unable to test III, IV, VI: Extraocular movements unable to test V, VII: Facial strength grossly intact and symmetric. VIII: unable to test pt intubated IX, X: unable to test pt intubated [**Doctor First Name 81**]: Sternocleidomastoid and trapezius unable to test pt sedated with intubation medications from outside hospital. XII: Tongue -unable to test pt intubated.pt sticks toungue out minimally to command Motor: Normal bulk and tone bilaterally. Strength pt minimally moving fingers and toes to command. Pronator drift unable to test Sensation: unable to test -pt sedated. Toes downgoing bilaterally Coordination:unable to test On Discharge: AOx3, left side neglect. R pupil [**4-12**], L pupil [**6-13**] both briskly reacting. MAE with left sided weakness -[**6-15**]. Speech is clear and fluent. Comprehension is intact. Right vision has been blurry. Pertinent Results: CT Head [**2163-2-14**]: IMPRESSION: 1. Compared to the examination from two hours prior, there is stable large right intraparenchymal hemorrhage with intraventricular extension. There is stable 5-mm leftward shift of midline. 2. Compared to the [**Month (only) 1096**] examination, a left occipital intraparenchymal hemorrhage has increased in size. 3. Stable right frontal encephalomalacia and right frontal subdural hematoma. 4. Stable position of the ventriculostomy catheter. Stable post-surgical changes along the right calvarium. ECHO: [**2163-2-14**] IMPRESSION: Normal biventricular cavity sizes with preserved global and regional biventricular systolic function. Mild mitral regurgitation with normal valve morphology MR [**Name13 (STitle) **] [**2163-2-14**] IMPRESSION: 1.Right frontoparietal, occipital, and left occipital lesions consistent with metastases with associated hemorrhage and surrounding vasogenic edema. 2. Stable right craniotomy changes and left frontal ventriculostomy catheter placement. CT Brain [**2163-2-14**] IMPRESSION: 1. Minimal decrase in size of large right parieto-occipital intraparenchymal bleed. 2. Slight increase in size of the hyperdense left occipital lesion. Brief Hospital Course: Ms. [**Known lastname 1806**] was admitted to the [**Hospital1 18**] ICU in an intubated state. After sedating medications wore off she was able to readily follow commands. She was extubated soon thereafter. Neurologic examinationa after extubation revealed a left hemiplegia that was attributable to the ICH. Subsequent serial imaging revealed no interval change in ICH. Her neurologic status remained stable in the remaining hospital course. PT and OT were consulted and she was able to go home with services. Medications on Admission: Keppra 1000 mg [**Hospital1 **] Metoprolol 25 mg po QD-[**Hospital1 **] Discharge Medications: 1. Polyvinyl Alcohol 1.4 % Drops Sig: 1-2 Drops Ophthalmic PRN (as needed) as needed for dry eyes. 2. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical QID (4 times a day) as needed for pruritis. 3. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain/fever. 4. Levetiracetam 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*120 Tablet(s)* Refills:*2* 5. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for Pain. Disp:*30 Tablet(s)* Refills:*0* 7. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 8. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 9. Dexamethasone 2 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours). Disp:*90 Tablet(s)* Refills:*1* 10. Prilosec 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: Intraventricular hemorrhage Intracerebral Hemorrhage Atrial Fibrillation Discharge Condition: Mental Status:Clear and coherent Level of Consciousness:Alert and interactive Activity Status:Ambulatory - Independent Discharge Instructions: General Instructions ??????Take your pain medicine as prescribed. ??????Exercise should be limited to walking; no lifting, straining, or excessive bending. ??????Increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. We generally recommend taking an over the counter stool softener, such as Docusate (Colace) while taking narcotic pain medication. ??????Unless directed by your doctor, do not take any anti-inflammatory medicines such as Motrin, Aspirin, Advil, and Ibuprofen etc. ??????Continue Keppra as prescribed. * Please stay on the Dexamethasone until Dr. [**First Name (STitle) **] sees you in follow-up Followup Instructions: Follow-Up Appointment Instructions ??????Please call ([**Telephone/Fax (1) 9403**] to schedule an appointment with Dr. [**First Name (STitle) **], to be seen in 4 weeks. ??????You will need a CT scan of the brain without contrast. * Please call and schedule an appointment with your primary care physcian regarding an episode of Afib while inpatient. You have been given Amiodarone for this. * Dr. [**First Name (STitle) **] has call [**Hospital3 3583**]- please call and setup an appointment for Radiation treatment with them. Completed by:[**2163-2-16**] ICD9 Codes: 431
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Medical Text: Admission Date: [**2193-6-21**] Discharge Date: [**2193-7-8**] Date of Birth: [**2131-11-17**] Sex: F Service: SURGERY Allergies: Sulfa (Sulfonamides) / Pentothal / Codeine / Wellbutrin / Zosyn / Meropenem Attending:[**Doctor First Name 5188**] Chief Complaint: raw skin around ostomy Major Surgical or Invasive Procedure: Takedown/reversal of ileostomy with ileorectal anastomosis. History of Present Illness: This is a 61 yo woman with h/o colostomy/ileostomy, COPD, morbid obesity who presents with increased output from wound adjacent to ostomy. Of note she went home from rehab at the end of [**Month (only) 116**] (about 2 weeks ago) and things seem to be worse since. She notes the VNA nurse told her about a week ago she had an open area adjacent to her ostomy that was draining. She has had such discomfort from the skin around her ostomy that she has been unable to keep an ostomy bag on it for the last week or so. She was seen by someone (? PCP) [**6-12**] who started her on keflex to try to help the abdominal wall irritation improve (with no sign change-finished [**6-19**]) and also started her on macrobid for a UTI (but Ms. [**Known lastname **] took it [**Hospital1 **] instead of QID so is still taking it even though it was to finish [**6-19**] and took 1/2 dose). She states she couldnt take it at home anymore so came in. Denies change in stool consistency, fevers or chills. She feels diffuse abdominal pain. No nausea or emesis but has been eating less intentionally so she could reduce her stool output for the last 3 days. . Past Medical History: Hypertension Diabetes Obesity COPD on home O2 2-3L at all times Obstructive Sleep Apnea on home CPAP: don't know settings Obesity hypoventilation syndrome diastolic CHF (by c.cath [**1-/2192**]) Osteoarthritis s/p total colectomy for c.diff colitis with end ileostomy [**2-18**] Social History: Quit smoking [**1-18**] after 40-50 pack years. No etoh, or illicit drugs. Recently moved home with her husband after long rehab stay. Family History: There is family history of premature coronary artery disease- her father died in his 40s of an MI. Physical Exam: VS: T 98.4 HR 84 BP 126/74 RR 18 Sat 99% 3L NC GEN: chronically ill appearing woman in NAD HEENT: EOMI, PERRL, conjunctiva clear, sclera anicteric, mmm, OP clear Neck: No JVD, no LAD, no thyromegaly, no carotid bruits Cardiovascular: RRR, nl S1/S2, no m/r/g Respiratory: CTA bilaterally, comfortable, no wheezing, no rhonchi, no rales Gastrointestinal: soft, non tender, no rebound, obese, no hepatosplenomegaly, normal bowel sounds, G tube in place, left side with large (15cm x 10cm) pink ulceration and erythema Musculoskeletal/Extremities: no clubbing, no cyanosis, no joint swelling, trace edema in the bilateral extremities Neurological: Alert and oriented x3, fluent speech, sensation WNL, CNII-XII intact . At Discharge: Gen: a and o x3, NAD V.S 99.1, 84, 134/66, 18, 100% RA. CV: RRR no m/r/g RESP: LSCTA, sl decreased at bases. ABD: soft, sl tender at incision site, obese, nd. Incision: abd ota with staples, small open area with w-d dressing, old G-Tube site with dressing. No s/s of infection at either site. Ext: Bilat lE edema Pertinent Results: [**2193-6-20**] 06:20PM BLOOD WBC-9.7 RBC-3.87* Hgb-10.4*# Hct-32.2*# MCV-83 MCH-26.9* MCHC-32.4 RDW-18.4* Plt Ct-413 [**2193-6-20**] 08:28PM BLOOD PT-13.2 PTT-21.5* INR(PT)-1.1 [**2193-6-20**] 06:20PM BLOOD Glucose-113* UreaN-29* Creat-1.7* Na-138 K-4.9 Cl-101 HCO3-26 AnGap-16 [**2193-6-20**] 06:20PM BLOOD %HbA1c-5.7 [**2193-6-20**] 06:20PM BLOOD TSH-2.5 [**2193-6-20**] 06:30PM BLOOD Lactate-1.0 . CT Abd CT ABDOMEN WITH IV CONTRAST: Focal consolidation at the left lung base is unchanged, and likely represents atelectasis. There is no pleural effusion. The heart is normal in size without pericardial effusion. In the abdomen, the liver, gallbladder, pancreas, spleen, adrenal glands, stomach, and duodenum are unremarkable. The kidneys enhance and excrete contrast symmetrically. There is no free air or free fluid in the abdomen. The abdominal aorta demonstrates mild atherosclerotic calcification. Scattered mesenteric and retroperitoneal lymph nodes do not meet CT criteria for pathologic enlargement. A percutaneous G-tube terminates in the stomach. CT PELVIS WITH IV CONTRAST: The patient is post colectomy. Multiple loops of small bowel contain oral contrast, and are not distended. Contrast extends through the small bowel to the ileostomy site in the anterior abdominal wall, and passes freely through the ileostomy. Only a single channel of contrast passes through the abdominal wall. No contrast-filled enterocutaneous fistula is identified. A small focus of air within the deep subcutaneous/muscular layers adjacent to the ileostomy site is noted, decreased since the prior study. There is no associated fluid collection to suggest abscess. Stranding is noted in the subcutaneous tissues. The urinary bladder, distal ureters, uterus, and adnexa are unremarkable. There is no free fluid in the pelvis. There is no pelvic or inguinal lymphadenopathy by size criteria. OSSEOUS STRUCTURES: S-shaped curvature of the spine is unchanged. There is no fracture or worrisome bony lesion. Soft tissues are unremarkable. IMPRESSION: 1. No evidence of enterocutaneous fistula at this time. 2. Interval decrease in size of subcutaneous air adjacent to the ostomy. No associated fluid collection to suggest abscess. . [**6-26**] CT abd: dilated SB to ostomy, contrast in stomach [**6-27**] BE: normal Hartmann pouch, no stricture/obstruction/oeak [**2193-7-3**] 10:00PM BLOOD WBC-8.8 RBC-3.08* Hgb-8.2* Hct-26.8* MCV-87 MCH-26.7* MCHC-30.7* RDW-17.0* Plt Ct-291 [**2193-7-3**] 10:00PM BLOOD Plt Ct-291 [**2193-6-30**] 04:42AM BLOOD PT-14.2* PTT-24.9 INR(PT)-1.2* [**2193-7-3**] 10:00PM BLOOD Glucose-138* UreaN-25* Creat-1.9* Na-138 K-3.7 Cl-103 HCO3-29 AnGap-10 [**2193-7-1**] 05:59AM BLOOD Calcium-7.8* Phos-3.0 Mg-2.2 [**2193-6-25**] 07:25AM BLOOD Albumin-3.6 Calcium-9.4 Phos-4.4 Mg-2.3 Iron-28* [**2193-6-25**] 07:25AM BLOOD calTIBC-239* TRF-184* [**2193-6-20**] 06:20PM BLOOD %HbA1c-5.7 Brief Hospital Course: In short, Ms [**Known lastname **] is a 61 y/o F with hx of colostomy, COPD, HTN, DM and obesity who presented from home with inability to care for her ostomy and worsening skin breakdown around the site. . # Ostomy wound and skin breakdown - patient was evaluated in the ED with a CT scan showing flow through the ostomy without any entero-cutaneous fistulas. Wound care nurse at home told patient there was a fistula. Surgery evaluated her in the ED and does not think there is a fistula as the wound adjacent to the ostomy was probed and could not be passed. The ostomy nurse examined the patient and recommended some various wound cleaning suggestions, as well as placing a bag over the ostomy. She continued to have pain around her wound throughout her admission and was treated with dilaudid PO which controlled the pain to an acceptable level. The wound did not appear infected. . # Nausea and vomitting - the two days prior to discharge, the patient developed some nausea and vomitting. It is unclear the etiology. She felt better with zofran. She thinks it was something in the food that she ate. She had the same level of abdominal pain that she had upon admission, and was tolerating POs and having appropriate output through her colostomy. Surgery was following along and did serial exams that were not concerning for an acute abdomen. She can continue to be treated wtih antiemetics as needed as long as she has appropriate stool output and vomit remains non bilious and non bloody. . # UTI - had positive UA but culture grew yeast and was likely a contaminant. Had one day of cipro and then it was stopped when culture data returned. . # DM - patient takes metformin at home, sugars have been well controlled, was d/c'ed on lantus previously. We held the metformin because of her CKD and put her on insulin sliding scale. Her HbA1c was 5.7. She can stay on insulin for now but eventually go back on metformin (if her kidney function is ok) as she would be unlikely to be able to administer insulin to herself. . # Neuropathy - patient with severe peripheral bilateral neuropathy today. At home takes celebrex and dilaudid for pain medicines. Held celebrex for CKD and added gabapentin for neuropathy. Per patient, gabapentin helped pain improve. . # CKD - seems to be at baseline, but creatinine has been variable past few months. Received some IVFs the night prior to CT scan, and creatinine was not rechecked because she refused labs every time. . # COPD - stable, did fine on room air . # OSA - stable, do not know CPAP settings . # Depression - was tearful and obviously depressed throughout hospitalization, she was on venlafaxine per old disharge summaries, but she does think she's taking it anymore. She kept saying that she hoped she died, but always denied suicidal ideation. Psych was consulted because depression was hindering her ability to get well from a medical standpoint. She was started on celexa. MICU Course ([**Date range (1) **]) Transferred to ICU after failure to extubate. Thought to be [**2-11**] hypoventilation in the setting of narcotics for post-op pain and baseline disease (COPD, obesity hypoventilation). Tolerated PS trial in ICU and was successfully extubated. Started on a dilaudid PCA. Bolused w fluid for hypotension. Transferred to floor. . The patient was transferred to the floor and was continued as NPO, with foley, G-tube to gravity and IV meds/IVF. An NGT was placed secondary to N/V and decreased ostomy output. On [**2193-6-28**] the patient was taken to the OR for Takedown/reversal of ileostomy with ileorectal anastomosis. She returned to the floor and was made NPO with IVF/Foley/G-Tube to gravity and IV Meds. With the return of bowel function and flatus her diet was advanced from sips to regular. Here G-tube was than removed, however it was noted that there was output from the g-tube site and a CT scan was done. See report. Staples were removed from her incision and packed with w-d dressing [**Hospital1 **]. Physical thearpy worked with patient daily and pt got oob to chair. The patient refused skin care, explained to patient the risks of this and she still refused. The patient will return to rehab for physical therapy and wound care. She will follow up with Dr. [**Last Name (STitle) 5182**] in 1 week. Medications on Admission: Meds: patient largely unable to verify DuoNeb 0.5-2.5 mg/3 mL [**1-11**] q4h prn shortness of breath zantac 150mg daily (confirmed) Dilaudid 2 mg PO q3h prn as needed for pain - takes at least daily nystatin powder santyl ointment to ostomy macrobid as above metformin [**Hospital1 **] (does not know dose) celebrex 200mg daily . Maybe: Calcium Acetate 667 PO TID W/MEALS Quetiapine 50 mg PO at bedtime . No longer taking we think: Arinesp 16mcg sc qWednesday Venlafaxine 75 mg PO DAILY Insulin 7 units Lantus SC qhs plus sliding scale Lorazepam 0.5 mg PO bid prn as needed for anxiety Discharge Disposition: Extended Care Facility: [**Location (un) **] center [**Location (un) **] Discharge Diagnosis: Primary Diagnosis: 1. Skin Breakdown around ostomy 2. Diabetes 3. Depression 4. COPD 5. Nausea and Vomitting Discharge Condition: Stable. Tolerating regular diet. Pain well controlled with oral medications. Discharge Instructions: Please call your doctor or return to the ER for any of the following: * You experience new chest pain, pressure, squeezing or tightness. * New or worsening cough or wheezing. * If you are vomiting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomiting, diarrhea or other reasons. Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * Your pain is not improving within 8-12 hours or not gone within 24 hours. Call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. *Avoid lifting objects > 5lbs until your follow-up appointment with the surgeon. *Avoid driving or operating heavy machinery while taking pain medications. * You have shaking chills, or a fever greater than 101.5 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. * Please resume all regular home medications and take any new meds as ordered. * Continue to ambulate several times per day. . Incision Care: -Your staples will be removed at your follow up appointment. -Steri-strips will be applied and will fall off on their own. Please remove any remaining strips 7-10 days after application. -You may shower, and wash surgical incisions. -Avoid swimming and baths until your follow-up appointment. -Please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. . Dressing: ABD: please continue with wet-dry dressing changes [**Hospital1 **]. . G-Tube was removed during your hospital stay. Followup Instructions: 1. Please call Dr.[**Name (NI) 6045**] office, [**Telephone/Fax (1) 5189**], to make a follow up appoinmtent in 1 week. 2. Please follow up with your PCP [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 15131**] at [**Telephone/Fax (1) 18203**] within one to two weeks after you are discharged from rehab. [**Name6 (MD) **] [**Last Name (NamePattern4) **] MD, [**MD Number(3) 5190**] ICD9 Codes: 5990, 2762, 496, 4280, 5859
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Medical Text: Admission Date: [**2194-10-14**] Discharge Date: [**2194-10-21**] Date of Birth: [**2123-6-12**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 689**] Chief Complaint: bleeding per rectum Major Surgical or Invasive Procedure: endoscopy with epinephrine injection History of Present Illness: Mr. [**Known lastname 84279**] is a 71 year-old Russian with a history of coronary artery disease s/p CABG and PCI [**7-/2194**] with DES, as well as a remote history of gastric ulcers s/p resection of [**1-8**] of his stomach, who presents with weakness, chest pain, and bright red blood per rectum. He states that all of these symptoms have evolved over the past 4 days. The chest pain comes and goes and is described as pressure similar to his usual angina. This time it has not been related to exertion but was responsive to nitroglycerin until an episode last night that was not. With regard to the BRBPR, he states that this has been ongoing with most stools for the past 3-4 days and consists of red blood mixed with brown stool. He denies black stool (although his daughter states that he has been telling her he is having black stool). He also denies abdominal pain, nausea, vomitting, or diarrhea. He denies any history of similar symptoms. Of note, he did have stomach ulcers in [**Country 532**] in [**2186**] and is s/p removal of "[**2-6**] of his stomach." He has never had a colonoscopy. . In the ED, initial VS T 98.6, HR 116, BP 110/90, RR 18, O2 100% RA. Exam was notable for palor and melena in the rectal vault. EKG was concerning for acute ischemia, and code STEMI was called. The patient was taken directly to the cath lab without any heparin given concern for GIB. Catheterization revealed no change in prior diffuse coronary disease with open stents. A nitroglycerin drip was started (reportedly for hypertension to the 170s, although apparently patient was also having ongoing chest pain). . On arrival to the ICU, Mr. [**Known lastname 84279**] complains of ongoing substernal chest pressure. He denies shortness of breath or palpitations. He denies abdominal pain, nausea, or vomitting. He has not had any bowel movement since arrival to the hospital. Past Medical History: -hypertension -dyslipidemia -CABG: 3 vessels in [**Country 532**]; [**2186**] per patient -PCI [**11/2193**] with diffuse native disease and grafts open. PTCA and stenting of proximal LCx with BMS. [**7-/2194**] stenting of Lcx with DES. -stomach ulcer s/p resection of [**1-8**] of stomach -appendectomy Social History: He previously smoked 1 PPD but quit in 12/[**2192**]. He has recently decreased his alcohol intake from TID vodka but unclear exactly how much he drinks. He lives with his wife. Family History: not obtained Physical Exam: VS: Afebrile BP 125/65, HR 107, RR 13, O2 100% on RA GENERAL: appears comfortable, pale, lying flat on back after cath HEENT: pale mucosa, oropharynx clear NECK: supple, JVP not elevated CARDIAC: regular, no murmur appreciated, no chest wall tenderness LUNGS: clear anteriorly ABDOMEN: Soft, NTND, +BS. No HSM or tenderness. EXTREMITIES: R groin site clean, dry, nontender. No peripheral edema. Peripheral pulses not palpable but dopplerable. Evidence of multiple vein graft harvesting sites. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. Pertinent Results: [**2194-10-14**] 04:30PM WBC-8.5 RBC-2.65*# HGB-7.0*# HCT-22.1*# MCV-83 MCH-26.6* MCHC-31.9 RDW-16.5* [**2194-10-14**] 04:30PM NEUTS-68.5 LYMPHS-25.6 MONOS-4.0 EOS-0.6 BASOS-1.3 [**2194-10-14**] 04:30PM GLUCOSE-124* UREA N-36* CREAT-0.8 SODIUM-139 POTASSIUM-4.2 CHLORIDE-106 TOTAL CO2-22 ANION GAP-15 Brief Hospital Course: A 71 year-old man with a history of CAD s/p recent DES on ASA and Plavix presented with GI bleed. . # GI bleed: In the MICU: Initially unclear if upper or lower, as patient had variably endorsed both black stool and brown stool admixed with BRB. Hct had fallen 38-->30 over 6 months [**11-13**] to [**4-14**]. Had fell an additional 10 points over the ensuing 6 months, and he did not follow up with the colonoscopy as an outpatient as instructed on previous admission. He was given a total of 9 units of pRBC, and Hct slowly increased although not to the extent expected. PPI drip was started. Endsoscopy was performed which showed a bleeding ulcer at the site of his prior anastomosis which was injected with epinephrine and cauterized. Despite achieving hemostasis, the patient continued to have melena and a falling hematocrit requiring transfusion. A second EGD was performed and the ulcer was cauterized once more for oozing, but it was the general sense that this oozing was not the source of the continued bleeding. It was recommended that the patient follow-up as an outpatient for repeat EGD in [**5-13**] weeks and that he may need to have a colonoscopy if his hematocrit remains unstable. He required a totoal of 12 units of blood thoughout his stay. His aspirin and Plavix were held during his time in the MICU but aspirin was restarted prior to transfer to the floor. On the floor: PPI was switched to IV BID, two large bore IVs and a type and cross were maintained. He had a transfusion goal of >30 but did not require further blood products. His aspirin was restarted on arrival to the floor. After some debate, his plavix was restarted one day later because, based on cardiology and GI consult input, the risk posed for coronary stent occlusion was deemed superior to GI bleeding. He was rescheduled for an EGD in 6 weeks for a biopsy at the ulcer site. He did not have any more episodes of melena or hematochezia prior to discharge. . . # CAD: In the MICU: Nothing acutely occluding arteries on cath, but the patient had ongoing severe chest pain with ST depressions precordially despite a nitroglycerin drip. Thus, he was aggressively transfused to Hct >30. With this, the nitroglycerin drip was titrated off, and his home dose of long-acting nitrate was restarted. Beta blocker was initially held but restarted for tachycardia likely related to withdrawal of the med and ACEI were held while there was concern of imminent hemodynamic instability Aspirin and Plavix were initially held and aspirin was restarted prior to transfer. On the floor, Plavix was restarted given the high risk of coronary stent occlusion knowing that this would pose a greater risk for repeat GI bleed. His metoprolol and ACE-inhibitor and statin were also restarted. . # Elevated INR: thought to be [**1-7**] nutritional issues. He was given vitamin K in the MICU. . # HTN: chronic issue, patient was normotensive-hypertensive in the MICU in the setting of bleed. His BP increased once bleeding stopped and amlodipine and lisinopril were restarted. Discharge Medications: 1. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 2. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. Disp:*30 Tablet(s)* Refills:*0* 4. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 5. atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 7. isosorbide mononitrate 60 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily). 8. cyanocobalamin (vitamin B-12) 1,000 mcg/mL Solution Sig: One (1) Injection DAILY (Daily) for 2 days. Disp:*2 ml* Refills:*0* 9. amlodipine 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 10. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 11. enalapril maleate 20 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home Discharge Diagnosis: Primary: Upper GI bleed Secondary: CAD Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Mr. [**Known lastname 84279**], you were admitted to the [**Hospital3 **] Medical center for a bleed in your stomach. You were sent to the ICU and seen by the gastroenterologist you performed 2 esophagealgastroduodenal (EGD) endoscopies to diagnose and stop the bleeding. Your ongoing bleeding required 12 Unites of blood before stabilizing. During your bleeding, your aspirin and plavix were held, but these were restarted once your bleeding stopped. You were stable on the floor and did not have repeat episodes of bleeding. Your hematocrit (a measure of red blood cells) was stable without transfusions for several days and you were deemed stable for discharge home. During your stay some of your medications were changed, you should START the following: -Pantoprazole 40mg Twice every day (for decreasing stomach acid) -Senna and docusate (for constipation) You should INCREASE: - Metoprolol to 25 mg twice every day Please obtain a hematocrit blood test with Dr. [**Last Name (STitle) 3357**] on your next appointment. You will need a repeat endoscopy at some point to reevaluate your ulcer and get a biopsy. You will have to discuss with your cardiologist if it is safe to be off plavix for this biopsy. You should continue all your other medications as prescribed by your physicians. It is important that your take your aspirin and plavix every day. Please call your PCP [**Name Initial (PRE) **]/or return to the Emergency if you have bloody/dark black stools or if your feel lightheaded or dizzy or have chest pain. Followup Instructions: Name: [**Last Name (LF) **],[**First Name3 (LF) **] L. Location: [**Hospital1 **] HEALTHCARE - [**Location (un) **] Address: [**State 4607**], [**Location (un) **],[**Numeric Identifier 588**] Phone: [**Telephone/Fax (1) 4606**] When: Tuesday, [**10-28**], 9:30AM Department: DIV. OF GASTROENTEROLOGY When: TUESDAY [**2194-12-9**] at 2:30 PM With: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 11716**] [**Name8 (MD) 11717**], MD [**Telephone/Fax (1) 463**] Building: Ra [**Hospital Unit Name 1825**] ([**Hospital Ward Name 1826**]/[**Hospital Ward Name 1827**] Complex) [**Location (un) **] Campus: EAST Best Parking: Main Garage ICD9 Codes: 4019, 2724
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Medical Text: Admission Date: [**2129-10-17**] Discharge Date: [**2129-11-2**] Date of Birth: [**2082-3-8**] Sex: M Service: ORTHOPAEDICS Allergies: Penicillins Attending:[**First Name3 (LF) 11415**] Chief Complaint: Motorcycle collision Major Surgical or Invasive Procedure: Open reduction internal fixation ABC to pelvic fracture with plating of the symphysis. History of Present Illness: [**Known firstname **] [**Known lastname 1968**] is a 47-year-old gentleman who was involved in a motorcycle accident on [**2129-10-17**] resulting in anterior posterior compression type 2 pelvic fracture with symphyseal diastasis. Past Medical History: HTN, NIDDM Social History: NA Family History: NA Physical Exam: GCS: 15 HEENT: normocephalic, atraumatic; PERRLA, TM's clear NECK: nontender, in cervical collar CV: RRR, no M/R/G RESP: CTA b/l ABD: obese, NT PELVIS: TTP, ecchymosis to b/l thighs, NEURO: nl rectal tone, sensation and motor grossly intact strength 5/5 b/l UE, 4+/5 b/l LE secondary to pain Pertinent Results: [**2129-10-17**] 08:00PM NEUTS-75* BANDS-8* LYMPHS-10* MONOS-5 EOS-0 BASOS-0 ATYPS-2* METAS-0 MYELOS-0 [**2129-10-17**] 08:00PM HYPOCHROM-NORMAL ANISOCYT-NORMAL POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-NORMAL [**2129-10-17**] 08:00PM PT-13.3 PTT-24.3 INR(PT)-1.2 [**2129-10-17**] 08:00PM PLT SMR-NORMAL PLT COUNT-395 [**2129-10-17**] 08:00PM FIBRINOGE-380 [**2129-10-17**] 08:00PM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.035 [**2129-10-17**] 08:00PM URINE BLOOD-MOD NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-NEG [**2129-10-17**] 08:00PM URINE RBC-[**2-5**]* WBC-[**5-13**]* BACTERIA-FEW YEAST-NONE EPI-[**2-5**] Brief Hospital Course: Upon admission, on [**2129-10-17**] the symphysis was widely malplaced at least 4 cm and the patient was significantly symptomatic and required a pelvic bandage to relieve comfort. He remained hemodynamically stable on the day of admission. He now ([**2129-10-19**]) presents for open reduction internal fixation ABC to pelvic fracture with plating of the symphysis. The patient tolerated the procedure well and was taken to the recovery room without incident. Dr. [**Last Name (STitle) 1005**] was present through the entire procedure. The patient was brought to CC6 and placed on lovenox for DVT prophylaxis. He was evaluated by physical therapy and occupational therapy and did well. His diabetes was kept in good control. On [**2129-10-24**] the patient's potassium was low at 3.0, so it was replaced with 40 mEq IV potassium. It was found to be low again on [**2129-10-25**] and another 40 mEq of potassium was given. His potassium stabilized with po. Hospital course was otherwise without incident. He is being discharged today to his home in stable condition. he was cleared by pt and was okay to be dc'd home with pt and ot Medications on Admission: Glucophage HTN medication Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) as needed. Disp:*60 Capsule(s)* Refills:*0* 2. Enoxaparin 40 mg/0.4mL Syringe Sig: One (1) Subcutaneous DAILY (Daily) for 4 weeks. Disp:*30 syringes* Refills:*0* 3. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for Indigestion. 4. Enalapril Maleate 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed. 6. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed. Disp:*50 Tablet(s)* Refills:*0* 8. Metformin 850 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Discharge Disposition: Home Discharge Diagnosis: Anterior posterior compression type 2 pelvic fracture with symphyseal diastasis Discharge Condition: Stable Discharge Instructions: Keep your incision clean and dry. You may shower, but do not tub bathe or immerse in water. Watch for signs of infection as written in the nursing discharge sheet. If you notice any fever, increased pain, swelling, or redness report to the emergency room. If you have any questions you may call the orthopaedic clinic. Do not bear weight on your legs for [**5-11**] wks. Take your medications as prescribed. Please follow up with Dr [**Last Name (STitle) 1005**] in 2 weeks. Physical Therapy: Strict NWB bilateral lower extremities Treatments Frequency: Staple removal at orthopaedic clinic with Dr. [**Last Name (STitle) 1005**] Followup Instructions: Please follow up with Dr. [**Last Name (STitle) 1005**] at the [**Hospital1 18**] orthopaedic clinic in 2 weeks. You may call [**Telephone/Fax (1) **] to make an appointment. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2235**] MD, [**MD Number(3) 11417**] Completed by:[**2129-11-2**] ICD9 Codes: 2851, 4019, 2768, 4589
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Medical Text: Admission Date: [**2120-4-27**] Discharge Date: [**2120-4-30**] Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 2186**] Chief Complaint: Respiratory Distress Major Surgical or Invasive Procedure: None History of Present Illness: Ms. [**Known lastname 49761**] is an 87 y/o female with a history of CHF, afib, pulm htn [**3-7**] COPD who was transferred from BIDN for respiratory distress likely from a pneumonia. She was noted to be short of breath at her nursing facility the day PTA and was found to have an O2 sat of 80% on RA and was put on 2L of 02 which brought her up to 88%. The following day she destated again with an O2 sat of 70% on 2L with worening tachypnea and tachycardia. She was sent to BIDN where she was noted to have a fever of 103 and a CXR with RLL infiltrate worse than previous concerning for pneumonia. Her blood gas was 7.44/58/62/She was given Ceftriaxone, Levaquin and dexamethasone and transferred to [**Hospital1 18**] for ICU admission. . In the ED, initial VS were: 97.9 104 104/62 20 92% 8L venti mask. She was noted to be mentating well with crackles noted bilaterally and decreaed breath sounds on the right side. Vital Signs Upon Transfer were: Temp: 97.4 ??????F (36.3 ??????C) (Oral), Pulse: 94, RR: 29, BP: 108/44, O2Sat: 94%, O2Flow: 8L (Mask). . On arrival to the MICU, she appeared comfortble and in NAD. She was speaking in full sentences and not using any accessory muscle use. She was a venti mask sating 95%. . While in MICU [**Location (un) **], the patient did well. She was started on vancomycin, cefepime and azithromycin to treat for HCAP. Solumedrol was discontinued as this was not thought to be secondary to a COPD exarbaction. Given where she lives, the decision was made to treat for CAP instead of HCAP so vancomycin and cefepime were discontinued on [**4-28**]. The patient was weaned down to 2L NC with saturations maintained in the mid-90s with no shortness of breath. BPs were initially low so home Bumex was held but they improved today so the medication was resumed. She is being transferred to the medicine floor for further management . On arrival to the floor, vital signs were T: 97.7, BP- 108/55, HR- 60, RR- 20, SaO2- 96% on 2L. The patient denies fevers, chills, chest pain or shortness of breath and reports feeling better. Past Medical History: 1. COPD/emphysema, not on home oxygen. 2. Possible diastolic dysfunction/congestive heart failure. 3. Pulmonary hypertension. 4. Hypertension. 5. Hyperlipidemia. 6. Diverticulosis. 7. Question diabetes mellitus/hyperglycemia/impaired fasting glucose. 8. Status post cholecystectomy. 9. History of vitamin B12 deficiency. 10. History of Pemphigoid and lichen planus. Social History: Lives alone currently in Recuperative Services Unit at NewBridge on the [**Doctor Last Name **]. Reports that her kids are not very close by, but are in contact. [**Name (NI) **] son is the healthcare proxy. [**Name (NI) **] husband passed away a few years ago. She smoked 1 pack a day for more than 60 years and still smokes 1 to 2 cigarettes a day. She says, "I drink little if anything." Denies drug history. Uses walker for ADLs. Family History: NC Physical Exam: On arrival to the floor Vitals: T: 97.7, BP- 108/55, HR- 60, RR- 20, SaO2- 96% on 2L General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, NC in place Neck: supple, JVP 12cm, no LAD CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Lungs: Bibasilar crackles, decreased breath sounds in right base, good respiratory effort. Abdomen: soft, non-tender, non-distended, bowel sounds present GU: no foley Ext: warm, well perfused, 1+ edema bilaterally. no clubbing, cyanosis Pertinent Results: Labs on admission: [**2120-4-27**] 06:53AM BLOOD WBC-8.1 RBC-4.07* Hgb-10.3* Hct-35.5* MCV-87 MCH-25.4* MCHC-29.1* RDW-16.5* Plt Ct-266 [**2120-4-27**] 06:53AM BLOOD Neuts-89.7* Lymphs-7.8* Monos-2.2 Eos-0 Baso-0.2 [**2120-4-27**] 06:53AM BLOOD PT-11.4 PTT-26.3 INR(PT)-1.1 [**2120-4-27**] 06:53AM BLOOD Glucose-201* UreaN-29* Creat-0.9 Na-142 K-4.8 Cl-100 HCO3-35* AnGap-12 [**2120-4-27**] 06:53AM BLOOD Calcium-8.7 Phos-3.1 Mg-2.2 [**2120-4-27**] 06:53AM BLOOD Digoxin-0.9 [**2120-4-28**] 06:00AM BLOOD Digoxin-1.3 [**2120-4-27**] 06:28PM URINE Color-Yellow Appear-Clear Sp [**Last Name (un) **]-1.028 [**2120-4-27**] 06:28PM URINE Blood-NEG Nitrite-NEG Protein-30 Glucose-NEG Ketone-10 Bilirub-NEG Urobiln-NEG pH-5.5 Leuks-TR [**2120-4-27**] 06:28PM URINE RBC-7* WBC-2 Bacteri-FEW Yeast-NONE Epi-<1 Labs on discharge: [**2120-4-30**] 05:40AM BLOOD WBC-5.4 RBC-4.27 Hgb-11.0* Hct-36.4 MCV-85 MCH-25.8* MCHC-30.3* RDW-16.5* Plt Ct-253 [**2120-4-30**] 05:40AM BLOOD Glucose-97 UreaN-23* Creat-0.9 Na-137 K-4.7 Cl-99 HCO3-31 AnGap-12 [**2120-4-30**] 05:40AM BLOOD Calcium-8.5 Phos-2.8 Mg-2.4 [**2120-4-28**] 06:00AM BLOOD Digoxin-1.3 Microbiology: [**2120-4-27**] 6:28 pm URINE Source: CVS. **FINAL REPORT [**2120-4-28**]** Legionella Urinary Antigen (Final [**2120-4-28**]): NEGATIVE FOR LEGIONELLA SEROGROUP 1 ANTIGEN. (Reference Range-Negative). Performed by Immunochromogenic assay. A negative result does not rule out infection due to other L. pneumophila serogroups or other Legionella species. Furthermore, in infected patients the excretion of antigen in urine may vary. Blood cultures ([**2120-4-27**]): pending at discharge Urine culture- no growth Urine legionella- negative Sputum culture- contaminant Imaging CXR PA/Lateral [**4-27**]: AP and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is enlarged. Bilateral prominence of pulmonary arteries is most likely consistent with pulmonary hypertension, although some degree of lymphadenopathy cannot be excluded. Coronary and aortic valve calcifications are noted. Patient is in interstitial pulmonary edema associated with bilateral pleural effusions. There is no pneumothorax. Re-evaluation of the patient is recommended to assess the hila for the presence of lymphadenopathy versus enlarged pulmonary arteries. Chest x-ray ([**2120-4-28**]) FINDINGS: In comparison with the study of [**4-27**], there is little interval change. Continued enlargement of the cardiac silhouette with evidence of increased pulmonary venous pressure, bilateral pleural effusions with compressive atelectasis, and probable engorgement of central arteries consistent with pulmonary artery hypertension or lymphadenopathy. Chest x-ray ([**2120-4-29**]) FINDINGS: In comparison with the study of [**4-28**], there is continued enlargement of the cardiac silhouette with pulmonary vascular congestion and bilateral pleural effusions with compressive atelectasis. Asymmetric opacification at the right base could well reflect developing consolidation. Hilar prominence is again seen. Brief Hospital Course: Ms. [**Known lastname 49761**] is an 87 y/o female with a history of CHF, afib, pulm htn [**3-7**] COPD who was transferred from BIDN for respiratory distress, likely [**3-7**] pneumonia. # Respiratory Distress: She was noted to have a RLL infiltrate in the setting of fevers making pneumonia the likely diagnosis. She also has a history of congestive heart failure whioch may be contributing to her shortness of breath. She was treated initially with azithromycin, Vanc and Cefepime. She improved dramatically in terms of her shortness of breath and was able to be weaned to 2L NC on day 3 of admission. She was subsequently transferred to the general medicine floor, at which time Vanc and cefepime were discontinued. On the medicine floor, she was switched from azithromycin to levofloxacin and did very well. Home bumetanide was also resumed on day of transfer to the medicine floor. She was weaned down to 2L NC with no fevers, shortness of breath, cough or any signs of hemodynamic instability. She walked without worsening of symptoms. Of note, the patient recently qualified for home oxygen at 2L NC so we will recommend that she be discharged on oxygen. Plan is to complete a total of 5 days of antibiotics (day 1- [**4-27**]). She will go out on levofloxacin 750mg q48hrs for one more dose on [**2120-5-1**]. # Atrial Fibrillation: She has a history of going in to afib with RVR. She apparently was well controlled on her current regimen as an outpatient. We continued metoprolol, digoxin 0.125 mcg and aspirin 325 mg without any episodes of RVR. She had been on extended release metoprolol prior to admission in [**3-/2120**] but was on short acting on discharge on [**2120-4-9**], which we recommended she continue on this discharge well. She will continue metoprolol tartrate 75mg [**Hospital1 **]. # Diastolic Congestive Heart Failure: Patient has a history of CHF and is on Bumex for diuresis as an outpatient. Last TTE was done on [**3-/2120**] which showed a preserved EF. Her bumex 1 mg daily was restarted on transfer to the floor and she never demonstrated any signs of gross volume overload. Home bumex was continued on discharge. # Hyperlipidemia- Previous notes say the patient had been on atorvastatin in the past but rehab paperwork state the patient has been taking pravastatin 40mg of late, which is what she was discharged on from this hospitalization. Medications on Admission: [**First Name8 (NamePattern2) **] [**Location (un) 620**] D/C summary 1. Bumex 1 mg p.o. daily. 2. Metoprolol 75 mg p.o. 3 times daily. 3. Digoxin 0.125 mg p.o. daily. 4. Aspirin 325 mg p.o. daily. 5. Atorvastatin 10 mg p.o. at bedtime. 6. Caltrate plus D 600 mg 400 international units p.o. twice daily. 7. Avoid beta agonists (that causes tachycardia). 8. Prilosec 20 mg p.o. at bedtime. 9. Tylenol 1 gram p.o. twice daily p.r.n. pain. 10. Prednisone 2.5 mg p.o. daily for her arthritis. Per rehab paperwork: 1. bumetanide 1 mg Tablet Sig: One (1) Tablet PO once a day. 2. metoprolol tartrate 75mg twice daily 3. digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Prilosec 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 6. acetaminophen 650 mg Tablet Sig: 1 Tablets PO q4hr as needed for pain. 7. prednisone 2.5 mg Tablet Sig: One (1) Tablet PO once a day. 8. bisacodyl 10 mg Suppository Sig: One (1) supp Rectal once a day as needed for constipation. 9. magnesium hydroxide 30mg daily as needed consiptation 10. senna 8.6 mg Tablet Sig: 1-2 Tablets PO once a day as needed for constipation. 11. cholecalciferol (vitamin D3) 1,000 unit Capsule Sig: One (1) Capsule PO once a day. 12. calcium carbonate 1300 mg daily 13. pravastatin 40 mg Tablet Sig: One (1) Tablet PO once a day. 14. ipratropium bromide 0.02 % Solution Sig: One (1) neb Inhalation every eight (8) hours as needed for shortness of breath or wheezing. Discharge Medications: 1. bumetanide 1 mg Tablet Sig: One (1) Tablet PO once a day. 2. metoprolol tartrate 50 mg Tablet Sig: 1.5 Tablets PO twice a day. 3. digoxin 125 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Prilosec 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 6. acetaminophen 500 mg Tablet Sig: 1-2 Tablets PO twice a day as needed for pain. 7. prednisone 2.5 mg Tablet Sig: One (1) Tablet PO once a day. 8. levofloxacin 750 mg Tablet Sig: One (1) Tablet PO Q48H (every 48 hours) for 1 doses: last dose- [**2120-5-1**]. 9. bisacodyl 10 mg Suppository Sig: One (1) supp Rectal once a day as needed for constipation. 10. magnesium hydroxide Oral 11. senna 8.6 mg Tablet Sig: 1-2 Tablets PO once a day as needed for constipation. 12. cholecalciferol (vitamin D3) 1,000 unit Capsule Sig: One (1) Capsule PO once a day. 13. calcium carbonate 500 mg calcium (1,250 mg) Tablet Sig: One (1) Tablet PO once a day. 14. pravastatin 40 mg Tablet Sig: One (1) Tablet PO once a day. 15. ipratropium bromide 0.02 % Solution Sig: One (1) neb Inhalation every 6 hours as needed for shortness of breath or wheezing. Discharge Disposition: Extended Care Facility: Newbridge on the [**Doctor Last Name **] - [**Location (un) 1411**] Discharge Diagnosis: Primary- Pneumonia Secondary- Diastolic CHF Atrial fibrillation COPD Hypertension Hyperlipidemia Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You were admitted to the hospital with difficulty breathing. You presented to [**Hospital1 **]-[**Location (un) 620**] and were transferred to [**Hospital1 18**] for further management. On arrival here, you were admitted to the ICU and they determined that you had a pneumonia. You were treated with IV antibiotics and steroids and you responded very well. The IV medications were discontinued and you were kept on an oral antibiotic for a pneumonia. While on the medicine service, you did very well and did not have any shortness of breath or fevers. You were kept on 2L of supplemental oxygen; you should continue this on discharge. The following changes were made to your medications: 1. START levofloxacin 750mg by mouth ONCE daily (only one dose left. last day- [**2120-5-1**]) 2. STOP your metoprolol ER (metoprolol succinate) once daily 3. START metoprolol tartrate 75mg by mouth TWICE daily Mo other changes were made to your home medications. Please resume your other medications as you were taking them prior to the admission. Followup Instructions: Name: [**Last Name (LF) **],[**First Name3 (LF) **] J. Location: [**Hospital **] MEDICAL ASSOCIATES-[**Location (un) **] Address: ONE [**Location (un) 542**] ST, [**Location (un) **],[**Numeric Identifier 9310**] Phone: [**Telephone/Fax (1) 8506**] Appointment: WEDNESDAY [**5-8**] AT 2:45PM Completed by:[**2120-4-30**] ICD9 Codes: 486, 4168, 4019, 2724, 3051, 4280
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7940 }
Medical Text: Admission Date: [**2103-4-24**] Discharge Date: [**2103-5-1**] Date of Birth: [**2059-9-15**] Sex: M Service: SURGERY Allergies: Dicloxacillin Attending:[**First Name3 (LF) 5569**] Chief Complaint: Liver mass Major Surgical or Invasive Procedure: hepatic segment 4b and 5 resection [**2103-4-24**] History of Present Illness: 43-year-old man with end-stageliver disease due to hepatitis C who is also coinfected with HIV. He has evidence of mild portal hypertension including thrombocytopenia and splenomegaly. He has never had ascites. Found to have a 1.5 x 1.5 cm hyperenhancing mass in segment IV b concerning for HCC. A recent endoscopy demonstrates no esophageal varices, although he does have a report of an upper GI bleed several years ago. Risks and benefits of the procedure as well as alternative procedures including liver transplantation and a percutaneous ablative therapies were discussed with the patient and his girlfriend. Appropriate consents were signed. Past Medical History: kidney stones s/p lithptripsy, DM II (on insulin), HTN, neuropathy, anxiety, [**Doctor Last Name 933**] disease, hypercholesterolemia, HIV, HCV Social History: Single. Supportive partner. Not currently working. Denies tobacco, etoh or recent substance use. Smoked 1ppd x10 yrs Family History: unremarkable for liver disease Pertinent Results: [**2103-4-24**] 01:20PM BLOOD WBC-16.5*# RBC-3.84* Hgb-12.7* Hct-36.5* MCV-95 MCH-33.0* MCHC-34.8 RDW-15.6* Plt Ct-142*# [**2103-5-1**] 04:43AM BLOOD WBC-5.2 RBC-3.14* Hgb-10.2* Hct-30.3* MCV-96 MCH-32.3* MCHC-33.5 RDW-16.0* Plt Ct-90* [**2103-4-27**] 03:00AM BLOOD PT-16.2* PTT-26.1 INR(PT)-1.4* [**2103-5-1**] 04:43AM BLOOD Glucose-143* UreaN-15 Creat-1.0 Na-137 K-4.2 Cl-105 HCO3-28 AnGap-8 [**2103-4-24**] 01:20PM BLOOD ALT-77* AST-190* AlkPhos-121 TotBili-2.5* [**2103-5-1**] 04:43AM BLOOD ALT-90* AST-164* AlkPhos-167* TotBili-0.7 [**2103-5-1**] 04:43AM BLOOD Calcium-7.1* Phos-2.5* Mg-1.7 Brief Hospital Course: On [**2103-4-24**], he underwent exploratory laparotomy, intraoperative ultrasound, cholecystectomy, and segment 4b/5 resection. Surgeon was Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]. [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 406**] drain was placed in the bare area behind the right lobe as well as in the resection bed. Please refer to operative note for details. Postop, BP was low requiring a neo drip, and iv albumin was given. BP responded to these treatments. Neo drip was stopped and BP stabilized. He complained of a lot of abdominal pain and was medicated with IV Dilaudid and methadone then a Ketamine drip. A Dilaudid PCA was also started. He was transferred to the CSICU for management. The pain service was consulted for difficult pain control management. Pain control improved. Ketamine was weaned off. Neurontin was increased. Mental status was notable for sleepiness. Blood sugars were elevated and an insulin drip was used with improvement. Diet was advanced. Hepatology was consulted. Recommendations included starting Lactulose and Rifaximin. [**Last Name (un) **] was consulted and assisted with insulin management. Insulin drip was switched to Lantus and Humalog sliding scale. Of note, Levoxyl was started. Recommendations included checking TSH, T4 and T3. Hepatology was consulted and recommended increasing Rifaximin dose titration of Lactulose per BMs. Home dose of Methadone was resumed. Diet was advanced. Abdomen was distended. He did have multiple stools likely from Lactulose. JP drain outputs (ascites)increased to ~ 1100-1000 ml/day. Abdomen became more distended concerning for ascites. Diet was changed to 2gm sodium and Lasix 20mg qd was started on [**5-1**] for 3 days. PT evaluated him and declared him safe for discharge to home. He was discharged and scheduled to f/u with Drs [**Last Name (STitle) **] and [**Name5 (PTitle) 497**] on [**5-4**]. Medications on Admission: albuterol, Xanax, Reyataz, Truvada, Nizoral, levothyroxine, lisinopril, methadone, omeprazole, oxycodone, Isentress, Norvir, Androderm, and NPH insulin Discharge Medications: 1. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 1-2 Puffs Inhalation Q4H (every 4 hours) as needed for shortness of breath. 2. ritonavir 100 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 3. atazanavir 150 mg Capsule Sig: Two (2) Capsule PO DAILY (Daily). 4. emtricitabine-tenofovir 200-300 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. raltegravir 400 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. gabapentin 300 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 7. lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO TID (3 times a day): decrease to 15ml 3x/day when Rifaximin available. you should have2-3 stools/day. if greater than 4 stools, decrease to 15ml 3x/day. Disp:*1000 ml* Refills:*2* 8. lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 9. levothyroxine 150 mcg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 10. rifaximin 550 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 11. furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 3 days: f/u with Dr. [**Last Name (STitle) **] [**5-4**] for further dosing. Disp:*10 Tablet(s)* Refills:*0* 12. NPH insulin human recomb 100 unit/mL Suspension Sig: Seventeen (17) units Subcutaneous once a day. 13. NPH insulin human recomb 100 unit/mL Suspension Sig: Five (5) units Subcutaneous at bedtime. 14. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 15. testosterone 5 mg/24 hr Patch 24 hr Sig: One (1) Transdermal once a day. 16. methadone 10 mg Tablet Sig: Four (4) Tablet PO three times a day: for pain. Disp:*84 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital1 6136**] VNA Discharge Diagnosis: HCC Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Please call Dr.[**Name (NI) 8584**] office [**Telephone/Fax (1) 673**] if you have: fever (101 or greater), chills, nausea, vomiting, jaundice, increased abdominal pain, increased abdominal distension, incision redness or bleeding. You will take Lasix 20mg daily for the next 3 days. Weigh yourself EVERY DAY. Write weight down on paper. Bring record of weights to next appointment with Dr. [**Last Name (STitle) **] [**Name (STitle) **] Dr.[**Name (NI) 8584**] office [**Telephone/Fax (1) 673**] if your weight increases by 2 pounds in a day. check your blood sugar prior to meals and write down results. follow up with your PCP Followup Instructions: Provider: [**First Name11 (Name Pattern1) 674**] [**Last Name (NamePattern4) 675**], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2103-5-4**] 10:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 8507**], MD Phone:[**Telephone/Fax (1) 2422**] Date/Time:[**2103-5-4**] 10:40 Completed by:[**2103-5-3**] ICD9 Codes: 5715, 2875, 4019, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7941 }
Medical Text: Admission Date: [**2195-10-18**] Discharge Date: [**2195-10-24**] Service: MEDICINE Allergies: Penicillins / Valsartan / Ace Inhibitors Attending:[**First Name3 (LF) 6578**] Chief Complaint: bright red blood per rectum Major Surgical or Invasive Procedure: Endogastric duodenoscopy colonoscopy History of Present Illness: Ms. [**Known lastname 57871**] is an 84 year old woman with a past medical history significant for left femur fracture, repaired [**Date range (1) 57872**] and on coumadin until [**10-8**], found with bright red blood per rectum at [**Hospital3 **]. There was also a report of a ? vaginal bleeding. The patient denies presyncope or hematemesis. She refuses to participate in the rest of the interview because she is very nervous. Of note, in a conversation with her daughter, it appears that Ms. [**Known lastname 57871**] had a hysterectomy about 1 year ago. Past Medical History: left femur fracture, repaired [**Date range (1) 57872**] and on coumadin until [**10-8**] HTN CAD DM-2 Parkinson's Hypothyroid Hyperlipidemia Pancreatitis h/o syncope h/o hysterectomy Social History: TOB-denies IVDA-denies ETOH-denies Family History: noncontributory Physical Exam: Vitals: T 98.7 BP 119/70 HR 87 RR 18 O2 sat 100% on RA Gen: anxious appearing awake lying in bed HEENT: dry MM, EOMI, pupils reactive CV: RRR Pulm: CTAB no crackles Abd: soft NT ND + BS no guarding no rebound obese Ext: WWP DP 2+ bilaterally skin: ecchymosis throughout Pertinent Results: [**2195-10-18**] 01:30PM HCT-28.0* [**2195-10-18**] 07:48AM GLUCOSE-258* UREA N-37* CREAT-0.7 SODIUM-139 POTASSIUM-4.8 CHLORIDE-104 TOTAL CO2-27 ANION GAP-13 [**2195-10-18**] 07:48AM ALT(SGPT)-7 AST(SGOT)-18 ALK PHOS-66 AMYLASE-77 TOT BILI-0.4 [**2195-10-18**] 07:48AM LIPASE-40 [**2195-10-18**] 07:48AM NEUTS-79.5* BANDS-0 LYMPHS-15.4* MONOS-3.9 EOS-0.8 BASOS-0.4 [**2195-10-18**] 07:48AM PLT SMR-NORMAL PLT COUNT-395# [**2195-10-18**] 07:48AM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-NEG [**2195-10-18**] 07:48AM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.023 Brief Hospital Course: # GIB - Patient was noted to have maroon stool, observed in the ED. The patient underwent EGD which revealed a Duodenal ulcer in bulb, Erythema in the antrum compatible with gastritis, Erythema and erosions in the second part of the duodenum compatible with duodenitis, Small hiatal hernia. A colonoscopy was prematurely terminated due to inadequate preparation. She was started on [**Hospital1 **] Protonix. She then experienced an episode of hypotension and tachycardia with passage of bloody stool. Her hematocrit was noted to drop from 33 to 23 and she was transferred to the MICU for further observation and transfusion of PRBCs. A repeat EGD revealed ulcers in the distal bulb and first part of the duodenum, one with a stigmata of bleeding (thermal therapy), and an ulcer in the distal stomach body on the greater curvature. This area was successfully cauterized. Her HCT remained stable over the next 72 hours and she tolerated a PO diet upon discharge. The daughter and rehab center reported vaginal bleeding. A speculum exam was performed revealing no stigmata of bleeding in her vagina. Gynecology was curbsided and recommended no further intervention since she has had a prior TAH/BSO. # Parkinsons- Stable and continues on current medications. # Urinary tract infection- Urinalysis revealed a urinary tract infection, >100k GNR and was started on a 7d course of levofloxacin. Medications on Admission: Aspirin atenolol 12.5 QD iron levoxyl 150 QD senna zocor 80 mg mirapex 0.125 QD sinemet 25/100 QID lasix 60 QD glipizide XL 10 Discharge Medications: 1. Carbidopa-Levodopa 25-100 mg Tablet Sig: One (1) Tablet PO QID (4 times a day). 2. Levothyroxine Sodium 150 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Pramipexole Dihydrochloride 0.125 mg Tablet Sig: One (1) Tablet PO QD (). 4. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection ASDIR (AS DIRECTED). 5. Trazodone HCl 50 mg Tablet Sig: 0.25 Tablet PO HS (at bedtime) as needed. 6. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 7. Atenolol 25 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 8. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours) for 2 weeks: after 2 weeks, you may go to once per day. Ask your doctor. 9. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 10. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 6 days. 11. Simethicone 80 mg Tablet, Chewable Sig: 0.5-1 Tablet, Chewable PO QID (4 times a day) as needed. 12. Glipizide 10 mg Tab, Sust Release Osmotic Push Sig: One (1) Tab, Sust Release Osmotic Push PO once a day. 13. Lasix 20 mg Tablet Sig: Three (3) Tablet PO once a day. 14. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO four times a day. 15. Vitamin D 400 unit Capsule Sig: One (1) Capsule PO once a day. 16. Morphine Sulfate 2 mg/mL Syringe Sig: One (1) Injection Q4H (every 4 hours) as needed for 5 days: hold for sedation. 17. Vitamin C 1,000 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - LTC Discharge Diagnosis: peptic ulcer disease Parkinson's disease urinary tract infection, complicated Hypertension Diabetes Mellitus Hyperlipidemia Discharge Condition: good Discharge Instructions: Please continue your home medications. Call your doctor if you feel short of breath, dizzy, or if you have dark stool. You should also call if you vomit blood or feel weak. Do not take aspirin until after your appointment with Dr. [**First Name (STitle) 572**] who will decide when you can start taking it. Followup Instructions: Please call your PCP: [**Name10 (NameIs) **],[**Name11 (NameIs) 177**] [**Name Initial (NameIs) **]. [**Telephone/Fax (1) 57873**] for an appointment in the next 2 weeks. Your PCP should look up the results of your h. pylori serologies. Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 4465**], MD Where: LM [**Hospital Unit Name 22399**] Phone:[**Telephone/Fax (1) 1983**] Date/Time:[**2195-12-3**] 2:15 ICD9 Codes: 5990, 4241, 2760, 2768, 2449, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7942 }
Medical Text: Admission Date: [**2118-7-6**] Discharge Date: [**2118-7-12**] Service: SURGERY Allergies: Penicillins / Ranitidine / Erythromycin Base / Ciprofloxacin / Enalapril / Bactrim Attending:[**First Name3 (LF) 5880**] Chief Complaint: abdominal pain, distention, leukocytosis Major Surgical or Invasive Procedure: [**2118-7-6**] Exploratory lap with lysis of adhesions History of Present Illness: [**Age over 90 **]-year-old female with a history of prior small bowel resection and repair of a femoral hernia who presented with 24 hours of nausea, vomiting and abdominal pain with distention. The patient was evaluated by her outside hospital physician who sent her to the emergency department. In the emergency department, she was found to be significantly distended with diffuse abdominal tenderness and cramping. Her white count was 22,000 with a lactate of 2.7. An abdominal CT scan was consistent with bowel obstruction with proximal small bowel dilatation, distal decompression. Based on these findings, the decision was made to take her to the operating room for laparotomy. Past Medical History: R hip fx s/p repair HTN hypercholesterolemia atrial fibrillation GERD duodenal ulcer legally blind severe OA fluid retention urinary incontinence Social History: Currently lives with her daughter- very involved in care. Denies tobacco/ETOH. Family History: Non-contributory Pertinent Results: [**2118-7-6**] 04:30PM GLUCOSE-152* UREA N-24* CREAT-0.6 SODIUM-136 POTASSIUM-3.8 CHLORIDE-103 TOTAL CO2-24 ANION GAP-13 [**2118-7-6**] 04:30PM CK-MB-6 cTropnT-<0.01 [**2118-7-6**] 04:30PM CALCIUM-7.6* PHOSPHATE-2.7 MAGNESIUM-1.9 [**2118-7-6**] 04:30PM WBC-5.1# RBC-3.22* HGB-9.8* HCT-30.4* MCV-94 MCH-30.3 MCHC-32.1 RDW-14.1 [**2118-7-6**] 04:30PM PLT COUNT-390 [**2118-7-6**] 04:30PM PT-12.2 PTT-31.1 INR(PT)-1.0 CHEST (PORTABLE AP) Reason: s/p ex lap/ SOB low saturation [**Hospital 93**] MEDICAL CONDITION: s/p ex lap REASON FOR THIS EXAMINATION: s/p ex lap/ SOB low saturation REASON FOR EXAMINATION: Decreased saturations. Portable AP chest radiograph compared to [**2118-7-7**]. The NG tube was removed in the meantime interval. There is worsening of bilateral perihilar opacities suggesting worsening of pulmonary edema. In addition, there is a significant increase in bilateral pleural effusion. The heart size is mildly enlarged but unchanged and there is also no change in the appearance of the mediastinum. IMPRESSION: Worsening pulmonary edema accompanied by increased pleural effusions. These findings were communicated to Dr. [**Last Name (STitle) **] during the time of dictation. Cardiology Report ECG Study Date of [**2118-7-8**] 2:29:54 AM Sinus tachycardia. Left ventricular hypertrophy with ST-T wave changes. Compared to the previous tracing of [**2118-7-6**] no diagnostic interim change. Intervals Axes Rate PR QRS QT/QTc P QRS T 111 154 84 296/[**Telephone/Fax (2) 98653**] 174 Brief Hospital Course: She was admitted to the Surgery Service and taken to the operating room for an exploratory laparotomy and lysis of adhesions. There were no intraoperative complications. Postoperatively she did have episodes of decreased oxygen saturations requiring supplemental oxygen. Her chest xray did show some evidence of pulmonary edema and she was given IV Lasix. Her oxygen was eventually weaned off and she is saturating well. A Speech and Swallow evaluation was also done because of concern for aspiration; there was evidence of aspiration with thin liquids. It is being recommended that she have thickened liquids and that her medications be crushed and given in applesauce or yogurt. A Rheumatology consult was placed during her hospital stay because of an elevated sed rate. In reviewing her paper work from her previous rehab stay it appears that this was not a [**Last Name **] problem associated with this hospitalization and that a Rheumatology consult was initiated. She does have a history of osteoarthritis but no history of PMR. It is recommended that she follow up with the Rheumatologist at rehab for further workup of this problem. Physical therapy was consulted and has recommended that she go to a rehab facility after hospital discharge. Medications on Admission: Norvasc 5' Betaxolol eye gtts Colace Dulcolax Lidoderm patch Lopressor 25'' Protonix 40' Dig .125' Rosuvastatin 5' Tylenol prn Ultram 50 prn Discharge Medications: 1. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) [**Last Name **]: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 2. Heparin (Porcine) 5,000 unit/mL Solution [**Last Name **]: One (1) ML Injection TID (3 times a day). 3. Insulin Regular Human 100 unit/mL Solution [**Last Name **]: One (1) dose Injection four times a day as needed for per sliding scale: See attached sliding scale. 4. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated [**Last Name **]: [**2-1**] Adhesive Patch, Medicateds Topical QDAY (). 5. Betaxolol 0.25 % Drops, Suspension [**Month/Day (2) **]: One (1) Drop Ophthalmic [**Hospital1 **] (2 times a day): apply to left eye . 6. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] DAILY (Daily). 7. Docusate Sodium 100 mg Capsule [**Last Name (STitle) **]: One (1) Capsule PO BID (2 times a day). 8. Rosuvastatin 5 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO DAILY (Daily). 9. Metoprolol Tartrate 25 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO BID (2 times a day): hold for HR <60; SBP <110. 10. Tramadol 50 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO every six (6) hours as needed for pain. 11. Digoxin 125 mcg Tablet [**Last Name (STitle) **]: One (1) Tablet PO once a day: hold for HR <60. 12. Norvasc 5 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO once a day: hold for SBP <110. Discharge Disposition: Extended Care Facility: [**Hospital6 979**] - [**Location (un) 246**] Discharge Diagnosis: Small bowel obstruction Discharge Condition: Stable Followup Instructions: Follow up with Dr. [**Last Name (STitle) **] in [**2-1**] weeks, call [**Telephone/Fax (1) 6439**] for an appointment. Completed by:[**2118-8-8**] ICD9 Codes: 4280, 2720, 4019
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Medical Text: Admission Date: [**2189-6-11**] Discharge Date: Date of Birth: [**2115-4-20**] Sex: M Service: CCU NOTE: This is an addendum to Dr. [**Last Name (STitle) **] dictation which describes the presentation, as well as the hospital course through [**6-26**]. On [**6-26**], the patient was stable with an improved congestive heart failure after his milrinone therapy with a creatinine of 2.4 and a sodium of 129 and the he was currently awaiting placement in rehabilitation. Over the next three days, his creatinine began to rise and he had fluid retention, increased peripheral edema and increased crackles on exam. On [**6-29**], it was decided he was not suitable for rehabilitation placement at that point and was decompensating and was thus restarted on milrinone with almost immediate symptomatic improvement. On [**6-30**], his creatinine was 3.0 and sodium 123. His weight was 168.8 pounds, so he was started on milrinone at 0.28 mcg per kg per minute. Over the next several days, his creatinine began to decrease and sodium began to increase. The patient had good symptomatic improvement. On [**7-3**], the rate of milrinone was increased to 37.5 mcg per kg per minute as he was being evaluated for potential of home intravenous milrinone therapy. Also, on [**7-3**], the patient spiked to a fever to 101.9?????? Fahrenheit with 15 white blood cells in his urinalysis. He was thus started on a seven day course of oral ciprofloxacin. The patient defervesced the following day. On [**7-3**], his creatinine was down to 1.8 and his sodium was up to 131 and his weight was continuing to decrease, such that on [**7-5**] his weight was 157.3 down 10 pounds in less than a week. Also, on [**7-5**], he had another gout flare in his right ankle and was started on colchicine 0.6 mg q day, as well as a short prednisone taper. During this time, the patient was followed by the heart failure team to be evaluated for the possibility of intravenous home milrinone versus intravenous milrinone at rehabilitation facility. There was no rehabilitation facilities that could take the patient with intravenous milrinone and thus the milrinone was stopped on [**7-8**], at which time his creatinine was 1.6, his sodium was 136 and his weight was 154 pounds. Also, during the milrinone therapy, his carvedilol dose was able to be increased to 4.685 mg [**Hospital1 **], so he has continued to do well off milrinone and is currently stable with PICC line placed for potential home milrinone therapy should he require it. His insurance company ultimately approved intravenous home milrinone should he need it and he is currently stable and being discharged to rehabilitation facility. In rehabilitation, he will need his digoxin level and INR checked 2x per week. DISCHARGE MEDICATIONS: 1. Carvedilol 4.685 mg po bid 2. Lisinopril 5 mg po qd 3. Digoxin 0.125 mg po q od 4. Mexiletine 150 mg po bid 5. Amiodarone 200 mg po bid 6. Coumadin 3 mg po q hs 7. Synthroid 0.125 mg po qd 8. Flomax 0.4 mg po qd 9. Lasix 120 mg po qd 10. Neurontin 100 mg po bid Discharge summary should be held until the rehabilitation facility is known, at which time it can be printed from the computer. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1544**], M.D. [**MD Number(1) 1545**] Dictated By:[**Last Name (NamePattern1) 104596**] MEDQUIST36 D: [**2189-7-10**] 09:17 T: [**2189-7-10**] 10:22 JOB#: [**Job Number 33507**] ICD9 Codes: 4280, 4254, 5849, 2761, 4019, 2449, 2749
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Medical Text: Admission Date: [**2119-2-2**] Discharge Date: [**2119-2-7**] Date of Birth: [**2047-3-19**] Sex: F Service: MEDICINE Allergies: Iodine; Iodine Containing / Iodipamide Meglumine Attending:[**First Name3 (LF) 358**] Chief Complaint: Hypotension and hypoxia Major Surgical or Invasive Procedure: Central Line Placement [**2118-2-4**] and removal on [**2119-2-7**] History of Present Illness: 71 F with HTN, dyslipidemia, recent pacer placement for sinus arrest complicated by recurrent hemorrhagic pericardial effusions, admitted to [**Hospital1 18**] for episode of hypoxia in the setting of worsened chest pain and DOE; on [**2-3**] she is transferred to the ICU for hypotension, new O2 requirement and confusion. . She was reportedly doing well at rehab s/p hemorrhagic pericardial effusion after PPM placement, until the day prior to presentation, when she developed worsening chest pain and SOB. She reported that the pain felt like it was "going around her heart", was sharp, worse with deep inspiration, and radiated to the left jaw. She also had SOB, with worsening DOE while walking at rehab. She otherwise denied n/v, diaphoresis. No lower extremity pain or swelling. She was found to have an O2 sat of 69% on RA. She was placed on a NRB with improvement in O2 sat to 89%. Sent to ED for evaluation. . ED Course: O2 sats >97% on 3L by NC, and SBP remained > 100. She had a bedside focused echo which showed a "small effusion and no wall motion abnormalities." Pulsus measurements in the ED remained < 10 mm Hg. A subsequent formal TTE showed a small to moderate circumferential pericardial effusion that was echo dense, consistent with "blood, inflammation or other cellular elements", without echocardiographic signs of tamponade. Overall EF 70%. She also received a V/Q scan for an elevated D-dimer (h/o contrast allergy) which showed multiple large and small matched defects through out all lobes of the lungs, consistent with COPD. It also showed an unmatched defect (greater on perfusion) in the posterior left lower lobe, thought related to shifting effusion upon position change from ventilation to perfusion. The study was read as intermediate probability. . Hospital Course: patient was admitted to medical service. Today ([**2-3**]) patient had trigger episode with hypotension responsive to IVF (75/48), new O2 requirement (96% on 2L), mental status changes - found to be cool and diaphoretic; this prompted her transfer to the ICU team. ABG at the time was 7.33/43/145. . Recent [**Last Name (un) 1724**] Course: Initially presented to [**Hospital3 **] with syncope and found to have sinus pause with junctional escape of 35. She received PPM on [**1-10**] @ [**Last Name (un) 1724**]. On [**2119-1-13**] (2 days after discharge for pacer implantation) came back to [**Last Name (un) 1724**] with chest pain and palpitations and was found to be in atrial fibrillation with a rapid ventricular response of 190. She was electrically cardioverted, but remained hypotensive. She was found to have a pericardial effusion with tamponade. A pericardiocentesis drained 200 cc of hemorrhagic fluid. However, she had recurrent effusion later that same day, and ultimately underwent mediastinotomy, where she was found to have a small bleeding vessel "at the site of her prior pericardiocentesis." Her atrial lead could also be seen in the atrium, though it was noted not to be protruding through, and was oversewn. Also of note, she was evaluated here for SIADH - found to have normal urine Osm (656) and low serum Osm (278), urine Na of 81; this resolved spontanteously. She was discharged to [**First Name4 (NamePattern1) 1820**] [**Last Name (NamePattern1) **] at [**Location (un) 78090**] on [**2119-1-23**]. Past Medical History: Hypertension Hyperlipidemia Parkinson's Seizure disorder s/p PPM placement for sinus arrest with syncope ([**Hospital3 **] [**2119-1-10**]) c/b hemorrhagic effusion and tamponade physiology from "leaking vessel" Cerebellar anerysm s/p coiling Blind in left eye [**1-28**] aneurysm Social History: Lives with daughter's family. Current tobacco, ~1ppd x 50yr. No EtOH or illicits. Family History: NC Physical Exam: Vitals - T 96.4, BP 107/67, HR 91, RR 18, O2 sat 97% 2L NC, wt 56.1 kg, pulsus 10 mm Hg General - elderly female, NAD HEENT - L eye medially deviated. R eye EOMI. OP clr, MM dry, no JVD CV - RRR, no rubs Chest - decr BS at L base Abdomen - soft Back - non-tender Extremities - no edema . Pertinent Results: [**2-1**] VQ Scan: INTERPRETATION: Ventilation images obtained with Tc-[**Age over 90 **]m aerosol in 6 views demonstrate multiplelarge and small defects through out all lobes of the lungs, consistent with COPD. Perfusion images in the same 6 views show matched defects with the ventilation scan with a somewhat greater sized perfusion defect seen in the posterior leftlower lobe, likely related to shifting effusion upon position change fromventilation to perfusion. Chest x-ray shows a small left pleural effusion. The above findings are consistent with an indeterminant probability scan. IMPRESSION: Indeterminant probability scan. Severe COPD. [**2-5**] CXR:Comparison is made with prior study performed a day earlier. There has been progressive interval increase in small-to-moderate right pleural effusion, moderate left pleural effusion is unchanged as is left lower lobe retrocardiac atelectasis. Left transvenous pacemaker leads terminate in the standard position in the right atrium and right ventricle. Right subclavian catheter tip remains in the proximal right atrium. The aorta is elongated. Cardiac size is top normal. There is engorgement of the pulmonary vasculature with no overt CHF. Patient is post median sternotomy. [**2119-2-1**] EKG: Sinus rhythm. T wave inversion in leads VI-V2 and T wave flattening in leads aVL and V3 which is non-specific. Ischemia should be considered. Clinical correlation is suggested. No previous tracing available for comparison. [**2119-2-3**] ECHO: The left ventricular cavity is small. Left ventricular systolic function is hyperdynamic (EF>75%). Right ventricular chamber size and free wall motion are normal. The aortic valve is not well seen. There is a moderate sized pericardial effusion subtending the apex, right ventricular free wall, and lateral wall. The effusion is echo dense, consistent with blood, inflammation or other cellular elements. There are no echocardiographic signs of tamponade. No right atrial or right ventricular diastolic collapse is seen. Compared with the findings of the prior study (images reviewed) of [**2118-2-2**], the findings are similar. [**2119-2-1**] 05:15PM BLOOD WBC-12.3* RBC-4.87 Hgb-14.1 Hct-42.8 MCV-88 MCH-29.0 MCHC-33.0 RDW-14.6 Plt Ct-176 [**2119-2-5**] 02:01AM BLOOD WBC-8.6 RBC-3.58* Hgb-10.4* Hct-31.5* MCV-88 MCH-29.0 MCHC-33.0 RDW-14.9 Plt Ct-157 [**2119-2-1**] 05:15PM BLOOD Neuts-82.1* Lymphs-13.5* Monos-4.0 Eos-0.3 Baso-0.1 [**2119-2-3**] 08:57PM BLOOD Neuts-92.4* Lymphs-4.2* Monos-3.3 Eos-0.2 Baso-0 [**2119-2-5**] 02:01AM BLOOD PT-13.0 PTT-34.8 INR(PT)-1.1 [**2119-2-1**] 05:15PM BLOOD D-Dimer-[**2076**]* [**2119-2-5**] 02:01AM BLOOD Glucose-81 UreaN-17 Creat-0.5 Na-134 K-4.0 Cl-104 HCO3-25 AnGap-9 [**2119-2-3**] 12:45PM BLOOD ALT-8 AST-46* LD(LDH)-202 CK(CPK)-8* AlkPhos-173* TotBili-0.4 [**2119-2-1**] 05:15PM BLOOD cTropnT-<0.01 [**2119-2-2**] 04:00AM BLOOD cTropnT-<0.01 [**2119-2-2**] 11:05AM BLOOD cTropnT-<0.01 [**2119-2-2**] 05:05PM BLOOD cTropnT-<0.01 [**2119-2-3**] 06:10AM BLOOD CK-MB-2 cTropnT-<0.01 [**2119-2-3**] 12:45PM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2119-2-3**] 12:45PM BLOOD Albumin-2.4* Calcium-7.6* Phos-2.7 Mg-1.6 [**2119-2-5**] 02:01AM BLOOD Calcium-8.2* Phos-2.5* Mg-1.5* [**2119-2-2**] 11:05AM BLOOD Osmolal-272* [**2119-2-3**] 06:10AM BLOOD TSH-3.9 [**2119-2-3**] 06:10AM BLOOD Free T4-1.3 [**2119-2-3**] 11:00PM BLOOD Cortsol-37.3* [**2119-2-3**] 10:41AM BLOOD Lactate-1.6 [**2119-2-3**] 10:41AM BLOOD Type-ART pO2-145* pCO2-43 pH-7.33* calTCO2-24 Base XS--3 Brief Hospital Course: A/P: 71 F with HTN, dyslipidemia, recent pacer placement for sinus arrest complicated by recurrent hemorrhagic pericardial effusions, admitted to [**Hospital1 18**] for episode of hypoxia in the setting of worsened chest pain and [**Hospital **] transferred to the ICU for hypotension (75/48), new O2 requirement (96% on 2L) and mental status changes. Was found to have Klebsiella UTI, was started on broad spectrum ABX and then tailored to cipro. Clinically improved, vitals stable >24hrs. Pt transferred back to medicine floor on [**2-5**], where she remained until day of discharge. . #) Klebsiella UTI/septicemia -- Pt presented with a high white cell count and hypotension. She was started on broad spectrum antibiotics. The urine culture grew Klebsiella, and with subsequent sensitivities was changed to oral course of ciprofloxacin. The WBC count improved and the hypotnesion resolved on antibiotics. End date for ciprofloxacine is [**2119-2-17**] for 14 day course. . #) Atrial fibrillation- Atrial fibrillation with RVR in the setting of sepsis. She was hemodynamically stable without signs of tamponade (pulses paradoxes <10). She initially required 15 iv metoprolol and 10 mg iv dilt to control her rate, and was placed on dilt gtt temporarily for rate control. She continued on her previous dose of amiodarone. She was not anticoagulated given her recent history of hemorrhagic effusion. She converted to Sinus Rhythm (SR) on dilt gtt and remained in SR for the remainder of her hospitalization. She was transitioned to PO diltiazem 30mg QID and dilt gtt was weaned. Following conversion to sinus rhythms, the pt remained asymptomatic throughout the remainder of her admission. We discharged the pt on PO diltiazem and her outpt dose of amiodarone. . #) anemia, acute blood loss: In the setting of volume repletion for hypotension/sepsis, and right subclavian line placement. Guaiac has been negative. At rehab, the pt should have repeat Hct drawn for the next 2 days to ensure that Hct does not continue to decrease. At discharge, iron studies and vitamin B12/folate were pending. Please call for results. . #) Hypoxia - initially pt required 2-3L supplemental O2 by nasal cannula to maintain O2 sats. Given her long tobacco history, and CXR findings, she likely has COPD and may now be at baseline. Pt initially reported some symptoms of pleuritic CP, thus raising the question of PE --> VQ scan was performed and demonstrated multiple matched defects, cw COPD but intermediate probability for PE. However, LENIs were negative. Anticoagulation was not considered given recent h/o hemorrhagic pericardial effusion. CXR did demonstrate [**Last Name (LF) 78091**], [**First Name3 (LF) **] pt was started on incentive spirometry. Her hypoxia significantly improved throughout her hospitalization, and she no longer had an O2 requirement by day of discharge. . #) Pericardial effusion - no evidence of tamponade physiology on exam: Pulsus wnl, hemodynamically stable. TTE was performed on 2 occasions during this hospitalization, both with no echocardiographic signs of tamponade. She did not demonstrate any symptoms or signs of tamponade during her admission. . #) Hyponatremia - SIADH. Admitted with Na of 129 but clinically dehydrated, and with Bu:Cr > 20. Pt was administered NS to alleviate hypotension. Serum Na improved to 130-134, with no clinical signs of dehydration. [**Last Name (un) **] stim test and TSH were normal. Pt did not demonstrate any sx/signs of hyponatremia this hospitalization. At rehab, her SIADH can likely be managed with free H2O restriction initially 2L and then less if needed and close monitoring. . #) HTN - pt was hypotensive at admission, most likely due to urosepsis/SIR. Thus, hypertension meds were held this admission. Diltiazem was initiated for atrial fibrillation and worked well for her hypotension throughout the remainder of her stay. Lisinopril can be reinitiated at the discretion of her rehab physcian. . #) Parkinsons: we continued outpt regimen of Sinemet. Pt remained stable this admission. . #) Seizure Disorder: we continued outpt regimen of Depakote; pt remained stable. . #) Code Status: was changed to full this admission (pt changed from DNR/I to full code after discussions with family). Medications on Admission: Combivent Amiodarone 200 qd Lipitor 20 qd Sinemet 25/100 2 tabs tid Depakote 250 tid folate 1 qd lisinopril 10 qd senna Discharge Medications: 1. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 2. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 10 days. Disp:*20 Tablet(s)* Refills:*0* 3. Carbidopa-Levodopa 25-100 mg Tablet Sig: Two (2) Tablet PO three times a day. 4. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Divalproex 250 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO TID (3 times a day). 7. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Ipratropium-Albuterol 18-103 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q6H (every 6 hours) as needed. 9. Diltiazem HCl 30 mg Tablet Sig: One (1) Tablet PO QID (4 times a day). Disp:*120 Tablet(s)* Refills:*2* 10. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day. 11. Dulcolax 10 mg Suppository Sig: One (1) Rectal once a day as needed for constipation. Discharge Disposition: Extended Care Facility: [**Location 1820**] Ctr. Discharge Diagnosis: Primary: 1) Urosepsis 2) Hypoxia due to atelectasis- resolved 3) Pericardial effusion- hemorrhagic- stable 4) Atrial fibrillation . Secondary: HTN Hyperlipidemia Parkinson's Seizure disorder Discharge Condition: Stable, improving. Discharge Instructions: Please return to the emergency room or call your rehab doctor if you develop dizziness, heart racing, fevers, chills, confusion, abdominal pain, nausea, vomiting, or any other worrisome symptoms. . The following changes were made to your medications: ADDED: 1) Ciprofloxacin- for treatment of your urinary tract infection 2) Diltiazem- for treatment of your atrial fibrillation. 3) Ipratropium-Albuterol Inhaler- prescribed to improve your breathing/oxygenation We stopped your lisinopril as we added diltiazem which is also a blood pressure pill. Followup Instructions: Follow up with your primary care physician [**Last Name (NamePattern4) **] [**12-28**] weeks. ICD9 Codes: 5990, 5119, 2851, 5180, 496, 4019, 2720
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Medical Text: Admission Date: [**2140-6-25**] Discharge Date: [**2140-7-1**] Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 1990**] Chief Complaint: Septic shock Major Surgical or Invasive Procedure: Central line placement History of Present Illness: Ms. [**Known lastname 20598**] is an 84yo female with PMH significant for c.diff sepsis, CAD, and atrial fibrillation who is being admitted to the MICU for septic shock. Patient was recently discharged to rehab on [**6-17**] after being hospitalized for septic shock thought to be [**1-2**] c. diff infection. She underwent an elective left total hip replacement at [**Hospital1 2025**] on [**4-27**]. She subsequently developed diarrhea and was admitted to an OSH in [**Month (only) **] and was found to be positive for c.diff toxin. She underwent an CT abd/pelvis during this time which showed diffuse colonic wall thickening with generalized mesenteric inflammation/edema. She was then transferred to [**Hospital1 18**] for further work-up and during this time required pressors to maintain her blood pressure. During her recent admission, she was admitted to the [**Hospital Unit Name 153**]. She completed a course of PO Vancomycin for c.diff. Her hospital course was also complicated by acute on chronic diastolic CHF and she was placed on a Lasix gtt and was diuresed aggressively. She also went into afib with RVR and was loaded with Amiodarone and was anti-coagulated on Coumadin. She was already on Coumadin given her history of DVT. She was discharged to [**Hospital 20605**] on [**6-17**]. This evening, the patient was found to be lethargic and febrile to 102.5. Blood and urine cultures were drawn and her urine was noted to be concentrated, foul, and dark. She received Tylenol 2gm and was started on IVFs. In route to [**Hospital1 18**], she was hypotensive and received IVFs. In the ED, initial vitals were T 100.8 Tmax 101.5 BP 71/56 AR 96 RR 16 O2 sat 91% RA, 96% on 4L. She received Vancomycin, Cipro 400mg IV, and Flagyl 500mg IV. A RIJ central line was placed and she received a total of 4L NS. Past Medical History: 1)CAD s/p stenting of LCx and RCA per OMR cath report [**12-4**] 2)PAF 3)C. diff colitis 4)LE DVT 5)HTN 6)Hyperlipidemia 7)Urinary incontinence 8)Osteoporosis 9)s/p ORIF and LTH 10)s/p hepatobiliary surgery [**42**])s/p hysterectomy 12)s/p cholecystectomy [**44**])s/p RTK x 1, LTK x 2 Social History: Lives in [**Location 7658**], MA with husband; 3 children live outside of MA; no ETOH, tobacco. Family History: Non-contributory Physical Exam: vitals T 97.6 BP 87/45 AR 120 RR 15 O2 sat 100% on NRB Gen: Awake and alert, mentating well HEENT: MMM Heart: Irregularly irregular, 2/6 systolic murmur Lungs: CTAB, crackles at posterior bases Abdomen: Soft, NT/ND, +BS Extremities: [**12-2**]+ DP/PT pulses bilaterally; PICC line in place Pertinent Results: [**2140-6-25**] 09:05PM BLOOD WBC-22.4*# RBC-3.08* Hgb-9.2* Hct-27.4* MCV-89 MCH-29.9 MCHC-33.6 RDW-16.1* Plt Ct-278 [**2140-6-30**] 05:48AM BLOOD WBC-8.9 RBC-3.80* Hgb-11.2* Hct-34.8* MCV-92 MCH-29.4 MCHC-32.1 RDW-15.7* Plt Ct-248 [**2140-6-25**] 09:05PM BLOOD Glucose-78 UreaN-33* Creat-1.0 Na-137 K-3.9 Cl-106 HCO3-19* AnGap-16 [**2140-6-30**] 05:48AM BLOOD Glucose-80 UreaN-19 Creat-0.8 Na-140 K-3.9 Cl-115* HCO3-20* AnGap-9 [**2140-6-26**] 05:41PM BLOOD Albumin-2.9* Calcium-7.1* Phos-2.4* Mg-1.7 [**2140-6-30**] 05:48AM BLOOD Calcium-7.9* Phos-3.0 Mg-1.8 [**2140-6-28**] 07:23AM BLOOD Vanco-17.8 [**2140-6-25**] 09:05PM BLOOD cTropnT-0.02* [**2140-6-26**] 02:49AM BLOOD CK-MB-NotDone cTropnT-0.01 [**2140-6-25**] 09:05PM BLOOD CK(CPK)-19* [**2140-6-26**] 02:49AM BLOOD CK(CPK)-21* . C. diff [**2140-6-25**]: CLOSTRIDIUM DIFFICILE TOXIN A & B TEST (Final [**2140-6-26**]): FECES POSITIVE FOR C. DIFFICILE TOXIN BY EIA. . CXR [**2140-6-27**]: The right internal jugular line tip terminates in mid-distal SVC. The right PICC line demonstrated on the prior study cannot be seen on the current exam, most likely removed in the meantime interval. Significant dextroscoliosis is again noted with subsequent left mediastinal shift. There is no change in the appearance of the cardiac silhouette. Interval increase of the bilateral right more than left pleural effusions is present with overall no appreciable change in the degree of vascular engorgement. No overt pulmonary edema is demonstrated. There is no pneumothorax. . Left wrist film due to wrist pain [**2140-6-14**]: IMPRESSION: 1. No acute fracture. 2. Widening of the scapholunate interval is compatible scapholunate ligamentous injury. 3. Severe degenerative changes of the STT and first CMC joints. Apparent collapse of the trapezoid and trapezium as described. . [**2140-6-4**] previous admission L UE U/S: IMPRESSION: No evidence of DVT of the left upper extremity. Brief Hospital Course: Ms. [**Known lastname 20598**] is an 84yo female with PMH as listed above who presents with septic shock. 1)Septic shock: Patient presented with hypotension, tachycardia, leukocytosis which was consistent with diagnosis of septic shock. She started having increasing amounts of diarrhea at the rehab facility and her urine was noted to be dark, concentrated, and foul smelling at rehab. She was recently admitted to [**Hospital1 18**] MICU for sepsis [**1-2**] c.diff. On admission, sepsis protocol was initiated. She was pan-cultured and started on broad spectrum antibiotics-Cipro, Vancomycin IV, PO Vancomycin, and Flagyl. The c.diff toxin came back positive. Her antibiotic regimen was weaned down to Flagyl IV and PO vancomycin. She should continue Flagyl for 2 week course and she should continue the Vancomycin PO which should be tapered over the next few months. Vancomycin taper as follows: 125mg PO four times daily for 6 days (last dose q6hrs is on [**2140-7-6**]) 125mg PO twice daily for 7 days 125mg once daily for 7 days 125mg every other day for 7 days 125mg every 3 days for 14 days 2)Diastolic CHF: Patient has history of diastolic CHF and required aggressive diuresis with a lasix gtt during her last admission. Cardiac enzymes were negative. She initially appeared volume overloaded on exam but is likely intravascularly dry based on her CVP since she presented with sepsis. Her Lasix was held given her hypotension and then restarted. She was restsrted on her home lasix regimen of lasix 20mg PO BID. 3)Atrial fibrillation: Patient first diagnosed with afib w/RVR during last admission. She is also anticoagulated with Coumadin. On admission, she was restarted on Amiodarone. The beta-blocker was held in light of her hypotension but then restarted after a few days. Anti-coagulation was also held given the supratherapeutic INR and coumadin 1.5mg PO daily was restarted today when her INR was 2.1 (see details below). 4)Anemia: Baseline hematocrit per OMR is low to mid 30's. She was transfused 2 units pRBCs in light of her hypotension. She was also maintained on iron supplements. Her HCT has since been stable. 5)Coagulopathy: Patient presented with elevated INR on admission. Remains elevated on transfer to medical floor. Likely [**1-2**] antibiotics she had received. She was restarted on coumadin 1.5mg PO daily today and should have daily INRs while at rehab given her c. diff history, amlodipine, and antibiotic regimen. 6)Non anion gap acidosis: Likely [**1-2**] diarrheal losses and she appears to be compensating based on the pH. Her bicarbonate level was followed daily. 7)Hypertension: Her outpatient anti-hypertensive regimen was initially held given hypotension and sepsis. The beta-blocker was restarted after her hypotension resolved. On several occasions in the last few days we have administered her beta-blocker despite SBP in the high 90s in order to control her heart rate as she has A fib and diastolic heart failure. Medications on Admission: Aspirin 325mg PO daily Clotrimazole 1% cream [**Hospital1 **] Acetaminophen 325-650mg PO Q6H PRN Ferrous Sulfate 325mg PO daily Warfarin PO daily Metoprolol Tartrate 50mg PO TID Atrovent neb Lasix 20mg PO BID Lansoprazole 30mg PO BID Amiodarone 200mg PO daily Discharge Medications: 1.Ferrous Sulfate 325 mg PO DAILY 2.Ipratropium Bromide 0.02 % Solution 1 Inhalation Q6H PRN 3.Amiodarone 200 mg Tablet PO DAILY 4.Sodium Chloride 0.9 % Syringe 10 ML Injection daily and PRN as needed for line flush. 5.Acetaminophen 325 mg Tablet 1-2 Tablets PO Q8H PRN 6.Dextromethorphan-Guaifenesin 10-100 mg/5 mL Syrup 5 ML PO Q6H as needed for [**Hospital1 **]. 7.Metoprolol Tartrate 50 mg PO TID 8.Trazodone 25 mg Tablet PO HS 9.Benzonatate 100 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 10.Furosemide 20 mg Tablet PO BID 11.Warfarin 1 mg Tablet, 1.5 Tablets PO DAILY 12.Vancomycin 125 mg Capsule PO Q6H for 7 days 125mg PO twice daily for 6 days (last dose q6hrs is on [**2140-7-6**]) 125mg once daily for 7 days 125mg every other day for 7 days 125mg every 3 days for 14 days 13.Lansoprazole 30 mg Capsule PO BID 14.Metronidazole in NaCl (Iso-os) 500 mg/100 mL Piggyback, One Intravenous Q8H for 9 days: Last dose to be given on [**2140-7-9**] Total duration was 14 days. 15. Aspirin 325 mg Tablet PO daily Discharge Disposition: Extended Care Facility: [**Hospital **] Medical Center - [**Hospital1 3597**] Discharge Diagnosis: Primary diagnosis: 1. c. diff sepsis 2. Acute on chronic diastolic heart failure . Secondary diagnosis: 1. A fib 2. Coagulopathy 3. Anemia 4. Hypertension Discharge Condition: Good. Diarrhea is improving. Discharge Instructions: You were admitted with c. diff sepsis. You were treated with IV fluids and with flagyl IV and PO vancomycin. Your infection has greatly improved and you need to finish a two week course of IV flagyl (last day [**2140-7-9**]) and you will take PO vancomycin for the next 6 weeks with the following taper: 125mg PO four times daily for 6 days (last dose q6hrs is on [**2140-7-6**]) 125mg PO twice daily for 7 days 125mg once daily for 7 days 125mg every other day for 7 days 125mg every 3 days for 14 days . Your Coumadin was held during your hospitalization because your INR was supertherapeutic. You are being discharged on Coumadin 1.5mg PO daily and you should have your INR followed daily at rehab as you are on a number of medications that can make your INR. . Please note we changed the doses of the following medications: Coumadin. . We have started you on the following new medications: 1. Flagy IV 2. Vancomycin PO 3. Dextromethorphan-Guaifenesin 10-100 mg/5 mL Syrup 5 ML PO Q6H as needed for [**Date Range **]. 4.Trazodone 25 mg Tablet PO HS 5.Benzonatate 100 mg Capsule One Capsule PO TID for [**Date Range **]. . You have been discharged on all your other home medications at their usual doses. . Please keep pt on telemetry for A fib . Please return to the hospital if you develop worsening diarrhea, abdominal pain, fevers, bleeding, shortness of breath, or chest pain. Followup Instructions: Please schedule a follow up appointment with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 572**] for 2 weeks from now. Phone number [**Telephone/Fax (1) 1983**]. . Infectious disease follow up appointment on [**2140-8-15**] at 10:00am with Dr. [**Last Name (STitle) **] and Dr. [**Last Name (STitle) 4020**] at [**Hospital1 18**] [**Hospital Ward Name 517**] [**Last Name (NamePattern1) 20606**]. Phone number ([**Telephone/Fax (1) 4170**] Completed by:[**2140-7-1**] ICD9 Codes: 5990, 2762, 4280, 4019, 2859
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Medical Text: Admission Date: [**2191-1-12**] Discharge Date: [**2191-1-17**] Date of Birth: Sex: Service: HISTORY OF PRESENT ILLNESS: The patient is an 86 year old male with persistent cough found to have left upper lobe mass on chest x-ray. Chest CT on [**2190-11-9**] confirmed the presence of a 6 cm cavitary left upper lobe mass and right hilar lymphadenopathy. The patient has lost about 30 pounds in the past six weeks. Fatigued on standing. Persistent cough. Right shoulder pain for the past six weeks with certain movements. No headaches. PAST MEDICAL HISTORY: Status post XRT eight years ago for prostate cancer. Mild hypertension. Pedal edema. AAA 2.4 cm in [**5-9**]. PAST SURGICAL HISTORY: None. ALLERGIES: None. MEDICATIONS: Aspirin 81 mg twice weekly. PHYSICAL EXAMINATION: The patient was a well appearing normal in no acute distress. HEENT pupils equally round and reactive to light. No scleral icterus. Lungs clear to auscultation bilaterally. Heart regular rate and rhythm, no murmurs. Abdomen negative. Extremities no cyanosis, clubbing or edema. Neuro no focal deficits. LABORATORY DATA: CAT scan on [**2190-11-9**] showed a 6 cm large cavitary left upper lobe mass and 2 cm right hilar mass. PET scan reported no peripheral mets, but question mediastinal involvement. HOSPITAL COURSE: The patient was admitted on [**2191-1-12**] and was taken directly to the operating room where left upper lobe resection and ribs two, three and four resections were performed. The patient did all right postoperatively and was transferred to the surgical ICU postoperatively, intubated. On transfer the patient didn't have any problems postoperatively. This was particularly important because the patient was an extremely difficult intubation. The patient had an epidural in place for pain. He received Kefzol perioperatively. He did have some postoperative oliguria requiring periodic fluid boluses. Chest tubes were in place and to suction. On postoperative day one the patient was successfully extubated. He had his diet advanced successfully and was heplocked. He was transferred to the floor. He stayed on the floor for another three days secondary to high chest tube output. On [**2191-1-17**] the chest tubes were removed successfully. His epidural was removed and the patient was changed to p.o. pain medication. He is doing well and will be discharged in the morning to a rehab facility. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3351**], M.D. [**MD Number(1) 3352**] Dictated By:[**Last Name (NamePattern4) 12487**] MEDQUIST36 D: [**2191-1-17**] 16:05 T: [**2191-1-17**] 17:09 JOB#: [**Job Number 53753**] ICD9 Codes: 4019, 2930
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Medical Text: Admission Date: [**2111-6-16**] Discharge Date: [**2111-6-26**] Date of Birth: [**2065-6-19**] Sex: F Service: SURGERY Allergies: Codeine Attending:[**First Name3 (LF) 6346**] Chief Complaint: septic shock Major Surgical or Invasive Procedure: [**2111-6-17**]: ERCP History of Present Illness: 45 yo F with recent admission for gallstone pancreatitis s/p ERCP w/ pseudocyst now transferred from [**Hospital3 3583**] with hypotension, leukopenia and gram negative rod bacteremia. Past Medical History: PMH: h/o gallstone pancreatitis, thoracic outlet syndrome s/p rib resection, with chronic pain PSH: CCY [**2100**], umbilical hernia [**2095**], epigastric incisional hernia [**2103**] Family History: N/A Physical Exam: On discharge: AFVSS Gen: NAD RRR CTAB Abd: soft, mild distended, mild TTP in epigastrium, +BS Ext: WWP Pertinent Results: [**2111-6-16**] 08:12PM BLOOD WBC-7.7 RBC-2.82* Hgb-9.5* Hct-28.8* MCV-102* MCH-33.7* MCHC-33.0 RDW-13.8 Plt Ct-110*# [**2111-6-18**] 01:40AM BLOOD WBC-8.4 RBC-2.97* Hgb-9.9* Hct-29.4* MCV-99* MCH-33.2* MCHC-33.5 RDW-15.1 Plt Ct-97* [**2111-6-21**] 02:32AM BLOOD WBC-7.5 RBC-2.98* Hgb-9.7* Hct-28.7* MCV-96 MCH-32.5* MCHC-33.8 RDW-15.1 Plt Ct-146* [**2111-6-24**] 04:23AM BLOOD WBC-13.6* RBC-3.25* Hgb-10.3* Hct-32.5* MCV-100* MCH-31.6 MCHC-31.6 RDW-15.8* Plt Ct-475*# [**2111-6-25**] 04:48AM BLOOD WBC-11.4* RBC-3.22* Hgb-10.4* Hct-32.4* MCV-101* MCH-32.3* MCHC-32.1 RDW-15.5 Plt Ct-538* [**2111-6-16**] 08:12PM BLOOD Fibrino-185 D-Dimer-5454* [**2111-6-17**] 03:30PM BLOOD Fibrino-322# [**2111-6-21**] 02:32AM BLOOD Fibrino-322 [**2111-6-16**] 08:12PM BLOOD Gran Ct-7200 [**2111-6-16**] 08:12PM BLOOD Glucose-142* UreaN-14 Creat-0.9 Na-141 K-4.1 Cl-117* HCO3-16* AnGap-12 [**2111-6-17**] 03:30PM BLOOD Glucose-100 UreaN-12 Creat-0.6 Na-137 K-3.9 Cl-113* HCO3-16* AnGap-12 [**2111-6-20**] 02:06AM BLOOD Glucose-110* UreaN-3* Creat-0.4 Na-140 K-3.5 Cl-107 HCO3-27 AnGap-10 [**2111-6-24**] 04:23AM BLOOD Glucose-107* UreaN-16 Creat-0.5 Na-138 K-4.7 Cl-104 HCO3-27 AnGap-12 [**2111-6-25**] 04:48AM BLOOD Glucose-104 UreaN-15 Creat-0.5 Na-138 K-4.4 Cl-105 HCO3-25 AnGap-12 [**2111-6-16**] 08:12PM BLOOD ALT-126* AST-251* LD(LDH)-302* AlkPhos-199* Amylase-31 TotBili-1.2 [**2111-6-17**] 02:29AM BLOOD ALT-137* AST-210* CK(CPK)-91 AlkPhos-224* Amylase-39 TotBili-2.5* [**2111-6-17**] 03:30PM BLOOD ALT-120* AST-110* AlkPhos-231* Amylase-33 TotBili-3.5* [**2111-6-18**] 01:40AM BLOOD ALT-96* AST-79* AlkPhos-223* Amylase-28 TotBili-2.9* [**2111-6-19**] 01:48AM BLOOD ALT-65* AST-38 AlkPhos-251* TotBili-2.3* [**2111-6-20**] 02:06AM BLOOD ALT-53* AST-30 AlkPhos-310* TotBili-2.2* [**2111-6-21**] 02:32AM BLOOD ALT-42* AST-25 AlkPhos-336* Amylase-29 TotBili-1.3 [**2111-6-22**] 05:20AM BLOOD ALT-33 AST-18 AlkPhos-333* TotBili-0.8 [**2111-6-25**] 04:48AM BLOOD ALT-22 AST-22 LD(LDH)-240 AlkPhos-277* Amylase-42 TotBili-0.6 [**2111-6-16**] 08:12PM BLOOD Lipase-28 [**2111-6-17**] 02:29AM BLOOD Lipase-21 [**2111-6-17**] 03:30PM BLOOD Lipase-11 [**2111-6-18**] 01:40AM BLOOD Lipase-9 [**2111-6-21**] 02:32AM BLOOD Lipase-24 [**2111-6-25**] 04:48AM BLOOD Lipase-40 GGT-215* [**2111-6-25**] 04:48AM BLOOD Albumin-3.6 Calcium-9.2 Phos-4.9* Mg-2.0 [**2111-6-16**] 08:12PM BLOOD Albumin-2.7* Calcium-5.7* Phos-2.5*# Mg-1.2* UricAcd-3.9 [**2111-6-21**] 02:32AM BLOOD Albumin-2.5* Calcium-8.1* Phos-2.9 Mg-2.0 [**2111-6-23**] 04:09AM BLOOD Calcium-8.5 Phos-3.2 Mg-2.2 . CT abd/pelvis: [**2111-6-22**] IMPRESSION: 1. Marked improvement of the pancreatitis and pseudocysts, with a residual pseudocyst near the body of the pancreas measuring 3.5 cm. 2. Small bilateral pleural effusions, the left is larger and the right is new from prior study. 3. Multiple low-attenuating foci within a large uterus, likely represents degenerating fibroids. 4. Stable hepatic cysts. Brief Hospital Course: 45 yo F with recent admission for gallstone pancreatitis s/p ERCP w/ pseudocyst now transferred from [**Hospital3 3583**] with hypotension, hypoxia, acidemia, leukopenia and gram negative rod bacteremia. Admitted intubated and sedated on pressors, first to MICU and then transferred to SICU. Broad spectrum abx were given. Review of her CT scan from [**Hospital3 3583**] showed resolving pancreatitis, no abscess. However, her LFTs were elevated, notably her Tbili=2.5. A RUQ u/s showed: No intrahepatic or extrahepatic biliary dilatation. Nonvisualization of the pancreas and peripancreatic region. Two small liver cysts. The GI team was consulted and felt that ERCP with stent placement was indicated. This was performed on [**2111-6-17**]. This showed sphincterotomy was widely patent, mormal bliliary tree, and a bilary stent was placed. Cultures from [**Hospital3 3583**] grew out Enterobacter sensitive to cefepime. Thus her abx were switched to cefepime. She was weaned off her pressors and then weaned off of the vent on HD5. She was then transferred to the floor. A follow-up CT on [**6-22**] showed Marked improvement of the pancreatitis and pseudocysts, with a residual pseudocyst near the body of the pancreas measuring 3.5 cm. Of note, she was on TPN during her hospitalization, but was weaned off and tolerating a regular low fat diet by the day of discharge. All cultures from this hospitalization were negative (bld, urine, cath tip). She had had 11 days of abx, and was discharged on po cipro for 3 more days for a total course of 14 days. On the day of discharge she was in stable condition, Afebrile, VSS, tolerating a regular low fat diet, had had a bowel movement the day prior and continued to pass flatus, was making adequate urine with no foley and pain was well=controlled on po pain medications. Medications on Admission: diazapam 5', amytriptyline 50', oxycodone 15''', vicodin 500''' Discharge Medications: 1. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q3H (every 3 hours) as needed: Do not drive or drink alcohol while taking this. take a stool softener while taking this. Disp:*40 Tablet(s)* Refills:*0* 2. Diazepam 5 mg Tablet Sig: Two (2) Tablet PO Q8H (every 8 hours) as needed. 3. Amitriptyline 50 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day): Take this while taking taking your narcotic pain medications. Disp:*60 Capsule(s)* Refills:*2* 5. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. Disp:*60 Tablet(s)* Refills:*0* 6. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 7. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO twice a day for 3 days: Please take all of your antibiotics. Disp:*6 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Sepsis gallstone Pancreatitis Discharge Condition: stable Discharge Instructions: Please contact us or seek medical attention immediately for any increased abdominal pain, abdominal distention, nausea, vomiting, chest pain, shortness of breath, or any other concerning signs or symptoms. Please continue to eat a low fat diet until instructed otherwise. Followup Instructions: Please follow-up with Dr. [**First Name (STitle) 2819**]. Please call his office for an appointment: ([**Telephone/Fax (1) 6347**] Please also follow-up with Dr. [**Last Name (STitle) **], please call [**Telephone/Fax (1) 65629**] for your appointment. It is currently scheduled for [**2111-7-16**] at 11am. Please call to verify. ICD9 Codes: 0389, 5990
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Medical Text: Admission Date: [**2123-11-19**] Discharge Date: [**2123-11-23**] Date of Birth: [**2043-2-23**] Sex: M Service: MEDICINE Allergies: Cipro Attending:[**Known firstname 134**] Chief Complaint: Fever, malaise, fall Major Surgical or Invasive Procedure: none History of Present Illness: 80yoM with a history of DM, PVD, s/p mechanical AVR (19 years ago) for AI is transferred from [**Hospital6 3105**] after initially presenting with a fever and s/p a fall. The patient was apparently in his USOH until two days prior to admission when per his wife had chills. He then got up to go to bed and fell, unwitnessed, no LOC. He got up and went to the kitchen and his wife noticed he had an abrasion on his head, she said he never lost consciousness and it seemed that he had tripped on the stairs. He was walking normally and had normal speech. He then went to sleep. The next a.m. he awoke and continued to have chills, he then went to the bathroom. While on the toilet he asked his wife for his jacket as he felt very cold. When she arrived with his jacket he had shaking chills and was conscious and conversive. Then he all of a sudden started staring straight ahead and was no longer conversing and seemed to have lost consciousness. His wife called 911 and she returned to find him still on the toilet but leaning on the wall. He had no abnormal movements while unconscious and no abnormal eye movements. Per wife his speech now seems the same as his speech when he is not wearing his dentures. . No measured temps at home, he has been more somnolent and having body aches over the past 2 weeks. No cough or rhinorrhea. No urinary symptoms. No chest pain or shortness of breath per his wife. [**Name (NI) **] [**Name2 (NI) **] contacts but does have 8 grandchildren. No recent dental work. . At [**Hospital3 **] his initial BP was 200/110, he was noted to have a superficial abrasion on his R scalp and a negative Head CT. He was given IV labetalol and his BP then was 180/90. He was noted to be febrile to 102 F and blood cultures were drawn, an LP was performed which was negative, and he was given 2g IV ceftriaxone. In addition he was noted to have "seizure like" activities in the ER and was given IV ativan. On review of systems, he denies any headache, blurred vision, he states he has had difficulty speaking for the last 2 days. Denies any weakness or numbness. No shortness of breath or orthopnea, no Chest pain or discomfort. No abdominal pain. No diarrhea or constipation, last BM today and was normal. No blood in stool or melena. Past Medical History: 1. Coronary artery disease s/p CABG (1 Vessel in [**2104**] with AVR) 2. Hypertension 3. Dyslipidemia 4. Diabetes mellitus on PO meds only 5. Peripheral [**Year (4 digits) 1106**] disease 6. Cerebrovascular accident in [**2114**] manifest by slurred speech and L hand paresthesia. 7. Transient ischemic attack with therapeutic INR so INR range increased to 3-4 range 8. bladder cancer in [**2113**], s/p resection 9. CRI PAST SURGICAL HISTORY: 1. [**First Name8 (NamePattern2) **] [**Male First Name (un) 923**] aortic valve replacement [**2104**]. 2. One vessel coronary artery bypass graft. 3. Status post bladder resection for bladder carcinoma in '[**13**] 4. Status post femoral popliteal bypass in [**2115-1-19**] 5. [**2119-12-7**]-Left lower extremity angiography, angioplasty of anterior tibial artery, angioplasty and stenting of superficial femoral artery. Social History: -Tobacco history: denies -ETOH: denies -Illicit drugs: lives with wife, independent in ADLs, functional at baseline Family History: Mother with DM Father with DM and renal failure Physical Exam: VS: T 98.7 BP 154/84 HR 71 RR 18 O2 sat 95% on RA GENERAL: NAD, AOX2, date is [**12-19**] but knows it is Halloween and year [**2121**]. HEENT: JVP 8. OP clear, MM dry, sclera anicteric, PERRL, EOMI, conjunctiva are pink without lesions, no carotid bruits CARDIAC: RRR, [**2-24**] diastolic murmur at LUSB, no thrill, no radiation PULM: Dullness at R base, otherwise CTAB ABD: SOFT, NT, ND, no masses or organomegaly, BS+ EXT: doppler DP and PT bilaterally, warm, no c/c/e NEURO: as above AOx2, able to follow commands and answer questions appropriately. PERRL, EOMI, CN2-12 intact. Slightly dysarthric speech but no assymetry of mouth and upper jaw is adentate. [**5-24**] stregnth in UE bicep, tricep, deltoid, grip, wrist flex / extend. [**5-24**] stregnth in LE quad, hams, abduct, adduct, dorsiflex, plantar flex. Normal sensation to light touch throughout. Diminished reflexes in UE brachioradialis and biceps but bilat symmetric and 1+ bilat patellar reflexes bilat symmetric. Toes downgoing. Pertinent Results: [**2123-11-23**] 07:25AM BLOOD WBC-7.7 RBC-3.71* Hgb-11.6* Hct-34.7* MCV-94 MCH-31.3 MCHC-33.5 RDW-13.9 Plt Ct-197 [**2123-11-19**] 12:09PM BLOOD Neuts-79.0* Lymphs-15.0* Monos-5.4 Eos-0.4 Baso-0.4 [**2123-11-22**] 06:55AM BLOOD PT-33.8* PTT-35.0 INR(PT)-3.5* [**2123-11-19**] 12:09PM BLOOD Fibrino-579*# [**2123-11-19**] 12:09PM BLOOD ESR-44* [**2123-11-23**] 07:25AM BLOOD Glucose-114* UreaN-47* Creat-2.2* Na-141 K-4.3 Cl-110* HCO3-25 AnGap-10 [**2123-11-19**] 12:09PM BLOOD ALT-16 AST-35 LD(LDH)-298* CK(CPK)-1263* AlkPhos-142* TotBili-0.5 [**2123-11-19**] 12:09PM BLOOD CK-MB-7 cTropnT-0.07* [**2123-11-22**] 06:55AM BLOOD Mg-1.9 [**2123-11-19**] 12:09PM BLOOD CRP-4.3 [**11-21**] MR [**Name13 (STitle) **]: 1. No acute infarction. 2. Patent major intracranial arteries, without flow limiting stenosis, occlusion or aneurysm more than 3 mm, within the resolution of MR angiogram. Some stenosis of the left distal vertebral, cavernous segments, and the middle cerebral artery on the right are noted, as described above. [**11-20**] CXR: In comparison with the study of [**11-19**], there are continued low lung volumes in this patient with intact sternal sutures. The nasogastric tube has been removed. Some increasing opacification is seen at the left base in the retrocardiac region. Although this could merely represent atelectasis, in view of the patient's fever of the possibility of supervening pneumonia cannot be excluded. ECHO [**11-19**]: The left atrium is mildly dilated. No atrial septal defect is seen by 2D or color Doppler. Overall left ventricular systolic function is normal (LVEF>55%). There are complex (>4mm) atheroma in the descending thoracic aorta. A bileaflet aortic valve prosthesis is present and appears well-seated. The aortic valve prosthesis leaflets appear to move normally. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. There is a trivial/physiologic pericardial effusion. No vegetation or abscess seen. LABS/STUDIES OSH labs [**11-18**]: Na 143, K 4.1, Cl 113, Bicarb 25, BUN 37, Cr 2.2, Glucose 122, Ca 8.5 Dilantin 7.1 WBC 9.3 (normal diff), HCT 35, plt 160 INR 3.2 . u/a negative alk phos 128, alb 3.4 ck 334, ast 26, alt 18, t prot 6.8, t bili 1.0 ck mb 7, MBI 2.1 . CSF: `WBC 3, RBC 44, no bacteria CSF protein 85 (high), Glucose 61 . CT HEAD W/O CONTRAST [**2123-11-18**]: no acute bleed. Microvascular changes c/w chronic infarcts, moderate ventriculomegaly. . EKG: NSR rate of 80. Normal axis and QRDS / QT intervals. PR prolonged at 240ms. no ST / T wave changes, normal RWP, isolate Q wave in III. No changes from prior in [**2121**]. Brief Hospital Course: FEVER: Patient presenting with vague febrile illness and fatigue. Pulmonary infection seemed most likely, given some evidence of progression of pulmonary infiltrates on CXR. Presentation would also be consistent with viral infection, although flu test negative. Originally transferred for TEE but this was negative for valvular pathology. Blood cultures negative. Story not very concerning for seizure. Since admission was afebrile with no leukocytosis. LP was negative. ESR and CRP elevated suggesting some subacute organic illness. UA suggested dehydration but no UTI. He was started on empiric Vancomycin for endocarditis on [**11-19**]. which was stopped. He was treated with a three day course of azithromycin of CAP. He improved with IV fluids. . ALTERED MENTAL STATUS: He was on dilantin at OSH for question of possible seizure. However, the story was more consistent with rigors. He had a normal head CT at the OSH and a non-focal neuro exam. He has a history of CVA and TIAs while on coumadin but none since his INR goal has been increased to [**3-23**], making TIA / CVA very unlikely especially given a non-focal neuro exam. An MRI/MRA showed mild stenosis in distal vessels. He also had several episodes of night-time delerium, at times requiring haldol and ativan for sedation. He was seen by geriatrics who felt he was at significantly elevated risk for the development of delirium given advanced age, multiple medical comorbidities, acute hospitalization w/ multiple transfers, and question of underlying cognitive impairment. While pt does not meet CAM criteria by evaluation this evening, there is clear evidence of delirium by history and given typical fluctuating course. His delerium improved after leaving ICU and he will follow up with geriatrics. . CORONARY ARTERY DISEASE: CAD s/p single vessel CABG in conjunction w/ AVR in [**2104**], per wife no chest pain and CABG was reportedly LIMA to LAD. He had no ischemic changes on EKG and was continued on crestor. . HISTORY OF ATRIAL FIBRILLATION: He was in sinus rhythm but has had AF at OSH, in addition has had CVA in past and TIA while on coumadin, so INR range is [**3-23**] for him. He was continued on coumadin and metoprolol. . ACUTE RENAL FAILURE: On admission, he had a creatinine slightly above baseline. He had a FeNa of 0.7 % suggesting good kidney function with avid sodium retention. He also appeared dry on exam in the setting of possible infection. He was rehydrated with IV NS@150cc. . DIABETES: His oral hypoglycemic (actos) was held. He was started on NPH 14u sc bid with humalog sliding scale and switched to 14 U SC QAM and 12 U SC QPM. He was discharged on his home regimen including actos and insulin. . FEN: Heart healthy, diabetic diet. IVF as above ACCESS: PIV's PROPHYLAXIS: INR supratherapeutic, PPI, pneumoboots CODE: FULL Medications on Admission: Insulin 75/25 60 units daily (? in OMR is 25 units [**Hospital1 **]) Coumadin 2mg M,F, 4mg daily on other days Neurontin 300mg po bid Crestor 20mg daily Prilosec 20mg daily Lopressor 50mg daily Actos 15mg daily Allopurinol 100mg daily Avodart 0.5mg daily Flomax 0.4mg daily Discharge Medications: 1. Warfarin 2 mg Tablet Sig: One (1) Tablet PO 2X/WEEK (MO,FR) as needed for ON MONDAY AND FRIDAY. 2. Warfarin 2 mg Tablet Sig: Two (2) Tablet PO 5X/WEEK ([**Doctor First Name **],TU,WE,TH,SA). 3. Rosuvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Allopurinol 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 5. Avodart 0.5 mg Capsule Sig: One (1) Capsule PO once a day. 6. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO HS (at bedtime). 7. Metoprolol Succinate 100 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*2* 8. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO twice a day. 9. Actos 15 mg Tablet Sig: One (1) Tablet PO once a day. 10. home equipment Commode for use at the bedside please. 11. Insulin Please continue your home insulin regimen Discharge Disposition: Home With Service Facility: [**Hospital6 **] Discharge Diagnosis: Delerium Community acquired pneumonia Viral syndrome with fevers Syncope Acute Renal Failure Diabetes Discharge Condition: BUN 47 creat 2.2 Hct 34.7 K 4.3 Discharge Instructions: You had a likely viral illness with a fever. All of your culture results were negative and you did not have any signs of infection in your heart. You became acutely confused and received some medicine to calm you down. A follow-up appointment with Dr. [**First Name (STitle) 1022**] in the gerontololgy department here at [**Hospital1 18**] was made on [**12-13**]. A MRI was done that preliminarily does not show any sign of an acute problem. There is a question of a pneumonia on your chest Xray, you have 1 more day of antibiotics (azithromycin) to take when you go home. . New medicines: 1. Your Metoprolol was replaced by a long acting type, Metoprolol Succinate 2. We have held your Furosemide. 3. Continue to take the insulin dose you were on at home. . Please stop smoking. Information was given to you on admission regarding smoking cessation. A nicotine patch of 14 mg per day was used during your hospital stay and should be used after discharge instead of smoking. Followup Instructions: [**Month/Year (2) **] Surgery: Provider: [**Name10 (NameIs) **] [**Apartment Address(1) 871**] ([**Doctor First Name **]) [**Doctor First Name **] LMOB (NHB) Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2123-12-20**] 10:00 Provider: [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], MD Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2123-12-20**] 11:00 Cardiology: Provider: [**Known firstname 122**] [**Last Name (NamePattern1) **], MF Phone: [**Telephone/Fax (1) 18438**] Date/Time: [**2124-1-7**] 03:00pm Provider: [**Name10 (NameIs) **] Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2124-1-7**] 2:00 Primary Care: Provider: [**Name10 (NameIs) **], [**Name11 (NameIs) **] MD Phone: [**Telephone/Fax (1) 3110**] Date/Time: Gerontology: Provider: [**Name10 (NameIs) **] [**Name11 (NameIs) 1022**], MD Phone: [**Telephone/Fax (1) 719**] Date/Time: [**12-13**] at 1:30. [**Last Name (NamePattern1) 439**], [**Location (un) 18439**] in the garage right next door. Please make a Neurology appointment with Dr.[**Name (NI) 5255**] office. Their number is [**Telephone/Fax (1) 1694**]. Completed by:[**2123-11-26**] ICD9 Codes: 486, 5849, 2930, 5859, 2724, 4439
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Medical Text: Admission Date: [**2167-12-4**] Discharge Date: [**2167-12-10**] Service: MEDICINE HISTORY OF PRESENT ILLNESS: The patient is an 84 year-old male with a history of Parkinson's disease who was admitted to MICU on [**2167-12-4**] with presumed left upper lobe aspiration pneumonia. On his initial presentation in the Emergency Room the patient was tachypneic with shortness of breath and a temperature of 103. He was treated with Ceftriaxone 2 grams intravenous and Levaquin 500 mg intravenous and Flagyl 500 mg intravenous. While in the MICU the patient was on a nonrebreather mask and was weaned overnight to nasal cannula. By the following morning he was stable for transfer to the floor. The patient has a 24 hour care giver who lives with him at home. According to care giver and his family they reported a one week history of increasing coughing with eating and increased dysphagia especially with solids. There is also some concern by the visiting nurse that the patient was not receiving his regular doses of Sinemet over the past several weeks. Either the patient nor care giver recalls specific aspiration events. The patient currently denies shortness of breath, lightheadedness, chest pain, nausea, vomiting, diarrhea. PAST MEDICAL HISTORY: Parkinson's disease since [**2161**], depression, T-12-L2 compression fractures, status post transurethral resection of the prostate in [**12/2165**] for benign prostatic hypertrophy now with chronic retention and chronic Foley catheter. Left heel ulcer. Remote history of peptic ulcer disease. History of otosclerotic hearing loss. ALLERGIES: No known drug allergies. HOME MEDICATIONS: BuSpar 5 mg po b.i.d., Duragesic patch 25 micrograms per hour, change every 72 hours. Mirapex 1.5 mg po t.i.d., Sinemet 25/100 every day at 7:00 a.m., 10:00 a.m., 1:00 p.m., 4:00 p.m. and 7:00 p.m. In addition to Sinemet 5200 q.a.m. and q.h.s. Amantadine 100 mg po b.i.d. HOSPITAL MEDICATIONS: Paxil 30 mg po q.d., Lorazepam 1 mg po q.h.s., Mirapex 1.5 mg po t.i.d., Sinemet 50/200 q.a.m. and q.p.m., in addition to Sinemet 2500 every day at 7:00 a.m., 10:00 a.m., 1:00 p.m., 4:00 p.m. and 7:00 p.m., Amantadine 100 mg po b.i.d., BuSpar 5 mg po b.i.d., Duragesic patch 50 micrograms per hour change every 72 hours, Tylenol prn, 5000 units subQ heparin b.i.d., Zantac 50 mg intravenous t.i.d., Levaquin 500 mg intravenous q day, Flagyl 500 mg intravenous q 8 hours. FAMILY HISTORY: Parkinson's disease. SOCIAL HISTORY: The patient lives alone with care giver, her significant other and her son lives in an apartment below. He has a fifty pack year tobacco history. He quit twenty years ago. His health care proxy is daughter Syva [**Name (NI) 13470**] who lives in [**Name (NI) 531**] City. Contact information home phone number [**Telephone/Fax (1) 22176**]. Work number [**Telephone/Fax (1) 22177**]. Pager number 1-[**Telephone/Fax (1) 22178**]. PHYSICAL EXAMINATION: Temperature 98.2. Pulse 69. Blood pressure 118/48. Respiratory rate 24. O2 sat 97% on 8 liters nasal cannula. General, the patient is sitting in chair in no acute distress with slowed speech, ______ spotting movements. HEENT pupils are equal, round and reactive to light. Oropharynx moist. Lungs positive for rales at bilateral bases left greater then right. Cardiovascular regular rate and rhythm. No murmurs. Abdomen soft, nontender, nondistended. Positive bowel sounds. Extremities no edema. 2+ peripheral pulses. Left heel with 2 cm dry ulcer with black base, minimal surrounding erythema. No drainage. Nontender to palpation. Neurological examination rigid body with cogwheeling of bilateral upper extremities, occasional resting tremor in upper extremities, no strength deficits. LABORATORY: Urine culture positive for Citrobacter. Blood culture negative, sputum culture negative. White blood cell count 6.2, hematocrit 24.9, platelets 258, sodium 131, potassium 4.0, chloride 99, bicarb 26, BUN 25, creatinine .9, glucose 117. HOSPITAL COURSE: 1. Neurology/Parkinson's disease: The patient was maintained on Parkinson's medication on a regular schedule. This included his Sinemet 25/100 five times a day in addition to his Sinemet 50/200 twice a day. It is very important for the patient to receive these on a regular schedule. He was also continued on his Amantadine and Mirapex. The patient periodically received Botox injections in his jaw secondary to bruxism and limited jaw movement. The patient was seen by neurology consul.t, however, they deferred Botox injections at this time. He follows up regularly with his outpatient neurologist Dr. [**Last Name (STitle) 10442**]. He is due for Botox injections in [**Month (only) 958**]. 2. Infectious disease/aspiration pneumonia: The patient was started on intravenous Levaquin and Flagyl. He is to complete a fourteen day course of these antibiotics. The patient's O2 sat is stable on 4 liters and can be weaned as tolerated. 3. Gastrointestinal: Aspiration risk, the patient had a video swallow study, which revealed inability to swallow. As a result of this study and a discussion with the patient and his family a PEG tube was placed in order to decrease aspiration risk and also in order to maintain nutrition and to allow the patient to receive his medication. A PEG tube was placed on [**2167-12-9**] without complications. Tube feeds were started on [**2167-12-10**]. Per nutrition consult he was started on Promote with fiber at 10 cc per hour. This was increased by 10 cc an hour every four to six hours to his goal rate of 55 cc an hour. If the patient requires additional hydration he can receive 150 cc free water boluses twice a day through his PEG tube. All of the patient's previously po medications are now being administered through his PEG tube. 4. Left heel ulcer: The patient's heel ulcer was evaluated by podiatry. They do not feel that his ulcer is ischemic nor infectious in nature. No need for surgical debridement at this time. The patient to maintain Multi-Podus boot and strict nonweight bearing to his left heel. The patient may benefit from enzymatic debridement of necrotic tissue either application of Accuzyme ointment or wet to dry dressing changes b.i.d. 5. Anemia: According to the patient's iron studies the patient has anemia of chronic disease. No evidence of GI bleeding while in the hospital. 6. Code status: The patient is DNR/DNI. CONDITION ON DISCHARGE: Satisfactory. DISCHARGE STATUS: Discharge patient to rehab. DISCHARGE MEDICATIONS: 1. Mirapex 1.5 mg t.i.d. via PEG tube. 2. Carbidopa/levodopa 50/200 q.a.m. and q.h.s. via PEG tube. In addition to Carbidopa/levodopa 25/100 q 7:00 a.m., 10:00 a.m., 1:00 p.m., 4:00 p.m., 7:00 p.m. every day via PEG tube. 3. Amantadine 50 mg per 5 ml suspension, 100 mg via PEG tube b.i.d. 4. Paxil 30 mg via PEG tube q day. 5. BuSpar 5 mg via PEG tube b.i.d. 6. Heparin 5000 units subQ b.i.d. 7. Duragesic patch 50 micrograms per hour transdermal change every 72 hours. 8. Zantac 150 mg q day via PEG tube. 9. Levaquin 500 mg intravenous q day until [**2167-12-14**]. 10. Flagyl 500 mg intravenous q 8 hours until [**2167-12-14**]. DISCHARGE DIAGNOSES: 1. End stage Parkinson's disease. 2. Aspiration pneumonia status post failed swallow study now with PEG tube. Discharge summary for [**Hospital **] Rehab Hospital. [**Name6 (MD) 2415**] [**Last Name (NamePattern4) 3474**], M.D. [**MD Number(1) 3475**] Dictated By:[**Name8 (MD) 7112**] MEDQUIST36 D: [**2167-12-9**] 23:55 T: [**2167-12-10**] 08:40 JOB#: [**Job Number 22179**] ICD9 Codes: 5070, 5990, 2859
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Medical Text: Admission Date: [**2110-11-28**] Discharge Date: [**2110-11-30**] Date of Birth: [**2110-11-28**] Sex: M Service: HISTORY OF PRESENT ILLNESS: This 2745 gm male infant born at 37 weeks gestation by repeat cesarean section by placenta previa to a 35 year old gravida 4, para 1 now 2 mother. Pregnancy was complicated by intermittent episodes of vaginal bleeding. Also mother with a history of anti cardiolipin antibodies, rupture of membranes at delivery, no maternal fever. Prenatal screens - O negative, antibody negative, Rubella immune, RPR nonreactive, hepatitis B surface antigen negative, Group B Streptococcus unknown. The infant emerged with spontaneous respirations. Apgars were 8 at one minute and 9 at five minutes. Infant was noted to be grunting at approximately 2 hours of age and was transferred to the Neonatal Intensive Care Unit for respiratory distress. PHYSICAL EXAMINATION: Physical examination on admission reveled birthweight 2745 gm, length 44.5 cm, head circumference 32 cm. Anterior fontanelle open and flat. Palate intact. Bilateral breath sounds clear and equal. Grunting, flaring and retraction noted. No murmur, normal S1 and S2, pink, well perfused. Abdomen soft, nontender, no hepatosplenomegaly, no masses, three vessel cord, positive bowel sounds. Anus patent. Normal male genitalia. Spine intact. Clavicles intact. Hips stable. Normal tone for gestational age. HOSPITAL COURSE: (By systems) Respiratory - Infant noted to have grunting, flaring and retraction at approximately 2 hours of age. Infant was placed on nasal CPAP, 6 cm of water requiring 21% FIO2. Infant transitioned to room air by day of life #1. Respiratory rates have been in the 30s to 60s. Infant has remained in room air with oxygen saturation 99 to 100%. Infant has not had any apnea or bradycardia this hospitalization. Cardiovascular, infant has remained hemodynamically stable this hospitalization, no murmur. Heart rate 120s to 140s with mean blood pressures 49 to 53. Fluids, electrolytes and nutrition - The infant was in initially nothing by mouth, receiving 60 cc/kg/day of D10/W. Enteral feedings were started on day of life #1 and he advanced to full volume feedings by day of life #1. Infant tolerated the feedings without difficulty. Dextrose sticks have been 61 to 83. The infant is currently taking Enfamil 20 cal/oz p.o. ad lib. The most recent weight on day of life #2 was 2595 gm. Gastrointestinal - The most recent bilirubin on day of life #2 showed a total of 7.8 with a direct of 0.3. The infant has not received phototherapy. Hematology - Blood type 0 negative, Coomb's negative. The infant has not received any blood transfusions this hospitalization. Hematocrit on admission was 46%. Infectious disease - Infant received 48 hours of Ampicillin and Gentamicin for rule out sepsis. All blood cultures remained negative to date. Complete blood count on admission showed a white blood cell count of 13.6, hematocrit 46%, platelets 243,000, 73 neutrophils, 4 bands. Neurology - Normal neurological examination. Sensory - Hearing screening is recommended prior to discharge home. Psychosocial - Parents involved with infant. CONDITION ON DISCHARGE: Stable in room air. DISCHARGE DISPOSITION: To level 1 newborn nursery. PRIMARY PEDIATRICIAN: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], [**Location (un) 36298**], Phone [**Telephone/Fax (1) 53258**]. CARE/RECOMMENDATIONS: Feedings at discharge - Enfamil 20 cal/oz p.o. ad lib Medications - None Carseat position screening - Not recommended State newborn screen - Due on day of life #3. Immunizations - Infant has not received any immunizations this hospitalization. Hepatitis B vaccine is recommended prior to discharge. Follow up - Appointment with primary pediatrician after discharge home. DISCHARGE DIAGNOSIS: 1. Status post respiratory distress, most likely transient tachypnea of the newborn 2. Status post rule out sepsis with antibiotics, ruled out [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 35940**], M.D. [**MD Number(1) 35941**] Dictated By:[**Last Name (NamePattern1) 47014**] MEDQUIST36 D: [**2110-11-30**] 19:52 T: [**2110-11-30**] 20:06 JOB#: [**Job Number 53259**] ICD9 Codes: V290, V053
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Medical Text: Admission Date: [**2109-2-23**] Discharge Date: [**2109-3-9**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 613**] Chief Complaint: chest/abd pain Major Surgical or Invasive Procedure: [**2109-2-22**]: central venous line, internal jugular [**2109-2-26**]: PICC line, left arm, removed [**2109-3-9**] History of Present Illness: Mr. [**Known lastname 805**] is a [**Age over 90 **]-year-old man with a history of atrial fibrillation not anticoagulated, hypertension, type 2 diabetes, anemia, and history DVT in [**2100**]. History is per patient and OMR. He was in his usual state of health until the morning of admission when he awoke with periumbilical abdominal pain. The pain is constant and non-radiating. It was accompanied by anorexia, no nausea or vomitting. There was no diarrhea or blood in his stools. Patient reports no eating and no gas or bowel movement since yesterday, although by report he was brought to the ED after being found unresponsive after a bowel movement by the Sherrrill House staff. At the time his BP was stable at 119/66 but O2 Sat 84% on RA-->95% on 2L. He was given an extra dose of lasix 40 mg PO and levofloxacin 500 mg PO x 1 as well as nebs. Received 2 units insulin for FS 393. . In the ED, he was hypotensive with initial vitals BP 84/52, HR 85, RR 20, O2 Sat 84% on RA and 95% on 2L. He was responsive, A&O x 1. On ROS he complained of abdominal pain. He underwent CT scan which was negative for intra-abdominal pathology but showed right lung consolidation and effusion. CXR also notable for RLL consolidation. He received levofloxacin 750 mg IV and ceftriaxone 1 gIV as well as 3 L of IV fluid. BP rose to 100/50, HR 87, O2 Sat 98% on 5L NC. A central venous line was placed. . On ROS, he denies any recent cough, shortness of breath, chest pain. He denies fevers, chills, night sweats or weight loss. No change in bowel movements, blood in bowel movements, or abdominal pain prior to today. Past Medical History: Diabetes Type II Hypertension Partial gastric resection with bilroth II anastomosis for bleeding peptic ulcer ([**2056**]) Multiple prior episodes of SBO Atrial tachycardia: recent hypotensive event from atrial tachycardia causing TIA like symptoms, no evidence of CVA on MRI. Peripheral Neuropathy Remote EtOH Circumcision ([**2106**]) L ankle fracture L DVT s/p filter [**2100**], GIB on coumadin Pernicious anemia GERD Osteoarthritis Right leg bakers cyst Social History: Widowed. No children. Active in church, sings in choir. Lives with friend from church [**Name (NI) **] although recently at [**First Name4 (NamePattern1) 2299**] [**Last Name (NamePattern1) **]. Pt has remote former EtOH and tobacco history, recently discharged to [**First Name4 (NamePattern1) 2299**] [**Last Name (NamePattern1) **] but had been living with adopted son prior to recent admission. *** DNR/DNI per HC [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] (h) [**Telephone/Fax (1) 79368**] and (c) [**Telephone/Fax (1) 79369**] Physical function: Independent at baseline with dressing, toileting, and walking wtih rolling walker. [**Doctor Last Name **] assists with meal preparation, housekeeping, laundry, errands. No home services. Family History: Unknown Physical Exam: Vital Signs: BP 104/52, HR 90, T 96.4, RR 16, weight 91.6 kg, CVP 6-8 Gen: elderly man lying in bed with flat affect, no apparent distress HEENT: moist mucous membranes, pupils bilaterally round and reactive, oropharynx clear without erythema or exudates Neck: supple, JVP ~8 cm Heart: RRR, no audible murmur, faint heart sounds Lungs: few crackles at b/l bases, scant wheezes Abdomen: diffusely tender, maximal in epigastrium and right upper quadrant with inconsistent voluntary guarding, no rebound, hypoactive bowel sounds Extremities: 2+ pitting edema bilaterally, L>R, TEDS in place, extremities warm, pulses doppler-able Rectal: good tone, light brown stool in vault, guaiac negative Pertinent Results: LABS ON ADMISSION 1/9/9: . HEMATOLOGY: [**2109-2-22**] 05:10PM BLOOD WBC-7.6# RBC-3.37* Hgb-10.9* Hct-31.9* MCV-95 MCH-32.2* MCHC-34.1 RDW-15.2 Plt Ct-202# [**2109-2-23**] 02:25AM BLOOD Hct-25.7* [**2109-2-23**] 08:43AM BLOOD Hct-25.6* [**2109-2-23**] 02:07PM BLOOD Hct-25.3* [**2109-2-24**] 05:16AM BLOOD Hct-24.3* [**2109-2-22**] 05:10PM BLOOD Neuts-41* Bands-41* Lymphs-2* Monos-3 Eos-0 Baso-1 Atyps-0 Metas-8* Myelos-4* [**2109-2-22**] 05:10PM BLOOD PT-15.3* PTT-33.2 INR(PT)-1.4* . CHEMISTRY: [**2109-2-22**] 05:10PM BLOOD Glucose-277* UreaN-43* Creat-2.2* Na-137 K-4.4 Cl-96 HCO3-26 AnGap-19 [**2109-2-22**] 05:10PM BLOOD ALT-16 AST-12 AlkPhos-78 TotBili-0.8 [**2109-2-22**] 05:10PM BLOOD Albumin-3.6 Calcium-8.5 Phos-4.6* Mg-1.6 . CARDIAC ENZYMES: [**2109-2-22**] 05:10PM BLOOD CK(CPK)-670* cTropnT-0.07* [**2109-2-22**] 11:20PM BLOOD CK(CPK)-532* CK-MB-2 cTropnT-0.05* [**2109-2-23**] 02:25AM BLOOD CK-MB-3 cTropnT-0.06* . OTHER: [**2109-2-22**] 05:10PM BLOOD Cortsol-61.1* [**2109-2-22**] 05:10PM BLOOD CRP-193.2* [**2109-2-22**] 05:47PM BLOOD Lactate-4.9* [**2109-2-23**] 02:43AM BLOOD Lactate-2.1* . c.diff neg x 4 [**3-8**] KUB: Interval improvement with no significant dilatation of the loops of large bowel. [**3-5**] KUB: Remaining colonic distention, likely of the rectosigmoid region, with interval improvement in the degree of colonic distension [**3-4**] KUB: Worsening pseudoobstruction [**2-28**] CT abd: Dilated loops of descending and transverse colon but with no lead point identified. Wall thickening rectosigmoid and lower left colon c/w colitis [**2-26**] U/S: No LE DVT bilat 1/9 CXR: New ill-defined opacity within the right lower lobe concerning for pneumonia. . Labs prior to discharge: [**2109-3-8**] CBC: WBC-3.5* RBC-2.44* Hgb-7.9* Hct-22.7* Plt Ct-372 --> transfused 1un pRBC --> [**2109-3-9**] Hct-24.2* [**2109-3-8**] Lytes: Glucose-124* UreaN-9 Creat-1.0 Na-139 K-4.1 Cl-105 HCO3-31 AnGap-7* Brief Hospital Course: A [**Age over 90 **] year-old man with a history of DM and HTN presented after an episode of syncope. In the ED he was hypotensive and complained of abdominal pain. He underwent an abd CT scan. The CT scan was negative for abd pathology (did mention slight distention of redundant sigmoid colon) but did show RLL and RML and pneumonia. He stayed in CCU for 2 days for concern of sepsis and was transferred to the floor on [**2-24**]. # [**Hospital 7502**] health care associated Upon transfer to the floor, he was treated w/ levoflox [**Date range (1) 79372**]; ceftriaxone on [**11-26**]; vanco on [**11-27**]. A PICC was placed on [**2-26**] for IV abx and it was removed the day of discharge. He remained afebrile and his respiratory status improved clinically. . # Colonic pseudo-obstruction Pt initially presented with abdominal pain. Pt's abdomen was distended and repeat KUBs showed colonic distentions. A CT scan was concerning for colitis but it was not clinically correlated and pt was c. difficile negative x 4. Multiple bowel regimens were tried and bowel movements resulted, however, he continued to have worsening distention. Rectal tubes were attempted x 2 and may have been slightly helpful. On [**3-6**], GI performed a colonic decompression in which they were able to advance scope to beyond splenic flexure, saw large amount of stool. The next day, the pt was given 1L golytely with resulting multiple soft stools. He did not have a BM after the golytely but his stomach remained soft and repeat KUB showed improvement. . # Decreasing WBC Has been worked up for leukopenia and thrombocytopenia in the past ([**11-21**]). No intervention was made at that time and his cell lines increased on their own. [**Month (only) 116**] be [**3-18**] meds but no new meds. [**Month (only) 116**] be a myelodysplastic picture. By discharge, his WBC was increasing again. . # Anemia Progressively decreasing HCT w/ low reticulocyte count. Transfused 1un pRBC with modest increase in HCT. . # Stage II coccyx ulcer Aggressively cared for by nursing. . # Syncope Most likely caused by hypotension secondary to sepsis and increased vagal tone after bowel movement. . # Acute renal failure Admission creatinine was 2.2 (baseline 1.2). Most likely secondary to poor perfusion in the setting of sepsis and hypotension. With fluids, his Cr decreased appropriately. All meds were renally dosed. . # Diabetes Pt had been on metformin at home but given his ARF at admission and his multiple radiology studies, this medicine was discontinued. He was started on insulin sliding scale and his blood glucoses were usually inthe mid 100s. The sliding scale was continued on discharge. Medications on Admission: metformin 500 mg qd trazodone 25 mg qhs docusate 200 mg qhs acetaminopohen 500 mg q6h prn bisacodyl 10 mg suppository qd prn clotrimazole cream 1% [**Hospital1 **] levothyroxine 75 mcg qd simvastatin 20 mg qd furosemide 40 mg qd omeprazole 20 mg qam MVI RISS fleet enema PRN milk of magnesia PRN senna PRN Discharge Medications: 1. Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 3. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. Simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for gas/abd pain. 6. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed for constipation. 7. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for constipation. 8. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. 9. Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 1-2 Puffs Inhalation Q4H (every 4 hours) as needed for wheezing. 10. Insulin Regular Human 100 unit/mL Solution Sig: sliding scale Injection QACHS: See attached insulin instructions. 11. Golytely 236-22.74-6.74 gram Recon Soln Sig: One (1) L PO No more than 2x weekly as needed for constipation: Please use under the direction of a physician. [**Name10 (NameIs) **] only be used when pt has not had a bowel movement for >4 days (and is eating a regular diet). 12. Senna 8.6 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital3 1186**] - [**Location (un) 538**] Discharge Diagnosis: Primary: health care- associated pneumonia Colonic pseudo-obstruction Syncope Secondary: pernicious anemia, possible myelodysplastic syndrome Stage II coccyx ulcer Diabetes mellitus type II, uncontrolled with complications Discharge Condition: Fair Discharge Instructions: You were admitted after you passed out. You had a chest xray that revealed you had pneumonia. You were treated with antibiotics. You also had abdominal pain. This was most likely related to colonic pseudo-obstruction. This was treated with laxatives and colonoscopy. Attached, is a list of your medications. While in the hospital, your blood pressure medicines were stopped. They were not restarted upon your discharge because your blood pressure was stable. Please follow up with your primary care doctor regarding the need to re-start these medications. Also, you need to make sure that you are on a bowel regimen. It is very important that you have regular bowel movements. If you have not had a bowel movement by [**2109-3-11**], please call your physician. [**Name10 (NameIs) **] may need to take another medicine to help you go or you may need more intensive treatment. Please adhere to your follow-up appointments. They are important for managing your long-term health. Please return to the hospital or call your doctor if you have temperature greater than 101, shortness of breath, worsening difficulty with swallowing, chest pain, abdominal pain, diarrhea, or any other symptoms that you are concerned about. Followup Instructions: You need to follow up with your primary care doctor, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 79370**], at the [**Hospital 86**] [**Hospital6 **]. Please call [**Telephone/Fax (1) 41354**] 5415 to schedule this apointment sometime in the next 1 to 2 weeks. Please call her sooner if you do not have a bowel movement within the next few days. [**Telephone/Fax (1) **] UNIT Phone:[**Telephone/Fax (1) 164**] Date/Time:[**2109-3-20**] 10:00 [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 617**] Completed by:[**2109-3-11**] ICD9 Codes: 486, 0389, 5849, 4019
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Medical Text: Admission Date: [**2187-12-1**] Discharge Date: [**2188-1-2**] Date of Birth: [**2118-3-31**] Sex: F Service: SURGERY Allergies: Erythromycin Base / Cephalosporins Attending:[**First Name3 (LF) 2597**] Chief Complaint: Fall from standing Major Surgical or Invasive Procedure: [**2187-12-28**]: Flexible bronchoscopy [**2187-12-1**]: Open abdominal aortic aneurysm repair [**2187-12-17**]: Percutaneous tracheostomy placement History of Present Illness: 69 year old woman with multiple medical problems now presenting on transfer from an OSH with a C-2 cervical fracture. She suffered a fall from standing. She did not lose consciousness. Immediately after the fall, she felt a pain in the back of her neck. Her daughter discovered her and called EMS. She was taken to an OSH where a CT scan of the neck revealed a C2 fracture. She was placed in a hard collar and transferred to [**Hospital1 18**] ED for further management. Neurosurgery evaluation at [**Hospital1 18**] recommended conservative management. Initial trauma workup revealed widened mediastinum on chest x ray. Follow-up CT of the torso was consistent with leaking infrarenal AAA. In further questioning of the family, we found she also was complaining of abdominal pain increasing in intensity radiating to the back. Past Medical History: -diabetes -COPD -anxiety -high blood pressure -s/p knee replacement -s/p abdominal hernias and surgery -h/o pneumonia -h/o recent leg cellulitis Social History: -lives by self -walks with walker -no tobacco or alcohol use Physical Exam: Admission exam 97.5 66 153/98 28 96%ra General: no acute distress Neck: in hard collar, trachea midline Lungs: decreased breath sounds at the bases CV: regular rate and rhythm; no murmur/rub Abdomen: mildly tender to palpation diffusely, multiple reducible incisional hernias no rebound. Multiple healed abdominal scars Ext: warm, no edema. DP 2+ Left/ 1+Right. Faint femoral pulses. Hemosiderin deposits bilaterally in lower extremities. Sensation decreased b/l LE distally in stocking distribution. Pertinent Results: Day of discharge~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ [**2188-1-2**] 01:48AM BLOOD WBC-15.1* RBC-2.48* Hgb-7.9* Hct-23.8* MCV-96 MCH-31.8 MCHC-33.0 RDW-19.0* Plt Ct-379 [**2188-1-2**] 01:48AM BLOOD Plt Ct-379 [**2188-1-2**] 01:48AM BLOOD PT-13.6* PTT-31.7 INR(PT)-1.2* [**2188-1-2**] 01:48AM BLOOD Glucose-116* UreaN-24* Creat-0.8 Na-137 K-3.8 Cl-103 HCO3-29 AnGap-9 [**2187-12-2**] 10:01PM BLOOD CK-MB-3 cTropnT-0.01 [**2188-1-2**] 01:48AM BLOOD Calcium-9.0 Phos-4.3 Mg-2.4 [**2188-1-2**] 03:59AM BLOOD Type-ART pO2-107* pCO2-53* pH-7.37 calTCO2-32* Base XS-3 ADMISSION LABS~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ [**2187-12-1**] 01:35PM BLOOD WBC-14.5* RBC-4.00* Hgb-12.4 Hct-36.9 MCV-92 MCH-31.1 MCHC-33.7 RDW-14.4 Plt Ct-260 [**2187-12-1**] 01:35PM BLOOD PT-13.0 PTT-29.8 INR(PT)-1.1 [**2187-12-1**] 01:35PM BLOOD Glucose-173* UreaN-8 Creat-0.4 Na-141 K-3.9 Cl-104 HCO3-27 AnGap-14 [**2187-12-2**] 02:23AM BLOOD ALT-18 AST-38 LD(LDH)-388* AlkPhos-48 Amylase-27 TotBili-0.7 [**2187-12-1**] 01:35PM BLOOD CK-MB-16* MB Indx-3.8 cTropnT-<0.01 [**2187-12-1**] 01:35PM BLOOD Calcium-9.2 Phos-3.5 Mg-1.9 [**2187-12-1**] 11:15PM BLOOD Type-ART pO2-210* pCO2-39 pH-7.37 calTCO2-23 Base XS--2 RADIOLOGY STUDIES~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CTA ABD W&W/O C & RECONS [**2187-12-1**] 8:23 PM IMPRESSION: 1. 5.8 x 6.3 cm infrarenal abdominal aortic aneurysm measuring approximately 10 cm in length. Blood in the retroperitoneal cavity is consistent with leak. There is at least one focus of extraluminal contrast which is likely contained in the wall. All branches of the abdominal aorta remain patent. The inferior mesenteric artery originates from the inferior aspect of the aneurysm. 2. Normal intrathoracic aorta. Mediastinal widening on previous chest x-ray was likely related to an overabundance of mediastinal fat and bilateral dependent atelectasis. 3. Left lower quadrant abdominal hernia as described above. Small amount of fluid at the hernia apex. 4. Gallstones. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CT C-SPINE W/O CONTRAST [**2187-12-1**] 1:04 PM IMPRESSION: Mildly displaced acute C2 fracture extending through both lateral masses and into the posteroinferior portion of the odontoid. NOTE ADDED AT ATTENDING REVIEW: The fracture extends into the left transverse foramen, raising the possibility of vertebral artery injury. If this is a clinical concern, then an MR examination with axial T1 images and an MRA are recommended. This is more reliable than CTA for this purpose. Osteophyte formation at C [**1-27**] and [**3-30**] narrow the spinal canal. CT lacks soft tissue contrast resolution to exclude ligamentous injury or disk or hematoma compromising the canal. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CT HEAD W/O CONTRAST [**2187-12-1**] 1:04 PM IMPRESSION: No fractures, no acute intracranial hemorrhage ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CHEST (PORTABLE AP) [**2187-12-1**] 7:40 PM IMPRESSION: Marked widening of the mediastinum concerning for mediastinal hematoma and possible aortic injury in the setting of trauma. CTA of the chest is recommended for further characterization. Small right pleural effusion and adjacent lung opacity. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CT PELVIS W&W/O C [**2187-12-4**] 3:23 PM IMPRESSION: 1. In this patient that is post open repair of a ruptured abdominal aortic aneurysm, there is absent perfusion of the right kidney. 2. No evidence of pneumatosis, as clinically questioned. Mild left colonic wall thickening and mildly dilated loops of small bowel, which are nonspecific findings, however, can be seen in the setting of bowel ischemia. Recommend close interval followup and clinical correlation. 3. Gallstones. 4. Small bilateral pleural effusions and adjacent atelectases ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ LIVER OR GALLBLADDER US (SINGLE ORGAN) PORT [**2187-12-13**] 8:12 AM IMPRESSION: 1. Cholelithiasis without cholecystitis. 2. Echogenic liver consistent with fatty infiltration. Other forms of liver disease including severe hepatic fibrosis/cirrhosis cannot be excluded on this examination. 3. No biliary duct dilatation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CT CHEST W/O CONTRAST [**2187-12-26**] 10:42 AM IMPRESSION: 1. Tracheomalacia. Assessment of likely tracheal stricture around tracheostomy tube would require extubation. Bronchi normal. 2. New, nonhemorrhagic pericardial effusion; no evidence of tamponade. 3. Small, nonhemorrhagic, left pleural effusion. 4. Bibasilar atelectasis. 5. Atherosclerotic aortic arch ulcer; aortic contour unchanged since [**2187-12-2**]. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CT HEAD W/O CONTRAST [**2187-12-26**] 10:42 AM IMPRESSION: 1. No evidence of acute intracranial hemorrhage. 2. Evidence of chronic microvascular infarction. 3. New, partial opacification and possible fluid level within the left mastoid air cells. This could represent mastoiditis in the appropriate clinical setting. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Cardiology Report ECHO Study Date of [**2187-12-27**] IMPRESSION: Moderate-sized pericardial effusion without echocardiographic signs of tamponade. Symmetric LVH with preserved global systolic function. Mild aortic regurgitation. Mildly dilated thoracic aorta. Compared with the focused TEE study of [**2187-12-2**] (images reviewed), the LV systolic function has improved, and there is now a pericardial effusion, as described above. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CHEST (PORTABLE AP) [**2188-1-1**] 8:19 AM IMPRESSION: 1. Increased left-sided basilar/retrocardiac opacity. Given the lack of deviation of the left main stem bronchus it is felt to likely represent an underlying consolidation with superimposed pleural effusion. Brief Hospital Course: Patient was admitted after initial evaluation in trauma ED for emergent ruptured abdominal aortic aneurysm repair by Dr. [**Last Name (STitle) **] of vascular surgery. Please see operative note for details of procedure. The patient tolerated this procedure well and was taken to the surgical intensive care unit still intubated and in critical, but stable condition. Her course in the intensive care unit was remarkable for development of ischemic colitis following the operation that resolved with conservative management. A flexible sigmoidoscopy was performed that confirmed this diagnosis intially and general surgery followed the patient as she resolved from this condition. She remained ventilator dependent and the decision to perform a tracheostomy was made. She underwent a bedside percutaneous tracheostomy on [**2187-12-17**]. Since that time she was weaned on the ventilator to the current status of alternating trach mask and CPAP+PS as tolerated. Tube feedings were intitiated via NGT (PEG deferred secondary to abdominal operations). She tolearated this at goal. Infectious issues were a ventilator associated pneumonia with respiratory cultures revealing proteus from [**12-7**]. She completed a course of zosyn and flagyl on [**12-17**] (on abx from day of surgery). Later in her hospitalization urine cultures revealed yeast, proteus and klebsiella for which she was treated as well. A mild leukocytosis developed the week of planned discharge with no evident source on work-up. The WBC was decreasing at the time of discharge. Retention sutures placed in the OR were removed on [**2187-12-31**] when her nutritional status had improved. Her wounds were healing well without complications. Cardiology evaluated the patient on [**2187-12-28**] for a small pericardial effusion seen on echocardiography. The patient was asymptomatic from this and it was deemed that no further work-up was necessary unless hypotension developed. The patient remained stable throughout. A repeat echocardiography was recommended as follow-up (1week). The patient was out of bed frequently and had been seen by physical therapy prior to discharge. Medications on Admission: glucophage, glyburide, advair, xanax, zestril, amitriptyline, lasix, vicodin, lipitor, lopressor Discharge Medications: 1. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 2. Nystatin 100,000 unit/g Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). 3. Albuterol 90 mcg/Actuation Aerosol Sig: 6-8 Puffs Inhalation Q4-6H (every 4 to 6 hours). 4. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical QID (4 times a day) as needed. 5. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 6. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed. 8. Famotidine 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 9. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: Six (6) Puff Inhalation Q4H (every 4 hours). 10. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime) as needed. 11. Docusate Sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 12. Furosemide 40 mg Tablet Sig: One (1) Tablet PO Q 8H (Every 8 Hours). 13. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation [**Hospital1 **] (2 times a day). 14. Citalopram 20 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 15. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 16. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 17. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 18. Insulin Sliding Scale Fingerstick QACHSInsulin SC Fixed Dose Orders Q12H 70 / 30 30 Units Insulin SC Sliding Scale Breakfast Lunch Dinner Bedtime Regular Regular Regular Regular Glucose Insulin Dose Insulin Dose Insulin Dose Insulin Dose 0-60 mg/dL [**11-27**] amp D50 [**11-27**] amp D50 [**11-27**] amp D50 [**11-27**] amp D50 61-120 mg/dl 0 Units 0 Units 0 Units 0 Units 121-140 mg/dL 4 Units 4 Units 4 Units 4 Units 141-160 mg/dL 7 Units 7 Units 7 Units 7 Units 161-180 mg/dL 10 Units 10 Units 10 Units 10 Units 181-200 mg/dL 13 Units 13 Units 13 Units 13 Units 201-220 mg/dL 16 Units 16 Units 16 Units 16 Units 221-240 mg/dL 19 Units 19 Units 19 Units 19 Units 241-260 mg/dL 22 Units 22 Units 22 Units 22 Units 261-280 mg/dL 25 Units 25 Units 25 Units 25 Units 281-300 mg/dL 28 Units 28 Units 28 Units 28 Units 301-320 mg/dL 31 Units 31 Units 31 Units 31 Units 321-340 mg/dL 34 Units 34 Units 34 Units 34 Units 341-360 mg/dL 37 Units 37 Units 37 Units 37 Units Discharge Disposition: Extended Care Facility: [**Hospital6 1293**] - [**Location (un) 1294**] Discharge Diagnosis: Abdominal aortic aneurysm Ischemic colitis Diabetes Melitus COPD Ventilatory Reqirement s/p tracheostomy Discharge Condition: Stable Discharge Instructions: Please call with any concerns or questions. Ventilator weaning for trach per protocols. C-collar to remain in place at all times with follow-up for open MRI needed when stable for transport and study. Please follow intermittent CBC to monitor mild leukocytosis and stable anemia. Followup Instructions: Follow-up needed: Open MRI on [**Hospital Ward Name 516**] of C-spine in 1-2weeks or when stable off vent consistently Appointments with Dr. [**Last Name (STitle) **]. Please call for appointment in [**12-29**] weeks. ([**Telephone/Fax (1) 16580**] Neurosurgery appointment needed following MRI. Please call for appointment with Dr. [**Last Name (STitle) 739**]. ([**Telephone/Fax (1) 88**] General surgery for trach. Please call for appointment when off ventilator support. Dr. [**Last Name (STitle) **]. ([**Telephone/Fax (1) 1483**] Please obtain echocardiography to assess pericardial effusion on [**2188-1-4**] (approximately). Follow-up with cardiology. Call for appointment ([**Telephone/Fax (1) 7437**] ICD9 Codes: 496, 5990, 4019, 311
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Medical Text: Admission Date: [**2102-3-13**] Discharge Date: [**2102-3-13**] Date of Birth: [**2029-12-18**] Sex: F Service: MEDICINE Allergies: Crestor Attending:[**First Name3 (LF) 338**] Chief Complaint: hypoxia Major Surgical or Invasive Procedure: None History of Present Illness: 72 yo female with afib, CHF (EF 30-35%), and metastatic colon cancer undergoing palliative chemotherapy transferred from BIDN for hypoxia in the context of bilateral multifocal pneumonia seen on CXR. Patient c/o productive cough, SOB, subjective fever (T to 100.1 at NH) for the past several days, given augmentin 500mg TID (D1=[**2102-3-11**]) at nursing home and brought to BIDN were she was found to be hypoxic to the 70s on RA, 80% on 5L NC. VS at BIDN: 93/50, 91, 25, 93% on nonrebreather. Labs at BIDN included: WBC 11.0 (83.6% N), K 3.0, lactate 1.7, AST 82, AP 204, alb 2.6. CXR reportedly showed bilateral multifocal PNA. Patient was given 2L NS, potassium supplementation (20meq), duonebs, as well as vancomycin 1gm IV and zosyn 3.375gm IV at 10:15pm and transferred to [**Hospital1 18**] for an ICU bed given hypoxia. Denies chest pain, nausea/vomiting, abdominal pain. She is DNR/DNI, confirmed with patient, but is okay with pressors. . In the ED inital vitals were T 97, HR 97, BP 112/61, RR 24, O2 sat 83% on 15L nonrebreather. Patient is reportedly confused, not understanding she has a foley in. Patient received 700 cc IVFs in ED. UA showed small leuks, 25 WBCs. Per nursing home, patient has a history of ESBL in urine. Vital signs on transfer were HR 108, BP 107/52, RR 28, sat 95% on 15L nonrebreather, however drops to 70s on RA. . On arrival to the ICU, VS T 98.6, HR 99, BP 107/61. RR 29, Sat 95% on 4L 100% nonrebreather, but desatted to the 70s with attempting to get out of bed to go to the bathroom. At rest, feels comfortable, without complaints except for cough exacerbated with speaking. Past Medical History: - colorectal cancer (dx 08) s/p low anterior resection and transverse colostomy [**12-21**] and is status post 14 cycles of Capox which she started in [**2099-2-12**] and completed in [**2100-8-12**]. She was then started on irinotecan in [**2100-9-12**] with the last dose being on [**12-24**] when she was hospitalized with abdominal pain and nausea. CT scan of the abdomen at that time showed progressive disease and new pulmonary metastases. She was subsequently sent to rehab since then and has not been on any further chemotherapy. - atrial fibrillation - CHF, EF 30-35% - coronary artery disease s/p CABG in [**2087**] at the [**Hospital1 24300**] Hospital; the patient has been followed by Dr. [**First Name4 (NamePattern1) 122**] [**Last Name (NamePattern1) **]; echocardiogram on [**2098-11-12**] showed inferior apical left ventricular aneurysm and ejection fraction of 30%-35% - htn - hyperlipidemia - hypothyroidism - UTI with ESBL - schizoaffective disorder - depression - anxiety - arthritis, knees - alcoholism - cataracts Social History: Lives at [**Location 931**] House Nursing Center at baseline is alert, oriented and follows instructions. Ambulates with assistance. Ms. [**Known lastname **] is single and has no children; she previously worked as a housekeeper and companion. She has a 75-pack-year history of cigarette smoking. Family History: Father died at age 58 from myocardial infarction and her mother died from complications of diabetes at age 78; a brother had lung cancer and a sister had breast cancer at age 74; a maternal uncle died of cancer; there is no family history of colon cancer. Physical Exam: ADMISSION EXAM Vitals: T 98.6, HR 99, BP 107/61. RR 29, Sat 95% on 4L 100% nonrebreather General: Alert, oriented, working to breathe HEENT: Sclera anicteric, dry MM, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: nonrebreather on, using abdominal muscles to breathe, rales throughout lungs bilaterally with minimal end-expiratory wheezes, no rhonchi CV: Tachycardic rate and reg rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: foley in place Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema, calves nontender and symmetric. Pertinent Results: [**2102-3-13**] 04:38AM BLOOD Glucose-115* UreaN-11 Creat-0.5 Na-142 K-3.5 Cl-108 HCO3-23 AnGap-15 [**2102-3-13**] 04:38AM BLOOD ALT-26 AST-79* LD(LDH)-509* AlkPhos-168* TotBili-0.9 [**2102-3-13**] 04:38AM BLOOD Albumin-3.3* Calcium-8.3* Phos-3.7 Mg-1.8 CXR [**2102-3-13**] There are extensive bilateral upper zone opacities with air bronchograms suggestive of pneumonia, previously diagnosed at an outside hospital. Outside hospital imaging was not available for direct comparison. Left hemidiaphragm is not visualized and suggests left lower field atelectasis and/or pleural effusion. Brief Hospital Course: 72 yo female with afib, CHF (EF 30-35%), and metastatic colon cancer undergoing palliative chemotherapy transferred from BIDN for hypoxia in the context of bilateral multifocal pneumonia seen on CXR. She was initially started on vancomycin, levaquin and cefepime for HCAP. Overnight she became progressively dyspneic and hypoxic. In the morning, she was started on BiPAP to assist with breathing. Around 11am, she was found to have right sided hemiplegia and dysphasia, with a constricted right pupil, suggesting that she had had a large hemispheric CVA. This information was explained to her health care proxy, [**Name (NI) **] [**Name (NI) **]. The decision was made to pursue Comfort Measures Only and all treatment was stopped. She was taken off the BiPAP and given a morphine drip and ativan for comfort. She expired at 13:31. The medical examiner was notified as she died within 24 hours of admission. An autopsy was waved and also declined by next of [**Doctor First Name **], her sister [**Name (NI) 43726**] [**Name (NI) 74569**]. Medications on Admission: zyprexa 20 mg daily colace 100mg [**Hospital1 **] Senna 1 tab Qday Magnesium oxide 400mg [**Hospital1 **] Synthroid 75mcg daily Melatonin 3mg Qhs sertraline 100 mg daily MV 1 tab daily Trazodone 50mg Qhs Ativan 0.5mg q4h prn anxiety Morphine 2mg SL q4h prn pain lidoderm patch 5%, 12hrs on, 12hrs off Motrin 600mg Q6hrs prn pain Acidophilus 2 tabs TID for 21 days (started [**3-9**]) Augmentin 500mg TID (started [**3-11**]) Started [**3-13**]: Saline nasal spray, duonebs, robitussin Discharge Medications: NA Discharge Disposition: Expired Discharge Diagnosis: Pneumonia Colon cancer Discharge Condition: Expired Discharge Instructions: NA Followup Instructions: NA ICD9 Codes: 486, 4019, 2724, 2449, 311
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Medical Text: Admission Date: [**2102-11-9**] Discharge Date: [**2103-3-7**] Date of Birth: [**2102-11-9**] Sex: M Service: NEONATOLOGY HISTORY OF PRESENT ILLNESS: [**Known lastname 5621**] [**Known lastname 37227**] was [**Known lastname **] with a birhtweight of 730 gm and gestational age of 28 and 2/7th week gestation baby boy to a 29-year-old gravida 3 para 2 to 3 mother. The patient's mother was transferred from [**Hospital6 11241**] prior to admission due to the fact that the [**Hospital1 2177**] Neonatal Intensive Care Unit was full. The pregnancy was notable for decreased fetal growth noted two weeks prior to delivery and the mother was admitted to [**Hospital6 11241**] on [**11-7**] with a biophysical of [**2-26**]. The mother had two healthy full term infants prior to this. Placenta was normal on gross examination. There was no history of maternal hypertension. [**Name (NI) **] mother was treated with one dose of betamethasone prior to delivery. Prenatal screens: Maternal blood type of O-, antibody negative, Hepatitis B surface antigen was negative. Group B strep was unknown. RPR was nonreactive. In the delivery room, the patient emerged with decreased tone, respirations and heart rate. The patient did respond to bag and mask ventilation and was intubated in the delivery room for poor effort. Apgars were 4 at 1 minute and 6 at 5 minutes. The patient was transferred to the Neonatal Intensive Care Unit for further management. ADMISSION PHYSICAL EXAM: On admission, the patient weighed 730 gm that was approximately the 50th percentile. He was pink, active and non dysmorphic. The skin was without any lesions. There was bilateral red reflex noted. Nares were patent. The palate was intact. The head circumference was 23 cm that was also the 50th percentile. Lungs were coarse and crackly with bilateral breath sounds. Cardiac exam was noted to be regular rate and rhythm without murmur. The abdomen was soft, nontender without hepatosplenomegaly. Genitalia was normal for this gestational age. (Both testes were undescended). The hips were stable and the back and skeletal structures were normal. The neurological exam was nonfocal and appropriate for age. SUMMARY OF HOSPITAL COURSE BY SYSTEMS: 1. RESPIRATORY: The patient was initially intubated in the delivery room and over the course of the first day received 3 doses of surfactant. He was initially placed on the conventional ventilator however was quickly transferred to the high frequency ventilator because of the severity of his lung disease. He was minimally responsive to the surfactant therapy and his progressive respiratory distress necessitated high frequency ventilation for the first 35 days of life. During this time, the patient also developed bilateral pleural effusions. The infant had a chest tube for drainage bilaterally from the [**10-23**] until the [**10-28**]. (There were bilateral chest tubes placed during that period). The patient was also briefly on caffeine for apnea of prematurity, although this is no longer an issue. His respiratory distress progressed to severe chronic lung disease which has been managed with fluid restriction at 130 cc per kg per day as well as diuretic therapy. He was intermittently on Combivent from the period of [**12-4**] to [**1-16**] which resulted in marginal improvement. At 2 months of age, attempts were made to wean him from the ventilator using inhaled betamethasone therapy. While this did result in some improvement in oxygen requirement, the infant still required moderate to high ventilatory settings due to the inability to ventilate. During this time diuretic therapy was also maximized. Initially, Diuril and Lasix was given and maximized, but because of hypokalemia the Lasix was discontinued. Pulmonary consultation at that time recommended initiation of systemic dexamethasone therapy due to severe unremitting bronchopulmonary dysplasia. This was initiated [**1-15**], and the infant received a prolonged taper of dexamethasone. Efforts to improve his pulmonary status using high doses or corticosteroids proved to have marginal effect. Tracheostomy was recommended to the family for better chronic management of his pulmonary disease and to allow transfer to a rehabilitation hospital for further care. Baby [**Known lastname 5621**] underwent a tracheostomy on [**1-29**] without any incidents. Bronchoscopy was done at that time that showed bilateral vocal cord granulation tissue. This surgical procedure was performed at [**Hospital3 1810**] where the postoperative recovery period was also done. The baby was transferred back to the [**Hospital3 **] Medical Center on [**2-3**] for further care. His ventilatory settings at the time was 24/6 x25 with an FIO2 in the mid 40s to 50%. He had a 3.5 Shiley tracheostomy tube in place. This has subsequently been changed to a 4.0 Shiley. Baby [**Known lastname 37236**] blood gases were acceptable and consistently had a PCO2 in the 70s (compensated). He received intermittent doses of Lasix during the last two weeks of [**Month (only) 958**]. His respiratory status did improve slowly and he was able to be converted to neonatal pressure support on [**2103-2-14**] (on day of life 97). At that time, the settings were as follows: Neonatal pressure support of 18, PEEP of 6, FIO2 in the 50s to 70%. After discussion with the pulmonary consultation, it was decided to augment his respiratory care with a scheduled course of Flovent. Over the next week, we were able to wean Baby [**Known lastname 26524**] pressure support down to 16 while keeping the oxygen requirements from 50% to 70%. However, by [**2-23**], his pulmonary status worsened again a chest x-ray showed bilateral coarse markings consistent with severe bronchopulmonary dysplasia and low lung volumes. He was switched back to SIMV support to a setting of 26/6 x28. Sepsis evaluation was performed at this this and cbc was unremarkable. Of note, a bagged urine specimen had grown [**Known lastname 37228**]. However, a catheter urine specimen that was sent later was negative. Trach secretions were also sent for culture as well as Mycoplasma. The Mycoplasma is pending as of today. Combivent use was also added as part of his respiratory therapy. Currently, Baby [**Known lastname 37227**] is on a vent setting of 30/6 with a rate of 26 with an oxygen requirement of 55% to 65%. After discussion with pulmonary consult as well as the team, we concluded that Baby [**Known lastname 5621**] would probably not benefit from a second course of systemic steroids. Currently, his chronic lung disease is at a stage that will require prolonged ventilatory support for now. He is stable and comfortable on his current ventilatory settings via his tracheostomy (of note, his tracheostomy was upsized to a 4.0 Shiley on [**2-22**] without any improvement). His current respiratory related medications include Flovent, Combivent, Diuril, and Aldactone. 2. CARDIOLOGY: Baby [**Known lastname 5621**] had his first echocardiogram on [**11-10**] at birth. This showed a large patent ductus arteriosus with dilated left and right atrium, good left ventricular and right ventricular function and a patent foramen ovale. The patient received a course of indomethacin to close the ductus. The patient does not currently have a murmur. During the first week of life, the patient did receive dopamine for low blood pressures. He has had no other problems with cardiac function. 3. FLUIDS, ELECTROLYTES AND NUTRITION: Due to abdominal concerns and concerns for sepsis, the infant was not fed for the first 20 days of life and was dependent solely on parenteral nutrition. Feedings were slowly advanced between day of life 25 and day of life 35 until he obtained full feeds. The patient has been tolerating full feeds and is currently PE-32 with ProMod 130 cc per kg per day pg. His transfer weight is 3355gm. His electrolytes reflect chronic respiratory acidosis and diuretic therapy. He is currently on Diuril and Aldactone. He is also receiving supplemental sodium and potassium. His most recent electrolytes were Na 139 K 6.0 Cl 102 CO2 26 BUN 15 Cre 0.2 Nutrition labs: Alk phos - 266 Ca 10.6 PO4 6.6 Albumin 4.1 Baby [**Known lastname 5621**] had also had some difficulties with hypoglycemia and has been followed by the Endocrine Consult service form [**Hospital3 1810**]. The is felt to be most likely secondary to prematurity and will hopefully resolve over time. Occasionally, his blood glucose still dips into the mid 50s. His metabolic evaluation has included urine organic acid and serum immuno acids which have been unremarkable. He did not show any evidence of metabolic acidosis. His newborn screens were also unremarkable, including a normal TSH. He did have a corticotropin stimulation test which was within normal limits. An insulin level was drawn at one point when he had hypoglycemia which was 6 which is within normal limits.. Currently, his hypoglycemic episode has improved and he has not had any hypoglycemic episodes while his feeds are given over 1.5 hours. We recommend that his glucose levels be continued to be monitored with the hopes that these hypoglycemic episodes are transient. If these hypoglycemic episodes persists, endocrinology may have to be reconsulted. Currently, their recommendation is observation. They do note that the patient will need endocrine follow up with an endocrinologist when transferred to [**Hospital1 13820**]. So far, they feel that the previous recurrent hypoglycemic episode may have been related to the pharmacological steroid use. 4. GASTROINTESTINAL: The patient had initial problems with sepsis as well as total parenteral nutrition dependency for the first 20 to 25 days of life. It was also noted that he had elevated transaminases with an elevated alkaline phosphatase and direct bilirubin. He has been on phenobarbital due to elevated conjugated bilirubin. Recently, his conjugated bilirubin has been trending downward. Bilirubin on [**3-6**] was 0.4 total and 0.2 direct. Hepatitis serology has been negative. He has been tested for the alpha-1 antitrypsin mutation. His genotype is MM which is usually normal. A HIDA scan that was performed showed a decrease in clearance of bile. He is on Zantac and Reglan due to concerns for potential reflux. This was started on [**1-12**] and has been continuing. He has not had a pH probe or upper gastrointestinal study. His trach secretions have been tested and is not consistent with microaspirations. 5. NUTRITION: He has been growing satisfactorily. He is on potassium phosphate, potassium chloride and sodium chloride supplementation. He is on iron, vitamin E. 6. INFECTIOUS DISEASE: The patient had a sepsis evaluation after birth. Early abdominal films showed a distended abdomen with some concerns of possible medical necrotizing enterocolitis. There was no clear mention of pneumatosis in his early abdominal films. He received 14 days of ampicillin, clindamycin and gentamicin. On [**11-23**], due to further emerging sepsis concerns, his ampicillin was switched to Vancomycin for an additional seven days. He ended up receiving a total course of 21 days of triple antibiotics. At one and a half months of life, cefotaxime and gentamicin were initiated due to concern for possible [**Known lastname 37228**] tracheitis. A lumbar puncture was obtained at that time which was benign. He was treated with antibiotics for 14 days. He is currently not on any antibiotics and has not been on any since a brief rule out sepsis that was done on [**2-23**] when he had worsening pulmonary status. CBC was negative, however, the blood culture did grow out gram positive cocci. Another blood culture was done prior to the start of antibiotics (Vancomycin and gentamicin) during this period and that culture remained negative. Because [**Known lastname 26524**] pulmonary status improved after we switched him to SIMV and the repeat culture prior to antibiotics remained negative and the gram positive cocci that initially grew appeared to be a contaminant, the antibiotics were discontinued after three days of therapy (48 hours after the repeat culture had been negative). Currently from an infectious disease standpoint, [**Known lastname 5621**] has not had any evidence of an active infection. His previous hospital history has noted that his trachea may be colonized with [**Known lastname 37228**] pneumonia that is resistant to gentamicin. 7. NEUROLOGY: The infant has had several cranial ultrasounds. His initial ultrasound on day of life 3 showed left grade 3 intraventricular hemorrhage. Progressive ultrasounds have shown resolution of this hemorrhage with relatively normal appearance of the lateral ventricles and the presence of small choroid plexus cyst. His last ultrasound was on [**2103-2-20**] which noted improvement as well. Neonatal neurology clinic follow up is needed. The patient also passed a recent hearing screen. His neurological exam includes an alert active boy moving all extremities equally. He is a bit hypertonic on all four extremities. 8. OPHTHALMOLOGY: The infant has been evaluated for risk of retinopathy of prematurity and developed only mild Stage I disease. This regressed completely and most recent examination on the [**3-9**] shows maturity of the retinal vessels bilaterally with no ROP. 9. AUDIOLOGY: Hearing screening was performed on [**2103-3-4**] with automated auditory brainstem responses and passed in both ears. 10. IMMUNIZATIONS: The baby has received his two month immunization as his second hepatitis B immunization. He has also received Synagis x2, the last one given on [**2103-3-5**]. 10. PSYCHOSOCIAL: The social worker has been involved with the family. They are French Creole speaking. They have been involved in and are participating in his care. They do have another child at home. We have had multiple family meetings including a recent discharge summary meeting. The parents are pleasant and understand [**Known lastname 26524**] medical conditions. [**Known lastname 5621**] will need to be followed by pulmonology consultant, endocrine consultant and neurology consultant. DISCHARGE CONDITION: Stable DISCHARGE DISPOSITION: To [**Hospital 13820**] Hospital CARE RECOMMENDATIONS AT DISCHARGE: 1. NUTRITION: The infant is receiving 130 cc per kg per day of PE-32 fortified with ProMod. 2. MEDICATIONS: Ranitidine 5.5 mg po/pg q8h, Reglan 0.27 mg po/pg q8h, potassium phosphate 1 milliequivalent po pg q 12 hours, sodium chloride supplement 2 milliequivalents po/pg qd, Flovent 44 mg 2 puffs [**Hospital1 **], vitamin E 5 international units po/pg qd, Combivent metered dose inhaler 2 puffs via trach q8h, Fer-In-[**Male First Name (un) **] 0.25 cc po/pg qd, aldactone 5.5 mg po/pg qd, Diuril 55 mg po/pg q 12 hours, potassium chloride supplements 2 milliequivalents po/pg q 12 hours. DISCHARGE DIAGNOSES: 1. History of surfactant deficiency, severe respiratory distress syndrome that progressed to severe chronic lung disease. 2. History of bilateral pleural effusions, resolved. 3. History of medical necrotizing enterocolitis, resolved. 4. History of [**Known lastname 37228**] tracheitis/pneumonia, treated for 14 days. 5. Patent ductus arteriosus, status post medical closure with indomethacin. 6. Presumed sepsis, resolved. 7. Persistent direct hyperbilirubinemia secondary to prolonged TPN use, resolving. 8. Presumed gastroesophageal reflux disease being treated with metaclopramide and ranitidine. 9. Resolved left grade 3 intraventricular hemorrhage. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 37237**], M.D. [**MD Number(1) 37238**] Dictated By:[**Last Name (NamePattern1) 37239**] MEDQUIST36 D: [**2103-3-6**] 13:03 T: [**2103-3-6**] 13:38 JOB#: [**Job Number 37240**] ICD9 Codes: 2762, V053, 0389
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Medical Text: Admission Date: [**2183-7-27**] Discharge Date: [**2183-8-1**] Date of Birth: [**2108-6-10**] Sex: M Service: MEDICINE Allergies: Lasix / Paxil / Allopurinol / Lipitor Attending:[**First Name3 (LF) 2901**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: Intubation, Central Venous Access History of Present Illness: HPI: 75yo M with complex history, including CCU admission [**Date range (1) 61041**] for NSTEMI c/b shock w/ IABP, intubation, trach/[**Date range (1) 282**], and s/p medicine admission [**Date range (1) 61042**] with repeat NSTEMI, trach replacement, removed 1 wk ago, now w/acute on chronic dyspnea x 2d. He was in his USOH, living at home on 2L NC O2 until 1 week ago when his prednisone was d/c'd, after trach removal. He gradually became dyspneic and on [**2183-7-25**] noted inability to lie flat and marked PND. He was brought to the ED today where he was in moderate respiratory distress and was transiently on BiPAP. He was then weaned to 2L NC with O2 100% after Bumex and Solumedrol. ABG: 7.26/73/79, concerning for hypercarbic respiratory failure. Past Medical History: 1.NSTEMI [**4-29**] - cardiac cath [**4-29**] w/ 3VD: distal LM 50%, Lcx 60%, OM2 90%, OM1 80%, no intervention, dropped BP at end of cath w/ PEA arrest---> resuscitated w/ epi/pressors 2. EF 35% 1-2+MR [**5-29**] echo (had flash pulm edema on last admit) 3. COPD on home Oxygen (2L for years) Dr. [**Last Name (STitle) **] is pulm fev1 590 cc by report- no pft's here 4. h/o pneumothorax 5. depression 6. IABP on last admit- was evaluated by CT surgery for CABG but was thought not to be a surgical candidate given MMP 7. ARF on last admit - Cr 1.7, now 0.98 8. GIB-- AVM on last admit at hepatic flexure- s/p embolization by IR (after 4 bleeding scans, c scope, push enteroscopy,etc) REQUIRED 15 units of prbc's on last admit Social History: Married with two children. Tobacco: 2 ppd x 25 years, quit 35 years ago. No EtOH. Family History: Non-contributory Physical Exam: Vit - 106/65 100 24 69% 2L Gen - elderly male, fatigued, depressed mood HEENT - NC/AT, PERRLA, EOMI Neck - JVP 10 cm, no carotid bruits, tracheostomy site C/D/I CV - tachycardic, regular rhythm, normal S1, S2, II/VI systolic murmur Pulm - increased accessory muscle use, diffuse rales Abd - benign Ext - 1+ peripheral edema bilaterally, 1+ DP and PT pulses bilaterally, weak LE bilaterally Skin - multiple excoriated regions on LE bilaterally Pertinent Results: ADMISSION LABS: 6.2 > 10.3/32.1 < 495 MCV=88 . N:81.0 L:7.5 M:6.4 E:4.7 Bas:0.5 Hypochr: 3+ Poiklo: 1+ . 136 / 95 / 12 --------------< 154 4.7 / 36 / 0.8 . Ca: 8.7 Mg: 1.9 P: 3.1 . CK: 33 Trop-*T*: 0.06 (trended down to 0.03 on [**7-28**]) proBNP: [**Numeric Identifier **] . PT: 12.1 PTT: 28.8 INR: 1.0 . ABG: 7.26/73/79/34 . [**7-29**] - Cortisol: 36.1 . EKG [**2183-7-27**]: Sinus rhythm. Left atrial abnormality. Left axis deviation with left anterior fascicular block. Right bundle-branch block. Probable old inferior wall myocardial infarction. Lateral ST-T wve changes which are non-specific. Compared to the previous tracing of [**2183-7-16**] no significant diagnostic change . CXR [**2183-7-27**]: 1. Interval increase of hazy opacities in the right upper lung zone and right lower lung zone. These findings could represent asymmetric CHF, but an infectious process cannot be excluded. 2. Cardiomegaly. 3. Interval removal of the tracheostomy tube. There is an area of narrowing of the trachea, where the lumen is as narrow as 1 cm. This could reflect post intubation stenosis or edema. 4. Fibrotic changes of the lung and emphysema. . ECHO [**2183-7-29**]: The left atrium is mildly elongated. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity is moderately dilated with regional dysfunction including hypokinesis of the distal half of the anterior septum and anterior walls, apex, and distal inferior and lateral walls. The remaining segments contract well. The right ventricular cavity is mildly dilated with mild global free wall hypokinesis. The aortic valve leaflets are moderately thickened. There is moderate aortic valve stenosis. No aortic regurgitation is seen. The mitral valve leaflets are structurally normal. Mild to moderate ([**1-26**]+) mitral regurgitation is seen. There is mild-moderate pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. Compared with the prior study (tape reviewed) of [**2183-6-9**], the left ventricular cavity is now dilated, moderate aortic valve stenosis is now identified. The right ventricle was mildly dilated with free wall hypokinesis on review of the prior study. . Brief Hospital Course: # Respiratory distress- Likely COPD and CHF exacerbation worsened by rapid decrease in steroids. Patient's hypercapnia was attributed to chronic CO2 retention. He was able to be weaned off the ventilator back to NC oxygen, which he uses at home, by the time of discharge. He responded well to nebulizer treatments and was restarted on steroids with a plan for a long slow taper over the next few months. At discharge patient was on nasal canula and satting above 90. Continue fluticasone inhaler, albuterol and atrovent nebs as outpatient. And continue PO steroids at 30 mg per day with slow taper down to 5 mg. Patient will follow up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] and Dr. [**Last Name (STitle) **] on [**2183-8-18**] for reassessment of his pulmonary function. # CAD: Patient has known 3VD, last cath ([**4-29**]), no intervention at that time given concurrent illness. CABG unlikely given severe COPD. Continued ASA, BB, ACEi, and weaned Nitro gtt. At discharge BB was changed to Toprol XL 25 mg and Lisinopril increased to 10 mg. Pressures and HR stable. Patient will follow up with Dr. [**Last Name (STitle) **] on [**2183-8-14**]. # Pump: EF 35% on echo ([**5-29**]) with 1-2+MR. Repeat ECHO from this admission showed EF 35-40%. Continue Ethacrynic Acid 25 mg daily as outpt. # h/o GIB with gastritis and multiple polyps. Continued on PPI during hospitalization. # Anemia - Patient received 1 unit of PRBCs during this hospitalization. # FEN: Electrolytes were repleted to maintain K>4, Mg>2. Patient was advanced to a low sodium heart healthy diet. # Prophylaxis - Patient was continued on PPI for gastric ulcer prophylaxis and heparin for DVT prophylaxis. # Code status: Patient clarified that he would like to be DNI only, not DNR # Dispo: Discharged to home with VNA and cardiac rehab. Medications on Admission: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY 2. Diclofenac Sodium 0.1 % Drops Sig: One (1) Ophthalmic once a day (). 3. Finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY 4. Lansoprazole 30 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY 5. Pravastatin Sodium 20 mg Tablet Sig: Four (4) Tablet PO HS 6. Toprol XL 50 mg Tablet Sustained Release 24HR Sig: Two (2) Tablet Sustained Release 24HR PO once a day. 7. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY 8. Tamsulosin 0.4 mg Capsule, Sust. Release 24HR Sig: One (1) Capsule, Sust. Release 24HR PO BID 9. Trazodone 50 mg Tablet Sig: One (1) Tablet PO HS 10. Mirtazapine 15 mg Tablet Sig: 0.5 Tablet PO HS 11. Hydrocortisone 1 % Cream Sig: One (1) Appl Topical TID 12. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID 13. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY 14. Salmeterol Xinafoate 50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation Q12H 15. Albuterol 90 mcg/Actuation Aerosol Sig: One (1) Inhalation q4-6h:PRN. 16. Ipratropium Bromide 18 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation QID 17. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID as needed. 18. Sodium Chloride 0.65 % Aerosol, Spray Sig: [**1-26**] Sprays Nasal TID as needed. 19. Lisinopril 2.5 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 2. Pravastatin Sodium 80 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 3. Mirtazapine 15 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). Disp:*30 Tablet(s)* Refills:*2* 4. Finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Ethacrynic Acid 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Metoprolol Succinate 25 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* 7. Prednisone 10 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily): Take 30 mg (3 tablets) every day for next 10 days, then decrease to 20 mg (2 tablets) every day for the next 10 days. Follow up with pulmonary for further taper regimen. Disp:*60 Tablet(s)* Refills:*2* 8. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 9. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). Disp:*60 Disk with Device(s)* Refills:*2* 10. Diclofenac Sodium 0.1 % Drops Sig: One (1) Ophthalmic qd (). Disp:*1 bottle* Refills:*2* 11. Tamsulosin 0.4 mg Capsule, Sust. Release 24HR Sig: One (1) Capsule, Sust. Release 24HR PO HS (at bedtime). Disp:*1 Capsule, Sust. Release 24HR(s)* Refills:*2* 12. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 13. Albuterol Sulfate 90 mcg/Actuation Aerosol Sig: 1-2 puffs Inhalation every 4-6 hours as needed for shortness of breath or wheezing. Disp:*2 MDI units* Refills:*1* 14. Atrovent 18 mcg/Actuation Aerosol Sig: 1-2 puffs Inhalation every 4-6 hours as needed for shortness of breath or wheezing. Disp:*2 MDI units* Refills:*1* 15. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital1 1474**] VNA Discharge Diagnosis: CHF and COPD exacerbation Discharge Condition: Good Discharge Instructions: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet Fluid Restriction: Followup Instructions: Follow up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] and Dr. [**Last Name (STitle) **] on [**2183-8-18**] at 2:15PM Provider: [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD Where: [**Hospital6 29**] CARDIAC SERVICES Phone:[**Telephone/Fax (1) 10548**] Date/Time:[**2183-8-14**] 3:30 Provider: [**Name10 (NameIs) 1571**] BREATHING TESTS Where: [**Hospital6 29**] PULMONARY FUNCTION LAB Phone:[**Telephone/Fax (1) 612**] Date/Time:[**2183-8-18**] 2:15 [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2908**] MD, [**MD Number(3) 2909**] Completed by:[**2183-9-19**] ICD9 Codes: 4280, 2762, 4240, 4019, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7956 }
Medical Text: Admission Date: [**2111-6-16**] Discharge Date: [**2111-6-28**] Date of Birth: [**2057-4-5**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 348**] Chief Complaint: Antifreeze ingestion Major Surgical or Invasive Procedure: Hemodialysis Endotracheal intubation RIJ central line placement History of Present Illness: Mr. [**Known lastname 78991**] is a 54 year old male who presents with antifreeze ingestion. Per report, the patient ingested 1.5-2L of antifreeze at 6 pm on [**2111-6-16**]. He vomited four times and EMS was called. He told the woman he was living with, [**First Name4 (NamePattern1) 2152**] [**Last Name (NamePattern1) **], that he would like to jump in front of a car, but didn't want to upset the driver. He initially complained of some burning in his throat and some slurred speech per report. He was transferred to [**Hospital3 **]. There he was given 2L 5%EtOH, Vitamin B1 100 mg POx1, Vitamin B6 100 mg POx1. He had diarrhea x 1 at the OSH which reportedly looked like antifreeze. He was then sent to BIMDC for consideration of HD. At [**Hospital1 18**], VS Temp 99.8, HR 50-60, BP 147/91, R 20. the patient was intermittently apneic. To sternal rub, he would wake up and call out "I want to die, let me die," and would not answer history questions. He was intubated in the [**Hospital1 18**] ED and was given a dose of 15 mg/kg fomepizole at toxicology recommendations. His pH was 7.19 and renal was consulted for consideration of HD. He was given 3 liters normal saline Past Medical History: Depression h/o ETOH abuse Social History: Divorced; 1 son- doesn't keep in touch with family. Lives with [**First Name4 (NamePattern1) 2152**] [**Last Name (NamePattern1) **] (listed as next of [**Doctor First Name **])- she is his landlord. history of ETOH abuse, sober for 12 yrs. Extent of ETOH unknown. No tobacco. no drugs. History of marijuana & cocaine use ~ 20 years ago. Currently works as a delivery driver for the [**Location (un) 86**] Globe. Family History: NC Physical Exam: VS: 97.5 121/62 71 22 100 AC 550/14/5/50% Gen: intubated, sedated, does not follow commands HEENT: conjunctival erythema bilaterally. pupils equal round and reactive to light. approx 2 mm Car: RRR no murmur Resp: coarse BS bilaterally Abd: soft, mildly distended, tympanic to percussion, hypoactive BS, no guarding Ext: no LE edema, 2+ DP/PT bilaterally Pertinent Results: [**2111-6-16**] 11:00PM BLOOD WBC-14.2* RBC-4.26* Hgb-13.5* Hct-41.4 MCV-97 MCH-31.7 MCHC-32.6 RDW-13.7 Plt Ct-269 [**2111-6-16**] 11:00PM BLOOD Neuts-92.6* Bands-0 Lymphs-5.3* Monos-1.7* Eos-0.2 Baso-0.1 [**2111-6-17**] 02:45AM BLOOD PT-13.6* PTT-22.5 INR(PT)-1.2* [**2111-6-16**] 11:00PM BLOOD Plt Ct-269 [**2111-6-18**] 03:42AM BLOOD Ret Aut-2.1 [**2111-6-16**] 11:00PM BLOOD Glucose-549* UreaN-8 Creat-1.1 Na-135 K-4.3 Cl-101 HCO3-11* AnGap-27* [**2111-6-16**] 11:00PM BLOOD ALT-14 AST-14 LD(LDH)-177 AlkPhos-62 TotBili-0.6 [**2111-6-16**] 11:00PM BLOOD Albumin-4.5 Calcium-8.5 Phos-2.3* Mg-2.1 [**2111-6-19**] 03:15AM BLOOD calTIBC-190* VitB12-147* Folate-GREATER TH Ferritn-799* TRF-146* [**2111-6-16**] 11:00PM BLOOD Osmolal-461* [**2111-6-19**] 03:15AM BLOOD Osmolal-296 Relevant Imaging: 1) CT [**2111-6-19**] IMPRESSION: 1. Very small amount of stranding and fluid in the right retroperitoneum, most consistent with a small retroperitoneal hemorrhage, likely related to right femoral central venous catheter placement. Amount of blood does not appear large enough to explain clinical hematocrit drop from 40 to 24. 2. Dense bilateral lung base consolidations, concerning for aspiration or infection. 2) CXR [**2111-6-22**] Brief Hospital Course: Mr. [**Known lastname 78991**] is a 54 year old male with depression s/p ethylene glycol ingestion for suicide attempt, acidotic with hospital course c/b fevers, hypotension, anemia, and difficult weaning from ventilator secondary to AMS. 1)Ethylene glycol ingestion: Patient was admitted to the MICU after an ethylene glycol ingestion. He had been started on an ethanol gtt at the OSH. Upon transfer to [**Hospital1 18**], renal was consulted and he was started on fomepizole and access was established for hemodialysis. He underwent two hemodialysis sessions and the ethylene glycol level was montiored until it was no longer detectable. The HD line was then removed. 2)Fevers: During his hospital stay, the patient spiked high fevers. The cause was thought to be a pneumonia given his sputum which grew staph aureus and the cxray which suggested a possible LLL infiltrate. He was started on Vancomycin Zosyn but he continued to spike through antibiotics. The decision was made to stop the antibiotics given lack of clear source of infection. He continued to have fevers but lower than they had been. Cultures remained negative. 3)Respiratory Failure: Patient was intubated initially for airway protection given changes in his mental status. There was also some thought that there was a component of PNA vs. volume overload. He was treated briefly for hospital aquired pneumonia (which were then stopped) and he was also diuresed with Lasix. He was successfully extubated and his mental status slowly improved. 4) Anemia: Patient had a significant drop in his hematocrit from admission. He was guaiac negative. He also underwent a CT abdomen/pelvis which was negative for an RP bleed. He did received 2 units of pRBCs during his stay in the MICU. 5)Depression: Patient presented with ethylene glycol ingestion as part of suicide attempt. Pscyhiatry and social work were consulted once patient was extubated. Medications on Admission: None Discharge Medications: 1. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO at bedtime. Discharge Disposition: Extended Care Facility: [**Hospital1 **] 4 Discharge Diagnosis: Primary Diagnoses: 1. Ethylene Glycol ingestion (Suicide attempt) 2. Acute Renal Failure 3. Bradycardia 4. Depression Secondary Diagnoses 1. Recovering Alcoholism Discharge Condition: Medically Stable Discharge Instructions: You have been admitted to the hospital after an ingestion of Ethylene glycol. While you were here you were in the Intensive Care Unit. Please take all medications as directed. Please return to the Emergency Room for Chest Pain, Shortness of Breath or any other medical concern. Followup Instructions: In-patient psychiatric Care ICD9 Codes: 5849, 2762, 5185, 311, 4589, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7957 }
Medical Text: Admission Date: [**2206-1-25**] Discharge Date: [**2206-1-29**] Date of Birth: [**2152-1-4**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 30**] Chief Complaint: dyspnea, respiratory distress Major Surgical or Invasive Procedure: none History of Present Illness: Mr. [**Known lastname 7086**] is a 54M h/o smoking, severe end-stage COPD on home O2 of 2-5LNC, presenting with increasing dyspnea, sputum production and transferred to MICU for need for NIPPV. . Roughtly one week prior to admission reports gradual onset nasal congestion, Patient called [**Company 191**] triage on [**1-24**] with c/o that congestion had progressed to his chest, and noted associated thick secretions. . Wake this with morning with acute worsening of SOB. Progressive symptoms prompted patient to call EMS. Sat 86% on RA per EMS, RR 30s-40s. On arrival to the ED, patient noted to be tri-poding. Exam consistent with poor air entry and wheeze therefore Treatment for COPD flare initiated with solumedrol 125mg, azithro/CTX and patient placed on NIPPV; off CPAP desaturated 87% on 3L. CXR demonstrated hyperlucency of upper and mid zones c/w severe emphysema, patchy opacities at bilateral bases, left>right c/w crowding at emphysematic bases though cant rule out super-imposed infiltrate. VS prior to transfer 100%02 on CPAP 5/5 100%, RR: 18, additional VS: 139/79 HR 98. Past Medical History: - COPD, on 4 L home oxgyen and 10 mg prednisone every other day, followed by [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]/[**First Name4 (NamePattern1) 4648**] [**Last Name (NamePattern1) **], no prior intubations - Diabetes Mellitus, type 2 - Obstructive sleep apnea, followed by [**First Name8 (NamePattern2) 450**] [**Last Name (NamePattern1) 437**], in process of starting therapy but not currently on non-invasive - Likely CAD (coronary calcifications on CT) - Depression/Anxiety - Diverticulosis - Scrotal hydrocele - Dupuytren contractures Social History: - Tobacco: Smokes one pack per day ([**11-26**] PPD) since age 13 - Alcohol: Occasional - Illicits: Denies Family History: (per chart) Multiple family members with DM Brother with [**Name2 (NI) 499**] cancer No family history of lung disease Physical Exam: General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear, EOMI, PERRL Neck: supple, JVP not elevated, no LAD CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Lungs: significantly redused air entry with distant breath sounds, scattered wheezes. R less air entry than L. Abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly GU: no foley Ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: CNII-XII intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact Pertinent Results: Admission Labs: [**2206-1-25**] 07:00AM BLOOD WBC-9.4 RBC-4.69 Hgb-13.7* Hct-40.1 MCV-85 MCH-29.2 MCHC-34.2 RDW-12.6 Plt Ct-254 [**2206-1-25**] 07:00AM BLOOD PT-11.4 PTT-27.9 INR(PT)-1.1 [**2206-1-25**] 07:00AM BLOOD Glucose-155* UreaN-10 Creat-0.8 Na-142 K-3.8 Cl-97 HCO3-35* AnGap-14 [**2206-1-25**] 12:23PM BLOOD Type-ART Temp-37.2 pO2-154* pCO2-89* pH-7.28* calTCO2-44* Base XS-11 Intubat-NOT INTUBA [**2206-1-25**] 04:33PM BLOOD Type-ART FiO2-40 pO2-74* pCO2-78* pH-7.34* calTCO2-44* Base XS-11 Intubat-NOT INTUBA [**2206-1-25**] 10:15PM BLOOD Type-ART pO2-64* pCO2-68* pH-7.38 calTCO2-42* Base XS-11 Intubat-NOT INTUBA [**2206-1-26**] 06:08AM BLOOD Type-ART pO2-84* pCO2-76* pH-7.36 calTCO2-45* Base XS-12 Intubat-NOT INTUBA [**2206-1-25**] 10:15PM BLOOD O2 Sat-92 Discharge Labs: [**2206-1-28**] 05:15AM BLOOD WBC-8.3# RBC-4.40* Hgb-12.7* Hct-37.8* MCV-86 MCH-28.8 MCHC-33.6 RDW-12.6 Plt Ct-199 [**2206-1-28**] 05:15AM BLOOD Glucose-98 UreaN-12 Creat-0.7 Na-142 K-3.7 Cl-99 HCO3-39* AnGap-8 ECGs: Cardiovascular Report ECG Study Date of [**2206-1-25**] 8:07:40 PM Sinus rhythm. Poor R wave progression, probable normal variant. Non-specific lateral ST-T wave changes. Compared to the previous tracing of [**2206-1-25**] the sinus rate is slower. The findings are otherwise similar. Cardiovascular Report ECG Study Date of [**2206-1-25**] 7:09:08 AM Baseline artfact. Probable sinus tachycardia. Poor R wave progression. Non-specific ST-T wave abnormalities, although artifact makes interpretation difficult. Compared to the previous tracing of [**2204-5-10**] sinus tachycardia and artifact are new. Read by: [**Last Name (LF) 2889**],[**First Name3 (LF) 2890**] K. Intervals Axes Rate PR QRS QT/QTc P QRS T 120 0 98 [**Telephone/Fax (2) 57074**]2 IMAGING: - Portable TTE (Complete) Done [**2206-1-27**] at 1:56:18 PM FINAL - IMPRESSION: Suboptimal image quality. Normal biventricular cavity sizes with preserved global and regional biventricular systolic function. No valvular pathology or pathologic flow identified. Dilated ascending aorta. CLINICAL IMPLICATIONS: The patient has a mildly dilated ascending aorta. Based on [**2203**] ACCF/AHA Thoracic Aortic Guidelines, if not previously known or a change, a follow-up echocardiogram is suggested in 1 year; if previously known and stable, a follow-up echocardiogram is suggested in [**12-27**] years. Brief Hospital Course: Mr. [**Known lastname 7086**] is a 54 year old man with history of current tobacco use, severe end-stage COPD on home O2 of 2-4L NC, admitted to the MICU for COPD exacerbation, requiring NIPPV on presentation. # COPD Exacerbation Patient was admitted for COPD exacerbation, initially to MICU for non-invasive ventilation, then transitioned back to nasal canula over one day. Patient reports that last exacerbation was about six months ago, for which he was not hospitalized, but he created his own prednisone taper based on symptoms, which lasted a couple of months. Patient was initially started on ceftriaxone and azithromycin for treatment of potential LLL pneumonia. Ceftriaxone was discontinued in MICU because pneumonia was felt to be unlikely. He required albuterol nebulizers every 2 hours in the MICU, transitioned to every 6 hours on the floor. He was also started on prednisone 60mg daily on admission, transitioned to 40mg daily after 4 days. Prednisone taper as follows: prednisone 40mg x 4 more days, then decrease to prednisone 30mg x 6 days, then prednisone 20mg x 6 days, then prednisone 10mg x 6 days, then back to home dose of prednisone 10mg every other day. Patient may uptitrate for symptoms if needed, but he should call primary care physician [**Last Name (NamePattern4) **]. [**First Name (STitle) 216**] if doing so. He would like to join outpatient pulmonary rehab at [**Hospital1 18**] once he meets requirements for smoking cessation. Followup appointment with Dr. [**Last Name (STitle) **] was set up. He was also started on alendronate in setting of chronic prednisone use. # Tobacco Use Patient was counseled extensively on smoking cessation. He will use nicotine patches at home, starting with 21mg/day patches, which he states he already has. He was seen by social work for extra support. # DM2 Patient was well controlled on home metformin, but had a few elevated blood sugars while on high dose steroids. He was maintained on insulin sliding scale during hospitalization, but transitioned back to metformin 500mg daily on discharge. Blood sugars should be monitored while on prednisone taper. # Hypertension Patient with elevated blood pressures at primary care office on multiple occasions, not on any medications yet. Had moderately elevated blood pressures during hospitalization, ranging 120s-160s systolic. Will defer starting low dose [**Doctor Last Name 360**] to primary care physician. # Depression Patient became anxious after discussion about severity of his COPD. Spoke with social work for extra support. Continued on home venlafaxine. Transitional Issues: - smoking cessation - dilated aortic root seen on TTE (which was done in MICU to look for dCHF as potential etiology of shortness of breath) --> needs followup echocardiogram in 1 year or in [**12-27**] years if clinically stable - monitor blood pressures - consider starting bactrim for PCP [**Name Initial (PRE) 1102**] Medications on Admission: FLUTICASONE [FLONASE] - 50 mcg Spray, Suspension - 2 sprays each nostril once daily *** not currently taking FLUTICASONE-SALMETEROL [ADVAIR DISKUS] - 250 mcg-50 mcg/Dose Disk with Device - 1 inhaled twice a day LORATADINE - 10 mg Tablet - 1 Tablet(s) by mouth once a day as needed for allergic symptoms *** not currently taking METFORMIN [GLUCOPHAGE] - 500 mg Tablet - 1 Tablet(s) by mouth once a day PREDNISONE - 10 mg Tablet - 1 Tablet(s) by mouth 1-3x/day as directed, but took 50mg today, and had been taking 60 earlier this week TIOTROPIUM BROMIDE [SPIRIVA WITH HANDIHALER] - 18 mcg Capsule, w/Inhalation Device - one capsule inhaled once a day Empty capsule into inhalation device VENLAFAXINE - (Prescribed by Other Provider) - 225 mg Tablet Extended Rel 24 hr - 1 (One) Tablet(s) by mouth Discharge Medications: 1. prednisone 10 mg Tablet Sig: AS DIRECTED Tablet PO once a day: - Prednisone 40mg x 4 days - Prednisone 30mg x 6 days - Prednisone 20mg x 6 days - Prednisone 10mg x 6 days, - then back to your previous dosing of prednisone 10mg every other day . 2. tiotropium bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) cap Inhalation once a day. 3. venlafaxine 75 mg Capsule, Ext Release 24 hr Sig: Three (3) Capsule, Ext Release 24 hr PO DAILY (Daily). 4. fluticasone-salmeterol 250-50 mcg/dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 5. metformin 500 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. temazepam 30 mg Capsule Sig: One (1) Capsule PO at bedtime as needed for insomnia. 7. loratadine 10 mg Tablet Sig: One (1) Tablet PO once a day as needed for allergic symptoms. 8. Calcium 500 + D 500 mg(1,250mg) -400 unit Tablet, Chewable Sig: One (1) Tablet, Chewable PO twice a day. 9. alendronate 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*0* 10. nicotine 21 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily) for 5 weeks. Disp:*30 Patch 24 hr(s)* Refills:*0* 11. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) capsule Inhalation every six (6) hours as needed for shortness of breath. 12. ipratropium bromide 0.02 % Solution Sig: One (1) capsule Inhalation every six (6) hours as needed for shortness of breath or wheezing. Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: COPD Exacerbation Diabetes Mellitus Hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mr. [**Known lastname 7086**], You were admitted to [**Hospital1 **] for a COPD exacerbation. You were started on high dose prednisone and given a 5 day course of azithromycin treatment. You will need to continue prednisone for a few weeks, as listed below. As we discussed, if you feel that the taper is too rapid, you can increase your dose as needed, but please call Dr. [**First Name (STitle) 216**] if you need to do this. Please also discuss smoking cessation with Dr. [**First Name (STitle) 216**]. The following changes have been made to your medications: * Prednisone taper as follows: - Prednisone 40mg x 4 days - Prednisone 30mg x 6 days - Prednisone 20mg x 6 days - Prednisone 10mg x 6 days, then back to your previous dosing of prednisone 10mg every other day * Please also start Alendronate 10mg daily and discuss this with your primary care physician. [**Name10 (NameIs) **] must be seated upright when taking this medication and drink a full glass of water with it. * Please continue taking calcium and vitamin D * Please start using the Nicotine Patch as follows: - nicotine patch 21 mg/day (highest dose) for 5 more weeks - nicotine patch 14 mg/day for 2 weeks - nicotine patch 7 mg/day for 2 weeks (Your current prescription is only for 30 days of the 21mg/day nicotine patch.) While you were here you were seen by social work. She provided you with information on smoking cessation and relaxation techniques. It was alos recommended that you engage in out atient therapy to help you cope with your chronic illness and anxiety. You can contact one of the following to make an appointment: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] [**Street Address(2) 57075**] [**Hospital1 8**] MA [**Telephone/Fax (1) 57076**] [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] [**Last Name (NamePattern1) 1046**] [**Street Address(2) 57077**] [**Hospital1 **] MA [**Telephone/Fax (1) 57078**] [**First Name8 (NamePattern2) **] [**Last Name (un) 41140**], [**Last Name (un) 1046**] [**Location (un) 57079**] MA [**Telephone/Fax (1) 57080**] If you need more referrals or any further assistance, please contact the social worker you saw while you were here: [**Name (NI) 636**] [**Last Name (NamePattern1) 12471**] [**Telephone/Fax (1) 57081**] Followup Instructions: Please be sure to keep your followup appointments as listed below: Department: [**Hospital3 249**] When: WEDNESDAY [**2206-2-5**] at 10:50 AM With: [**Name6 (MD) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 2010**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: PULMONARY FUNCTION LAB When: THURSDAY [**2206-2-13**] at 2:40 PM With: PULMONARY FUNCTION LAB [**Telephone/Fax (1) 609**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: MEDICAL SPECIALTIES When: THURSDAY [**2206-2-13**] at 3:00 PM With: [**Name6 (MD) 610**] [**Name8 (MD) **] RN/DR. [**Last Name (STitle) 611**] [**Telephone/Fax (1) 612**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 3051, 4019, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7958 }
Medical Text: Admission Date: [**2109-3-31**] Discharge Date: [**2109-4-5**] Date of Birth: [**2026-11-6**] Sex: F Service: MEDICINE Allergies: Codeine Attending:[**Last Name (NamePattern1) 1167**] Chief Complaint: STEMI Major Surgical or Invasive Procedure: cath History of Present Illness: 84F h/o MI in [**2086**] and CVA [**2099**], on Coumadin FOR AFIB, denies CABG or stents, c/o 1 hr of chest tightness, nausea, diaphoresis, onset while at rest watching TV. Followed by Mark [**Doctor Last Name **] at [**Location (un) **]. In ED had inferior STEMI with 2>3 STE in inferior leads. She got ASA and a Heparin bolus. INR was >3 so no gtt started. She was not given plavix prior to procedure. She was taken to the cath lab where she was found to have 90-100% mid RCA occlusion. The wire was delpoyed across the lesion but due to her INR of >3 and fragile appearing [**Last Name (un) 12599**] she was not felt to be a canditate for stenting. She underwent baloon angioplasty. . Following proceure, As radial T band was being remove she vagaled and had SBP drop to 50's with HR in the 150's. Was given 1-2 mg of atropine, started on dopamine. Systolics rose to the 80's. She was then given 10mg IV diltiazem followed by 15mg IV metoprolol with control of her HR to the 130's and SBP to 100's. She arrives ont he floor on 10 of dopa. . On review of systems, s/he denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. S/he denies recent fevers, chills or rigors. S/he denies exertional buttock or calf pain. All of the other review of systems were negative. . Cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. Past Medical History: 1. CARDIAC RISK FACTORS: CAD 2. CARDIAC HISTORY: - CABG: - PERCUTANEOUS CORONARY INTERVENTIONS: - PACING/ICD: 3. OTHER PAST MEDICAL HISTORY: - Knwon MI in [**2088**] - CVA - Afib on coumadin - Social History: - Tobacco history: Quit smokign 21 years ago - ETOH: occasional glass of wine - Illicit drugs: none Family History: No family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. Physical Exam: VS: 120 97/70 RR18 02 SAT 100% GENERAL: NAD. Oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with no JVP elevation CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. . Exam at discharge: Vitals T 98.4 BP 125-156/76-86 HR 85-100RR 18 O2 94RA I/O: Tele: AF, rate 90's-low 100's no VEA Weight: 58.3(58.6) . General Appearance: NAD, sitting in chair Head, Ears, Nose, Throat: Normocephalic Cardiovascular: irregularly irregular (S1: Normal), JVP 12cm H2O, no murmurs, rubs or gallops Respiratory / Chest: CTAB Abdominal: Soft, Non-tender Extremities: right LE with 1+, LLE nl. Neurologic: Oriented to self, [**Hospital1 18**], Month, year, good attention Pertinent Results: ADMISSION LABS: [**2109-3-31**] 06:15PM BLOOD WBC-6.6 RBC-3.59* Hgb-12.1 Hct-36.5 MCV-102* MCH-33.8* MCHC-33.3 RDW-12.6 Plt Ct-219 [**2109-3-31**] 07:00PM BLOOD PT-40.4* PTT->150 INR(PT)-4.0* [**2109-3-31**] 07:00PM BLOOD Glucose-113* UreaN-17 Creat-1.0 Na-144 K-3.0* Cl-105 HCO3-26 AnGap-16 [**2109-3-31**] 06:15PM BLOOD cTropnT-<0.01 [**2109-4-1**] 12:54AM BLOOD CK-MB-88* MB Indx-12.0* cTropnT-3.54* [**2109-4-1**] 05:11AM BLOOD CK-MB-87* MB Indx-11.0* cTropnT-3.65* [**2109-4-1**] 12:54AM BLOOD Calcium-7.8* Phos-3.8 Mg-1.5* [**2109-3-31**] 07:00PM BLOOD %HbA1c-5.9 eAG-123 [**2109-3-31**] 07:00PM BLOOD Triglyc-81 HDL-52 CHOL/HD-2.3 LDLcalc-52 [**2109-3-31**] 06:22PM BLOOD Glucose-109* Lactate-2.3* Na-141 K-3.3 Cl-102 calHCO3-28 PERTINENT INTERVAL LABS: [**2109-3-31**] 07:00PM BLOOD WBC-7.0 RBC-3.35* Hgb-11.0* Hct-33.1* MCV-99* MCH-32.9* MCHC-33.3 RDW-12.7 Plt Ct-194 [**2109-4-1**] 12:54AM BLOOD Hct-32.2* Plt Ct-199 [**2109-4-1**] 05:11AM BLOOD WBC-7.5 RBC-3.35* Hgb-10.9* Hct-33.4* MCV-100* MCH-32.5* MCHC-32.6 RDW-12.8 Plt Ct-203 [**2109-4-2**] 01:31AM BLOOD WBC-8.5 RBC-3.13* Hgb-10.4* Hct-31.0* MCV-99* MCH-33.3* MCHC-33.6 RDW-12.9 Plt Ct-182 [**2109-4-3**] 06:29AM BLOOD WBC-6.4 RBC-3.12* Hgb-10.2* Hct-31.6* MCV-101* MCH-32.7* MCHC-32.3 RDW-13.4 Plt Ct-179 [**2109-3-31**] 07:00PM BLOOD PT-40.4* PTT->150 INR(PT)-4.0* [**2109-4-1**] 05:11AM BLOOD PT-29.3* PTT-41.3* INR(PT)-2.8* [**2109-4-2**] 12:31PM BLOOD PT-38.9* INR(PT)-3.8* [**2109-4-3**] 06:29AM BLOOD PT-29.0* PTT-38.1* INR(PT)-2.8* [**2109-3-31**] 07:00PM BLOOD Glucose-113* UreaN-17 Creat-1.0 Na-144 K-3.0* Cl-105 HCO3-26 AnGap-16 [**2109-4-1**] 05:11AM BLOOD Glucose-131* UreaN-18 Creat-1.1 Na-140 K-4.1 Cl-103 HCO3-26 AnGap-15 [**2109-4-2**] 01:31AM BLOOD Glucose-118* UreaN-22* Creat-1.2* Na-141 K-3.6 Cl-104 HCO3-22 AnGap-19 [**2109-4-3**] 06:29AM BLOOD Glucose-78 UreaN-21* Creat-1.0 Na-142 K-3.5 Cl-107 HCO3-25 AnGap-14 [**2109-4-1**] 12:54AM BLOOD CK(CPK)-734* [**2109-4-1**] 05:11AM BLOOD CK(CPK)-788* [**2109-4-1**] 01:22PM BLOOD CK(CPK)-633* [**2109-4-2**] 01:31AM BLOOD CK(CPK)-603* [**2109-4-3**] 06:29AM BLOOD ALT-41* AST-67* AlkPhos-41 TotBili-0.7 [**2109-3-31**] 06:15PM BLOOD Lipase-59 [**2109-3-31**] 06:15PM BLOOD cTropnT-<0.01 [**2109-4-1**] 12:54AM BLOOD CK-MB-88* MB Indx-12.0* cTropnT-3.54* [**2109-4-1**] 05:11AM BLOOD CK-MB-87* MB Indx-11.0* cTropnT-3.65* [**2109-4-1**] 01:22PM BLOOD CK-MB-48* MB Indx-7.6* cTropnT-2.35* [**2109-4-2**] 01:31AM BLOOD CK-MB-25* MB Indx-4.1 cTropnT-1.88* [**2109-4-1**] 12:54AM BLOOD Calcium-7.8* Phos-3.8 Mg-1.5* [**2109-4-2**] 01:31AM BLOOD Calcium-8.0* Phos-2.7 Mg-1.8 [**2109-4-3**] 06:29AM BLOOD Calcium-8.3* Phos-2.7 Mg-2.1 [**2109-3-31**] 07:00PM BLOOD %HbA1c-5.9 eAG-123 [**2109-3-31**] 07:00PM BLOOD Triglyc-81 HDL-52 CHOL/HD-2.3 LDLcalc-52 STUDIES: ECG ([**3-31**]): Sinus rhythm. Right bundle-branch block. Inferior ST segment elevation consistent with an acute inferior myocardial infarction and probable lateral extension with slight ST segment elevation in leads V5-V6. There is reciprocal ST segment depression in leads I, aVL and V1-V2. No previous tracing available for comparison. Cardiac Cath ([**3-31**]): COMMENTS: 1) Selective coronary angiography of this right-dominant system demonstrated one-vessel coronary artery disease. The LMCA, LAD, and LCx had minimal disease but were free of angiographically-apparent flow-limiting stenoses. The mid-RCA was subtotally occluded. 2) After the mid-RCA angioplasty, she began complaining of nausea and dizziness and was noted to have a noninvasive sBP in the high 50s. The transducer was connected to the right radial arterial sheath sidearm, with blunted pressure recordings. Noninvasive readings were consistently below sBP 70. She was given 2 mg atropine for presumed vagal reaction, and started on IV fluids and dopamine, up to 20 mcg/kg/min. A right common femoral arterial sheath was placed in preparation for possible IABP placement. However, her sBPs were then noted to be in the 80s-90s. At that time, her heart rates were in the 140s-150s (transiently as high as 200) and appeared to be atrial fibrillation; she was then given 15mg IV metoprolol with resulting heart rates in the 120s and stable sBPs in the 100s. The RCFA sheath was manually pulled and a TR band was applied to the RRA site. She was transported to the CCU in stable condition. ADDENDUM: PCI COMMENTS: Initial angiography revealed a subtotally occluded RCA. We planned to treat this using PTCA. A 6 Fr JR5 guiding catheter provided reasonable support throughout the procedure. Chronic Warfarin therapy with known INR of 3.2 48 hours prior. A Prowater wire was successfully advanced across the target lesion and positioned in the distal vessel. An Apex 2.0 x 8 mm balloon was used to pre-dilate the occlusion, restoring flow to the vessel. Attempts were made to deliver a Mini-Vision 2.0 x 12 mm and then a 2.0 x 8 mm stent, however we were unable to advance these across the lesion. Final angiography showed TIMI 3 flow within the vessel and no apparent dissection. It was elected to stop with conventional balloon angioplasty given her elevated INR. Post angioplasty hemodynamic course as documented above. Hemostasis achieved at right radial arterial access site using TR band. FINAL DIAGNOSIS: 1. One vessel coronary artery disease status post primary balloon angioplasty of the mid-RCA stenosis. 2. Vagal reaction and hypotension requiring pressors and fluids. . ECG ([**2109-3-31**]): rate 84, Baseline artifact makes P wave morphology difficult. This could be sinus rhythm with premature atrial contractions and ventricular premature beats versus atrial fibrillation with ventricular premature beats. Right bundle-branch block. Inferior and lateral ST segment elevation consistent with an acute inferior myocardial infarction. Compared to tracing #1 baseline artifact is more pronounced. . ECG [**2109-3-31**]: rate 133. Probable atrial fibrillation with a rapid ventricular response and baseline artifact. Right bundle-branch block. Left anterior fascicular block. Q waves in leads III and aVF consistent with an inferior myocardial infarction which is probably acute. Compared to tracing #2 the inferior and lateral ST segment elevation is less pronouced. Q waves are more apparent in leads III and aVF. TRACING #3 . ECG [**2109-3-31**]: rate 126. Possible atrial flutter with variable block. Right bundle-branch block with left anterior fascicular block. Slight ST segment elevation in leads III and aVF with Q waves suggesting evolution of an inferior myocardial infarction. Premature ventricular contraction is also present. Lateral ST-T wave changes consistent with ongoing ischemia. Compared to tracing #3 atrial flutter may be present. The ventricular premature beat is new. . ECG [**2109-3-31**]: rate 123. Probable atrial fibrillation with a rapid ventricular response. Right bundle-branch block with left anterior fascicular block. Inferior myocardial infarction which is evolving. ST-T wave changes suggest ongoing ischemia. Compared to tracing #5 the ventricular rate is slower. . ECG [**2109-4-1**]: rate 86. Atrial flutter at an atrial rate of about 300 with variable block. Right bundle-branch block with left anterior fascicular block. Inferior myocardial infarction with inferior T wave inversions suggesting an evolving inferior myocardial infarction. Non-specific T wave flattening in leads V4-V6. Compared to tracing #6 the ventricular rate is slower. The ST segment depression in leads V1-V2 is less pronounced. . ECHO [**2109-4-1**]: The left atrium is elongated. No left atrial mass/thrombus seen (best excluded by transesophageal echocardiography). No atrial septal defect is seen by 2D or color Doppler. The estimated right atrial pressure is 5-10 mmHg. There is mild symmetric left ventricular hypertrophy with normal cavity size. There is mild to moderate regional left ventricular systolic dysfunction with severe hypokinesis of the basal half of the inferior septum, inferior and inferolateral walls. The remaining segments contract normally (LVEF = 35 %). The right ventricular cavity is mildly dilated with normal free wall contractility. [Intrinsic right ventricular systolic function is likely more depressed given the severity of tricuspid regurgitation.] The diameters of aorta at the sinus, ascending and arch levels are normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild to moderate ([**11-26**]+) mitral regurgitation is seen. Severe [4+] tricuspid regurgitation is seen. There is mild pulmonary artery systolic hypertension. [In the setting of at least moderate to severe tricuspid regurgitation, the estimated pulmonary artery systolic pressure may be underestimated due to a very high right atrial pressure.] There is no pericardial effusion. IMPRESSION: Mild symmetric left ventricular hypertrophy with moderate regional systolic dysfunction c/w CAD. Severe tricuspid regurgitation. Pulmonary artery hypertension. Mild-moderate mitral regurgitation. Labs on Discharge: [**2109-4-5**] 06:55AM BLOOD WBC-6.3 RBC-3.12* Hgb-10.2* Hct-31.4* MCV-101* MCH-32.6* MCHC-32.4 RDW-13.6 Plt Ct-198 [**2109-4-5**] 06:55AM BLOOD PT-26.2* INR(PT)-2.5* [**2109-4-5**] 06:55AM BLOOD UreaN-19 Creat-0.9 Na-144 K-3.8 Cl-108 HCO3-30 AnGap-10 [**2109-4-4**] 06:56AM BLOOD Calcium-8.4 Phos-2.6* Mg-1.9 Brief Hospital Course: Brief Clinical Summary: Ms. [**Known lastname **] is an 82 year old woman with history of CAD, Afib on coumadin and CVA who presented with inferior STEMI secondary to RCA occlusion now s/p percutaneous balloon angioplasty with immediate post procedural course complicated by hypotension and tachycardia initially requiring pressors, hospitalization complicated by delirium. Issues: # Inferior STEMI: Because patient presented with supratherapeutic INR, decision was made not to commit patient to plavix with PCI, so she underwent POBA of the RCA. She was chest pain free with resolution of ST changes after intervention. She was initially hypotensive and bradycardic on presentation, requiring dopamine for support which was soon weaned off. She also received a dose of atropine on the night of presentation, after which she became more delirious. She was continued on aspirin, beta blocker. Atorvastatin dose was increased to 80mg daily. Lisinopril 2.5mg was started prior to discharge. TTE showed EF of 35%, symmetric LVH with moderate regional systolic dysfunction, severe TR, moderate mitral regurgitation, and RV failure. Hemoglobin A1c was 5.9% consistent with prediabetes. Lipid panel showed HDL 54, LDL 47 and trigl 108. The patient has been arranged with cardiac follow-up. # Acute Systolic Dysfunction: EF 35% on ECHO. No signs of CHF during her hospital stay. Her discharge weight is 128 pounds. She will require daiy weights with the consideration of starting a diuretic if her weight increases or she shows signs of CHF. An ECHO should be scheduled in [**3-1**] weeks to assess LV function. # Delirium: ICU course was complicated by significant delirium which quickly resolved on the floor. She was given several doses of olanzapine and quetiapine in the ICU in efforts to restore her sleep-wake cycle. # Afib with RVR: She remained in atrial fibrillation throughout hospitalization. CHADS score is 4. Presented with supratherapeutic INR, so warfarin was initially held, then restarted prior to discharge. She was continued on metoprolol. # Hypertension Home antihypertensives were initially held in the setting of hypotension. When hemodynamically stable, she was restarted on metoprolol in setting of atrial fibrillation, and she was started on low dose lisinopril. Her metoprolol was increased to 150 of succinate once per day. Home HCTZ was discontinued. # Code Status was FULL CODE during this hospitalization # Husband: [**Name (NI) **] [**Name (NI) **]: [**Telephone/Fax (1) 18277**]. Transitional Issues: 1. cardiology f/u 2. uptitrate lisinopril as tolerated 3. uptitrate metoprolol as tolerated Medications on Admission: Warfarin 3.75-7mg Calcium 600 D HCTZ 25 mg QD Lipitor 10mg QD Immodium PRN Maalox 2 tsp QHS Metoprolol 50mg QD MVI Probiotics Tylenol 500mg [**Hospital1 **] PRN - Discharge Medications: 1. metoprolol succinate 100 mg Tablet Extended Release 24 hr Sig: 1.5 Tablet Extended Release 24 hrs PO once a day. [**Hospital1 **]:*45 Tablet Extended Release 24 hr(s)* Refills:*0* 2. Coumadin 1 mg Tablet Sig: Three (3) Tablet PO once a day: please adjust dose as instructed by your doctor. [**Last Name (Titles) **]:*90 Tablet(s)* Refills:*2* 3. Calcium 500 + D Oral 4. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). [**Last Name (Titles) **]:*30 Tablet(s)* Refills:*2* 5. aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). [**Last Name (Titles) **]:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 6. lisinopril 2.5 mg Tablet Sig: One (1) Tablet PO once a day. [**Last Name (Titles) **]:*30 Tablet(s)* Refills:*2* 7. immodium Sig: One (1) once a day as needed for diarrhea. 8. Maalox RS Oral 9. multivitamin Tablet Sig: One (1) Tablet PO once a day. 10. probiotics Sig: One (1) once a day. 11. Tylenol 325 mg Tablet Sig: 1-2 Tablets PO twice a day as needed for pain. Discharge Disposition: Extended Care Facility: [**Location (un) 582**] at [**Location (un) 620**] Discharge Diagnosis: ST Elevation Myocardial Infarction Delirium Hypertension Tachycardia Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Ms. [**Known lastname **], You were admitted to the hospital because you had a heart attack. We started you on new medications to help protect your heart. You had some delirium (confusion) in the hospital, which is now improved. The following changes were made to your medications: - STOP Hydrochlorothiazide - DECREASE Warfarin to 3mg daily and adjust your dose as instructed by your doctor - INCREASE Lipitor to 80mg daily to lower your cholesterol - START Aspirin 325mg daily to prevent blood clots - INCREASE Metoprolol Succinate to 150mg daily to slow your heart rate - START lisinopril 2.5mg daily It was a pleasure taking care of you, we wish you all the best! Followup Instructions: Name: MARK [**Name Initial (MD) **] [**Name8 (MD) **],MD Location: [**Hospital3 **] CARDIOLOGISTS When: Tuesday [**4-9**] at 1pm Address: [**2109**], [**Location (un) **],[**Numeric Identifier 8934**] Phone: [**Telephone/Fax (1) 18278**] Completed by:[**2109-4-5**] ICD9 Codes: 4254, 4271, 4019
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Medical Text: Unit No: [**Numeric Identifier 72703**] Admission Date: [**2114-4-9**] Discharge Date: [**2114-4-9**] Date of Birth: [**2114-4-9**] Sex: F Service: NB HISTORY OF PRESENT ILLNESS: Patient is the 485 gram product of a 28-week gestation born to a 25-year-old prima 1st mother with an [**Name (NI) 37516**] of [**2114-7-4**]. Mother was admitted on [**2114-3-29**], for evaluation of disconcordant growth of these di-di twins. Infant uterine growth restriction and low amniotic fluid was noted in sibling of this child. The estimated fetal weight of twin A on [**3-30**], of this twin was 541 grams and the sibling was 863 grams on [**2114-3-30**]. Biophysical profiles at that time were reassuring. A course of betamethasone was done during that admission on [**2114-3-30**]. The pregnancy was otherwise complicated by migraines, irritable bowel syndrome, and maternal anxiety. She received [**Year (4 digits) 34491**] p.r.n. for her migraines. Prenatal screens showed a maternal blood type of A-positive with a negative antibody screen, hepatitis B surface antigen was negative, RPR nonreactive, rubella immune. Maternal group B strep colonization status was unknown. The mother was readmitted on [**4-5**], at 27 weeks and 1 day for fetal monitoring. There was absent diastolic flow noted on a Doppler of this twin. Fetal testing remained otherwise reassuring through this evening when abnormalities of fetal heart monitoring for twin B were noted. Given the history of poor growth and absent diastolic flows, decision was made to proceed to C-section. MATERNAL HISTORY: Notable for, according to labor and delivery records, for a history of migraines, irritable bowel syndrome, and anxiety. The mother was treated with [**Name (NI) 34491**] on a p.r.n. basis. At delivery, the patient emerged vigorous with Apgars of 6 and 7. She was treated with blow-by O2, then CPAP. The development of moderate respiratory distress prompted intubation in the delivery room with a 2.0 oral ETT> (Larger tube not attempted). PHYSICAL EXAM ON ADMISSION: Shows pink, active, nondysmorphic infant intubated with good perfusion and saturations. Left great toe is held in flexion and sl abducted. Bones appear normal to palpation Skin is without lesions. HEENT exam was unremarkable. Cardiac exam shows a normal S1 and S2 without murmurs. Abdomen is benign. Lungs show bilateral crackles with moderate retractions. Genitalia shows a normal premature female. Anus was patent. The spine is intact. Hip exam was normal. The patient, who is in breech presentation, shows a left hyperextended hip at rest. Again, hip exam otherwise appears normal. Neuro exam was nonfocal and age appropriate. HOSPITAL COURSE BY SYSTEMS: 1. The patient was intubated in the delivery room as noted above. Initial dose of Survanta was administered in the NICU. The patient has weaned to settings of 14/5 IMV 20 60-> 30% O2. Mean blood pressure on admission was in the 30s. 2. Fluid, electrolytes, and nutrition: Patient was maintained NPO, IV fluids of D10W at 120 cc per kilogram administered. Initial blood sugar was 40 prior to start of IVF 3. Infectious disease: CBC and blood culture were sent at the time of admission. These results remain pending. Ampicillin and gentamicin were begun for a presumed 48- hour rule out. 4. Routine healthcare maintenance: Newborn screening sample was to be sent prior to transfer to [**Hospital3 1810**]. Hearing screening has not been accomplished, but is suggested prior to ultimate discharge home. PMD not yet identified. DISCHARGE DIAGNOSES: 1. Twenty-eight-week preemie. 2. Respiratory failure requiring intubation. 3. Hyaline membrane disease. 4. Rule out sepsis. 5. ? positional deformity of left great toe. 6. Intra-uterine growth restriction. DISCHARGE DISPOSITION: Patient is to be transferred to [**Hospital3 1810**] neonatal intensive care unit care of Dr. [**Last Name (STitle) **]. Parents had signed consent for transfer and had visited with infants prior to their transfer. [**First Name11 (Name Pattern1) 449**] [**Last Name (NamePattern1) **], [**MD Number(1) 54604**] Dictated By:[**Last Name (NamePattern1) 56160**] MEDQUIST36 D: [**2114-4-10**] 00:03:51 T: [**2114-4-10**] 05:41:23 Job#: [**Job Number 72704**] ICD9 Codes: 769, V290
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Medical Text: Admission Date: [**2124-8-5**] Discharge Date: [**2124-8-13**] Date of Birth: [**2066-5-17**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1267**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: Cardiac catheterization [**2124-8-7**] Coronary artery bypass graft x 5 (Left internal mammary artery > left anterior descending, Saphenous vein graft > diagonal > obtuse marginal, saphenous vein graft > right coronary artery > posterior descending artery) [**2124-8-9**] History of Present Illness: 58M presented to [**Hospital1 **] [**Location (un) 620**] with a three day history of chest pain, now severe and radiating to his upper back. The patient was hypertensive to 198/124, equal in both arms. CXR was negative. He was given labetalol, NGT, and ASA. Troponin was elevated to 0.268, CK-MB 51, MBI 13. CXR was negative. Transferred to [**Hospital1 18**] for CTA to rule out dissection. . Patient drove up to MA a few days ago and noticed tightness in his shoulders and back. Played golf the next day and continued to have upper back and upper chest pain b/l. Denies SOB, dizziness. Had some nausea at first, but resolved. Continued to play golf. At night used a cold pack to releive the pain and was able to sleep. The next day he continued to have the pain without relief so he went to the [**Hospital1 **] at [**Location (un) 620**]. . In the ED, the troponin was elevated to 0.4, MB 88. A CTA was negative for acute dissection. Patient was seen by cardiology and they recommended heparin, integrillin gtt's for possible cath. Past Medical History: 1. slipped disc durgery in [**2087**] 2. rhinoplasty in [**2097**] Social History: Patient works in the golf buisness, recently had been caddying and walks 6 to 10 miles per day. Lives in [**Doctor First Name 5256**], now in [**Location (un) 7349**] for the summer; in MA on a visit to play golf. -Tobacco history: Patient has smoked [**1-26**] ppd for 20 years -ETOH: has about 4 drinks per night. Denies having hangovers or withdrawal symptoms. -Illicit drugs: hx of cocaine use in the 80's, nothing recently Family History: His paternal grandfather had an MI at the age of 39, otherwise non-contributory. Physical Exam: VS: T= 97.6 BP= 130/82 HR= 55-64 RR= 18 O2 sat= 96 % on RA GENERAL: middle-aged male lying in bed in NAD. Alert and appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. OP clear, MMM NECK: Supple with JVP of 7 cm. CARDIAC: Regular and bradycardic, normal S1, S2. No m/r/g. LUNGS: CTAB ABDOMEN: Soft, NTND. No HSM or tenderness. EXTREMITIES: No c/c/e. SKIN: no rashes Pertinent Results: [**8-5**] Chest CT: 1. No aortic dissection 2. Findings concerning for right lower lobe pneumonia with slightly enlarged medistinal nodes. 3 month followup is recommended to ensure resolution. . EKG: Sinus bradycardia, T wave inversions in III, aVF, V5, and V6 and biphasic T waves in II and V4. . [**8-7**] Cardiac cath: 1. Selective coronary angiography of this right dominant system revealed three vessel disease. The LMCA had no significant disease. The LAD had an 80% stenosis involving the bifurcation at the D1. The D1 additionally had at the mid segment an 80% stenosis. The OM1 was a small vessel with 95% stenosis. The OM2 had a 100% total occlusion with a large proximal thrombus. The OM2 had retrograde filling by collaterals. The RCA had an 80% stenosis at the proximal segment, an 90% stenosis at the mid/distal segment. The R-PDL had an 80% stenosis. 2. Limited resting hemodynamic assessment demonstrated normal systemic arterial pressure with a central aortic pressure of 138/78 mm Hg. The LVEDP was mildly elevated at 22 mm Hg, which was suggestive of diastolic dysfunction. Carefull pullback across the aortic valve showed no evidence of aortic stenosis. 3. Left ventriculogram demonstrated normal systolic function and normal wall motion. There was no mitral regurgitation. [**8-9**] Echo: PRE-BYPASS: The left atrium is dilated. No spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. No atrial septal defect or patent foramen ovale is seen by 2D, color Doppler or saline contrast with maneuvers. There is mild symmetric left ventricular hypertrophy with normal cavity size. There is mild regional left ventricular systolic dysfunction with mild focal abnormalities in the lateral wall, apex and inerior wall.. Overall left ventricular systolic function is mildly depressed (LVEF= 45 to 50 %). Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve leaflets are mildly thickened. Mild (1+)mitral regurgitation is seen. There is no pericardial effusion. Dr. [**Last Name (STitle) **] was notified in person of the results on Mr. [**Known lastname 2093**], D at 10 AM on [**2124-8-9**]. Post_Bypass: Ascening aortic contour is intact. Mild MR and there is no change from the preop. Normal RV systolic function. Overall LVEF 50%. [**2124-8-5**] 02:55AM BLOOD WBC-10.2 RBC-4.49* Hgb-13.7* Hct-39.7* MCV-88 MCH-30.5 MCHC-34.5 RDW-13.6 Plt Ct-196 [**2124-8-11**] 06:40AM BLOOD WBC-9.6 RBC-3.20* Hgb-10.0* Hct-28.7* MCV-90 MCH-31.2 MCHC-34.8 RDW-13.1 Plt Ct-184 [**2124-8-5**] 02:55AM BLOOD PT-13.2 PTT-28.6 INR(PT)-1.1 [**2124-8-10**] 01:11AM BLOOD PT-13.6* PTT-29.9 INR(PT)-1.2* [**2124-8-5**] 02:55AM BLOOD Glucose-136* UreaN-20 Creat-0.9 Na-139 K-3.6 Cl-104 HCO3-28 AnGap-11 [**2124-8-11**] 06:40AM BLOOD Glucose-110* UreaN-22* Creat-1.2 Na-137 K-4.5 Cl-101 HCO3-28 AnGap-13 [**2124-8-11**] 06:40AM BLOOD Calcium-8.4 Phos-3.9 Mg-2.0 Brief Hospital Course: 58 yo male smoker with no PMH found to have a NSTEMI with positive cardiac enzymes. On [**8-7**] he underwent a cardiac cath which revealed sever three vessel coronary artery disease. He was appropriately worked-up for bypass surgery and on [**8-7**] he was brought to the operating room where he underwent a coronary artery bypass graft x 5. Please see operative report for surgical details. Following surgery he was transferred to the CVICU for invasive monitoring in stable condition. Later on op day he was weaned from sedation, awoke neurologically intact and extubated. On post-op day two beta-blockers and diuretics were started and he was transferred to the telemetry floor for further care. Also on this day, chest tubes were removed without incident. The remainder of his postoperative course was uneventful and he progressed well. He was discharged to home on POD#4 on [**8-13**]. Medications on Admission: None Discharge Medications: 1. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 3. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 5. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*1* 6. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*1* 7. Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 8. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Coronary artery disease s/p Coronary artery bypass graft x 5 Myocardial Infarction PMH: s/p Back surgery, s/p Rhinoplasty Discharge Condition: Good Discharge Instructions: Please shower daily including washing incisions, no baths or swimming Monitor wounds for infection - redness, drainage, or increased pain Report any fever greater than 101 Report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week No creams, lotions, powders, or ointments to incisions No driving for approximately one month No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Followup Instructions: Chest CT scan in 3 months as follow up for enlarged mediastinal lymph nodes. Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] - ([**Telephone/Fax (1) 2037**] - you have an appointment on [**9-21**] at 1pm Dr [**Last Name (STitle) **] in 4 weeks - please call to schedule appointment It is recommended that you remain locally until follow up appointment with Dr [**Last Name (STitle) **] and Dr [**Last Name (STitle) **] ICD9 Codes: 3051
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Medical Text: Admission Date: [**2107-9-21**] Discharge Date: [**2107-9-27**] Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 598**] Chief Complaint: left chest pain Major Surgical or Invasive Procedure: none History of Present Illness: Patient speaks minimal English. Most of history obtained from chart. He arrived via ems from day care program with report s/p fall - report pt slid off of chair and hit back of head - no LOC. Complains of pain L chest and L knee Past Medical History: COPD CAD (severe LAD disease, ?no stent per UMG but on plavix) Chronic diastolic heart failure DM (followed by [**Last Name (un) **]) HTN Arthritis s/p compression fx L1 Spinal stenosis L4-5 presumed Gout, on colchicin Stage II chronic renal failure Social History: Lives at [**Location 78275**] living ([**Telephone/Fax (1) 78276**]). Uses cane at baseline. No EtOH, smoking, drugs per patient Family History: No sudden death or early CAD Physical Exam: Time Pain Temp HR BP RR Pox + 10:12 5 98.5 64 162/68 22 96 Looks well, in pain. Alert and oriented. No scalp injury. Pupils equal and reactive; Neck: No tenderness Lungs: Clear bilateral;Decreased air entry bilateral bases Tenderness L chest Heart: Regular rate and rhythm Abdomen: soft nondistended. Some tenderness RLQ Rectal: Sphincter tone present. No occult blood Spine: Tenderness in lower thoracic spine and lumbar spine Pertinent Results: [**2107-9-21**] 11:45AM WBC-5.4 RBC-4.50* HGB-13.1* HCT-39.6* MCV-88 MCH-29.1 MCHC-33.0 RDW-14.7 [**2107-9-21**] 11:45AM NEUTS-72.8* LYMPHS-19.6 MONOS-4.8 EOS-2.2 BASOS-0.6 [**2107-9-21**] 11:45AM PLT COUNT-129* [**2107-9-21**] 11:45AM GLUCOSE-328* UREA N-34* CREAT-2.0* SODIUM-135 POTASSIUM-5.0 CHLORIDE-100 TOTAL CO2-26 ANION GAP-14 [**2107-9-21**] CT Chest/Abd/pelvis : 1. L1 vertebral body compression fracture with an 8-mm retropulsion of indeterminate age, although no surround hematoma or soft tissue swelling. Retropulsion causes severe spinal canal narrowing at this level, which increases risk of spinal cord injury. If clinical concern, MRI is more sensitive in evaluation of spinal cord injury. 2. Multiple bilateral rib fractures as above, with underlying left chest wall/mediastinal contusion/hematoma. Multiple old-healing fractures, as detailed above. 3. Cholelithiasis. [**2107-9-21**] C Spine CT : 1. No acute fracture or subluxation. 2. Multilevel degenerative changes including osteophytes with mild spinal canal narrowing at C3-C4, increasing risk of spinal cord injury. If clinical concern for spinal cord or ligamentous injury, MRI is more sensitive. [**2107-9-21**] Head CT : Fracture of nasal spine of the maxilla, age indeterminate. Lucency in the anterior left maxilla, of indeterminate age. Findings may be periapical and dental related, although while felt less likely, traumatic injury is not excluded [**2107-9-21**] Right hip and knee : No evidence of acute fracture involving the right hip, right femur, or right knee. [**2107-9-22**] Carotid studies : On the right,likely carotid occlsuion with recanalization. On the left, there has been progression in the plaque, now with 70-79% carotid stenosis. Clinical correlation MRA or CTA evaluation is warranted. [**2107-9-22**] Cardiac echo : The left atrium is dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size. There is mild regional left ventricular systolic dysfunction with hypokinesis of the basal inferior and inferolateral segments. Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. The pulmonary artery systolic pressure could not be determined. There is an anterior space which most likely represents a fat pad. Compared with the report of the prior study (images unavailable for review) of [**2106-5-5**], a focal wall motion abnormality can be seen on the current study. This may have been present on the prior but image quality precluded certainty. Mild symmetric LVH is seen on the current study. [**2107-9-24**] CXR : Left lower lobe opacity has minimally increased; this could be due to atelectasis, pneumonia cannot be totally excluded but less likely. There are low lung volumes. Cardiomegaly is unchanged. Atelectasis in the right base is stable. There are no enlarging pleural effusions or pneumothorax. [**2107-9-24**] KUB : The ascending colon has a large amount of stool. The transverse colon is slightly distended measuring 8.5 cm in maximal diameter. There are no air- fluid levels. The visualized sigmoid colon is of normal caliber. Haziness of the abdomen could be due to patient body habitus and/or ascites. There are degenerative changes in the lumbar spine. [**2107-9-26**] Video swallow : There is penetration and aspiration with thin consistency. There is also penetration with nectar consistency, but no evidence of aspiration. For further details, please refer to full speech and swallow division note in OMR. FINDINGS: Penetration with thin and nectar consistencies. Aspiration with thin consistency. Brief Hospital Course: Mr. [**Known lastname 78277**] was evaluated in the ER by the Trauma Service and Ct scans of the C Spine, Chest, Abdomen and Pelvis were notable for multiple rib fractures and an old L1 compression fracture. He was admitted to the Trauma floor for pain control, pulmonary toilet and a syncopal work up. It was difficult to fully explain the mechanism of his fall despite the help of the Italian interpreter and on exam he seemed to have no vision in the left eye. Eventually his daughter explained that his visual problems were old secondary to a detached retina. He had carotid studies which showed a string sign on the right and 70-79% occlusion of the left internal carotid artery. The vascular surgery service was consulted and recommended an MRA of the neck however this was not obtained as the family felt that surgery was not an option due to his age and comorbidities. His pain was partially controlled with a PCA but language barrier limited more instruction therefore he was changed to Tylenol around the clock and prn oxycodone. Unfortunately despite resuming his pre admission inhalers and pulmonary toilet he desaturated to the mid 80's on 2 liters and was tachypneic prompting transfer to the ICU. A chest Xray revealed a left lower lobe density and he was placed on IV Vancomycin and Zosyn. After a 48 hour stay in the ICU for pulmonary toilet he was transferred back to the Trauma floor and was evaluated by the Physical Therapy service. Due to his age and deconditioned state as well as his pulmonary compromise he was transferred to rehab to further help increase his mobility and contine pulmonary toilet. He remained afebrile with a normal WBC and was changed to oral Cipro in [**2107-9-27**] which will continue thru [**2107-10-1**]. His cultures were negative but the antibiotic was for Xray findings. His main complaint of left sided rib pain was controlled with Tylenol and prn Oxycodone. Medications on Admission: Vitamin D 1,000 unit Cap; Plavix 75 mg Tab Advair Diskus 100 mcg-50 mcg/Dose for Inhalation Aspir-81 81 mg Tab; Omeprazole 10 mg Cap, Isosorbide Mononitrate 10 mg Tab Glipizide SR 2.5 mg 24 hr Tab Sertraline 25 mg Tab; Atrovent HFA 17 mcg/Actuation Aerosol Inhaler; *flaxseed oil 1000mg Once Daily Lasix 20', Colace 100 " Discharge Medications: 1. Heparin (Porcine) 5,000 unit/mL Solution Sig: 5000 (5000) units Injection TID (3 times a day). 2. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: 2.5 mg Inhalation Q6H (every 6 hours). 3. Ipratropium Bromide 0.02 % Solution Sig: One (1) inhalation Inhalation Q6H (every 6 hours). 4. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: 250/50 mcg/Disk with Devices Inhalation [**Hospital1 **] (2 times a day). 5. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 6. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 7. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Sertraline 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day): hold for SBP < 100 HR < 60. 11. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 12. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 13. Tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO HS (at bedtime). 14. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily): 12 hours on / 12 hours off. 15. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 16. Oxycodone 5 mg/5 mL Solution Sig: 5-10 mls PO Q6H (every 6 hours) as needed for pain. 17. Isosorbide Dinitrate 10 mg Tablet Sig: One (1) Tablet PO TID (3 times a day): Hold for SBP < 100. 18. Ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours): Thru [**2107-10-1**]. 19. Insulin Regular Human 100 unit/mL Solution Sig: 2-8 units Injection four times a day as needed for elevated blood sugars per sliding scale: Check blood sugars Pre meal and HS. 20. Glipizide 10 mg Tablet Extended Rel 24 hr Sig: One (1) Tablet Extended Rel 24 hr PO BID (2 times a day). 21. Brimonidine 0.2 % Drops Sig: One (1) Drop Ophthalmic [**Hospital1 **] (2 times a day): Both eyes. 22. Latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime): Both eyes. Discharge Disposition: Extended Care Facility: [**Hospital3 537**]- [**Location (un) 538**] Discharge Diagnosis: S/P fall with : Left anterior [**5-15**] rib fracture Right anterior 7th rib fractuer Left lateral 6th rib fracture Old L1 compression fracture with stenosis Bilateral carotid stenoses COPD CAD DM2 Discharge Condition: stable Discharge Instructions: ?????? Take your pain medicine as prescribed. ?????? Exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? Increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. We generally recommend taking an over the counter stool softener, such as Docusate (Colace) while taking narcotic pain medication. ?????? Unless directed by your doctor, do not take any anti-inflammatory medicines such as Motrin, Aspirin, Advil, or Ibuprofen etc. CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING ?????? New onset of tremors or seizures. ?????? Any confusion, lethargy or change in mental status. ?????? Any numbness, tingling, weakness in your extremities. ?????? Pain or headache that is continually increasing, or not relieved by pain medication. ?????? New onset of the loss of function, or decrease of function on one whole side of your body. Followup Instructions: Call Dr. [**Last Name (STitle) **] at [**Telephone/Fax (1) 600**] for a follow up appointment in 2 weeks Call Dr. [**Last Name (STitle) 4321**] at [**Telephone/Fax (1) 608**] for a follow up appointment in [**12-10**] weeks [**First Name8 (NamePattern2) **] [**Name8 (MD) **] MD [**MD Number(2) 601**] Completed by:[**2107-9-27**] ICD9 Codes: 486, 4280, 496, 2749
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Medical Text: Admission Date: [**2165-3-1**] Discharge Date:[**2165-3-7**] Date of Birth: [**2101-5-12**] Sex: M Service: ADDENDUM: Two days prior to discharge the patient developed an oral lesion consistent with erythema multiforme likely related to a penicillin reaction. As a result, the patient's penicillin was discontinued. He was switched to intravenous vancomycin one gram intravenous q. 12 hours. He tolerated this without any problems. His oral lesions did not progress, ruling out the possibility of [**Doctor Last Name **]-[**Location (un) **] syndrome development. The patient remained comfortable throughout the rest of his hospital stay. He had no further problems. DISCHARGE INSTRUCTIONS: 1. Continue vancomycin for a total of two weeks with an end date of [**2165-3-19**]. 2. Continue all outpatient medications. 3. Use viscous lidocaine and Vaseline to oral lesions as needed. 4. Follow up with primary care physician on [**3-10**] to assess progress and make sure arrangements are made to have PICC line discontinued. 5. Follow up with neurology on [**2165-4-9**] at 1 PM with Dr. [**Last Name (STitle) 1004**] in the [**Hospital Ward Name 23**] Building. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3090**], M.D. [**MD Number(1) 3091**] Dictated By:[**Last Name (NamePattern1) 1595**] MEDQUIST36 D: [**2165-3-7**] 12:57 T: [**2165-3-7**] 13:07 JOB#: [**Job Number 36674**] ICD9 Codes: 5180, 4019
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Medical Text: Admission Date: [**2197-1-7**] Discharge Date: [**2197-1-11**] Date of Birth: [**2144-5-19**] Sex: M Service: CCU HISTORY OF PRESENT ILLNESS: The patient is a 52 year old gentleman with a past medical history significant only for heavy smoking, who was transferred from outside hospital for management of an acute myocardial infarction and nonsustained ventricular tachycardia. The patient has a seventy plus pack year history of tobacco use, who presented to the outside hospital with new left-sided chest pain that occurred at rest. He described the chest pain as radiating to his left shoulder and neck and eight to nine out of ten in intensity. The pain started at 8:00 p.m. the night prior to admission and continued until the patient presented to [**Hospital1 1474**] Emergency Department. The patient had inferolateral ST depressions on his initial electrocardiogram. After three sublingual Nitroglycerin, the patient became pain free. In the [**Hospital1 1474**] Emergency Department, he was started on Nitroglycerin drip, Lovenox, Lopressor, Aspirin and Aggrestat drip. The patient was then transferred to the [**Hospital1 1474**] CCU. There, the patient had initial CK of 271 with a MB of 4.4 and troponin less than 0.3. However, CK #2 came back at 1360 with a MB of 172 and troponin greater than 50. The patient was also noted to have frequent runs of nonsustained ventricular tachycardia and was transferred to [**Hospital1 346**] for further management. Of note, at baseline, the patient is an active gentleman. He walks several rounds of golf a week and he can climb five flights of steps without difficulty experiencing no shortness of breath or chest pain. He had one episode of chest pain in [**2170**], which he attributed to musculoskeletal strain. PAST MEDICAL HISTORY: None. PAST SURGICAL HISTORY: Status post appendectomy. ALLERGIES: No known drug allergies. MEDICATIONS ON ADMISSION: No medications as an outpatient. FAMILY HISTORY: Grandfather with myocardial infarction at age 80. SOCIAL HISTORY: He works as a carpenter. He is divorced. He lives alone. He continues to smoke. He smokes two packs a day and he has for thirty-five years. He denies any alcohol or drug use. PHYSICAL EXAMINATION: The patient's weight is 75 kilograms, his temperature on presentation was 97.4, his blood pressure was 103/62, heart rate 52 and regular, respiratory rate 15 and oxygen saturation 99% on two liters nasal cannula. Generally, he is well developed, well nourished male sitting up in bed in no acute distress. Head, eyes, ears, nose and throat examination - The pupils are equal, round, and reactive to light and accommodation. Extraocular movements are intact. The oropharynx is clear and moist. He is anicteric. The neck is supple, jugular venous pressure was seven to eight centimeters, 2+ carotid upstroke bilaterally, and there were no bruits. Cardiovascular is regular rate and rhythm, normal S1 and S2, no murmurs, rubs or gallops. Lungs are clear to auscultation bilaterally. Abdomen is soft, nontender, nondistended, with normal bowel sounds. Extremities - no cyanosis or edema but there was clubbing which was marked in all four extremities. LABORATORY DATA: On arrival, the patient had the following laboratory values: White blood cell count 9.0, hemoglobin 14.6, hematocrit 42.4, platelet count 241,000. He had a prothrombin time of 12.4, partial thromboplastin time 60.8 on Heparin and INR 1.0. His chemistry seven was sodium 139, potassium 4.1, chloride 104, bicarbonate 26, blood urea nitrogen 20, creatinine 0.9, glucose 111, calcium 8.7, magnesium 2.1, phosphate 3.2. The patient had a normal chest x-ray. The patient was taken to the Cardiac Catheterization Laboratory on [**2196-1-10**], where he had the following findings: Sinus bradycardia at 49 beats per minute. Left ventriculogram showed pressures in the left ventricle of 92/4 with a mean of 20. The patient was found to have anterolateral hypokinesis with a left ventricular ejection fraction of 45%. His coronary angiography was as follows: He had a right dominant system. His left main coronary artery had an ostial lesion 30% stenosis. He had a twin left anterior descending system with a large bifurcating diagonal vessel with eccentric proximal 50% stenosis in the left anterior descending. The left anterior descending itself is small and diffusely diseased vessel. The D1 was a large vessel with multiple branches supplying the lateral wall. The left circumflex and right coronary artery were nonobstructed. The patient had a stent placed in the D1 and then rescue of the jailed left anterior descending without complications. His electrocardiograms showed sinus bradycardia with normal axis, normal intervals. He had Q wave in aVL and flipped T waves in leads I and aVL. He also had some concave minor ST elevation in leads II, III, aVF, and V3. He had Q waves in V1, V2, V3, V4, and he had T wave flattening in V1, V2, V3 and T wave inversion in V4, V5 and V6 upon discharge. HOSPITAL COURSE: As previously mentioned, the patient was admitted for acute myocardial infarction and cardiac catheterization. 1. Cardiovascular - The patient was started on beta blocker and Captopril, however, his blood pressure remained borderline low with systolic pressure around 90 and his heart rate remained roughly around 45 to 50. Therefore, during his hospital stay, the Metoprolol was generally held. The ace inhibitor was administered intermittently. Two days prior to discharge, the patient was switched from Metoprolol to Acebutolol for intrinsic symptomatic activity and although the patient's blood pressure remained borderline low in the 80s to low 90s systolic and his heart rate in the 40s, he seemed to tolerate these pressures well and there is a question of whether these are baseline parameters as he was able to walk around without difficulty with no orthostasis, no chest pain or shortness of breath. He was also treated with Atorvastatin 20 mg p.o. once daily, Aspirin and he continued Heparin and Aggrestat drips following his cardiac catheterization. As previously mentioned, the cardiac catheterization demonstrated a significant lesion in a twin left anterior descending system and he had a large diagonal stented and a jailed left anterior descending rescued with restoration of good flow. From a rhythm standpoint, the patient had roughly three to four runs of nonsustained ventricular tachycardia of up to eight beats the first two days of admission but thereafter he experienced no ectopy but remained in sinus bradycardia. 2. Pulmonary - Although the patient has extensive smoking history, his chest x-ray was normal. 3. Hematologic - The patient had a hematocrit drop of roughly five points the day following catheterization which is expected and which was stabilized the day of discharge. CONDITION ON DISCHARGE: The patient was in good condition at discharge. DISCHARGE STATUS: To home. DISCHARGE DIAGNOSES: 1. Status post anterolateral myocardial infarction, non ST elevation, with a peak CK of 1163 at our hospital with a peak MB of 124 and troponin greater than 50. 2. Tobacco abuse. 3. Hyperlipidemia, the patient has LDL of 144, total cholesterol 200, HDL 43. 4. Sinus bradycardia. 5. Borderline baseline hypotension. MEDICATIONS ON DISCHARGE: The plan was to discharge the patient on the following medications: 1. Acebutolol 200 mg p.o. once daily. 2. Plavix 75 mg p.o. once daily times nine months. 3. Captopril 6.25 mg p.o. three times a day. 4. Atorvastatin 20 mg p.o. once daily. 5. Aspirin 325 mg p.o. once daily. FOLLOW-UP PLANS: The patient is to follow-up with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 7047**] in [**Hospital1 1474**]. He will be given the telephone number and indicates that he will do so. [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) **] [**Name8 (MD) **], M.D. [**MD Number(1) 7169**] Dictated By:[**Last Name (NamePattern1) 47155**] MEDQUIST36 D: [**2197-1-11**] 08:26 T: [**2197-1-11**] 18:42 JOB#: [**Job Number **] ICD9 Codes: 4271, 3051
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Medical Text: Admission Date: [**2198-11-22**] Discharge Date: [**2198-11-27**] Date of Birth: [**2124-8-28**] Sex: F Service: MEDICINE Allergies: Penicillins / Sulfonamides / Compazine Attending:[**First Name3 (LF) 2297**] Chief Complaint: hypoxia / hypotension. Major Surgical or Invasive Procedure: none. History of Present Illness: 74 F with EtOH cirrhosis who presents from rehab with hypoxia and hypotension. Pt recently dc'd from [**Hospital1 18**] on [**11-15**] after hospitalization for ARF (creatinine incrased to 4.8), VRE UTI, and cellulitis. During that admission she was diagnosed with pulmonary hypertension. The work up was unrevealing for etiology. She was started on diltiazem on discharge empirically per pulmonary consult for her pulmonary hypertension. Pt denies any SOB, DOE, cough, F/C, dysuria, frequency. Pt feels well. She does report some ? increased diarrhea with lactulose for which the dose of her lactulose was halved recently. In [**Name (NI) **], pt bradycardic to 30s. Noted to be hypotensive to 50s. Pt resuscitated without effect with 3L NS. Throughout time in ED, she was mentating and making urine. Pt also given Levoquin for +UA. Past Medical History: 1. Alcoholic cirrhosis with portal HTN, esophageal varices (grade 1) and hepatic encephalopathy 2. a-fib. not anticoagulated 3. s/p meningitis with epidural abscess 4. BCC s/p MOHS excision 5. pseudogout 6. VRE UTI 7. Lower extremity edema 8. CRI, baseline cr 1.5-1.9 until recent admit [**10-24**] 9. Anemia of Chronic Inflammation 10. Chronic Thrombocytopenia 11. Pulmonary HTN / RV dysfunction Social History: Pt lived with her daughter in [**Name (NI) **]. She has not had alcohol in [**3-23**] years. She continues to smoke [**1-21**] ppd. Family History: CAD, Hyperlipidemia Physical Exam: VS T 95. HR 47 BP 80/30s RR 22 O2 92% 2L Gen: elderly F arousable. oriented x 3. HEENT: PERRL. mild scleral and sublingual icterus. MM dry. tongue midline. facial mm symmetic. Neck: flat neck veins CV: bradycardic. 2/6 sem with loss of S2 at apex Lungs: + crackles focally in LLL. + decreased BS at bases Abd: active BS. soft. NT. no masses. liver span 10 cm. no caput Extr: 2+ pitting edema to knees b/l. DP 2+. feet warm. no palmar erythema. no asterixis. + slight tremor. Neuro: MAE. Pertinent Results: CXR: + increased interstitial markings. loss of L costaphrenic angle. unchanged from [**2198-11-13**]. . CXR ([**2198-11-26**]): An endotracheal tube has been withdrawn in the interval and now terminates approximately 2 cm above the carina with the neck in a flexed position. A left subclavian vascular catheter remains in satisfactory position. Cardiac silhouette is mildly enlarged. Previously reported minimal pulmonary edema has resolved in the interval. Bilateral pleural effusions are again demonstrated with improvement on the right and no significant change on the left. Gastric distension appears decreased in the interval with mild-to-moderate distention remaining. . EKG: nl axis. nl intervals. sinus brady. ST segment depression in I, AVL unchanged from old EKG. . Renal U/S: The right kidney measures 9.8 cm, and the left kidney measures 9.2 cm. There is no hydronephrosis. Nonobstructing stones are present in both kidneys. There is an 11-mm stone in the lower pole of the right kidney, which was previously seen on [**2198-11-3**]. There is a 4-mm stone in the upper pole of the left kidney. The bladder is decompressed by a Foley catheter. No hydronephrosis. Bilateral nonobstructing renal stones. . echo ([**11-13**]): 1. The left atrium is mildly dilated. No atrial septal defect or patent foramen ovale is seen by 2D, color Doppler or saline contrast with maneuvers. 2. Left ventricular wall thickness, cavity size, and systolic function are normal (LVEF>55%). Regional left ventricular wall motion is normal. 3. The right ventricular cavity is dilated. Right ventricular systolic function appears depressed. 4. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. 5. Moderate [2+] tricuspid regurgitation is seen. 6. Compared with the findings of the prior study of [**2198-11-5**], there has been no significant change. . echo ([**2198-11-26**]): The left atrium is mildly dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size. Left ventricular systolic function is hyperdynamic (EF>75%). The right ventricular free wall is hypertrophied. The right ventricular cavity is moderately dilated. Right ventricular systolic function is normal. The aortic root is mildly dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. Moderate to severe [3+] tricuspid regurgitation is seen. There is severe pulmonary artery systolic hypertension. Significant pulmonic regurgitation is seen. The main pulmonary artery is dilated. There is a trivial pericardial effusion. There are no echocardiographic signs of tamponade. Brief Hospital Course: Mrs [**Known lastname **] initially presented with hypotension and bradycardia in the setting of chronic liver failure and acute on chronic renal failure. The presenting symptoms of hypotension and bradycardia were due to nodal toxicity caused by recently started dilitazem plus chronic nadolol, worsened by renal failure. While she initially responded to treatment for beta blocker toxicity, her hypotension was persistent, and attributable to chronic vasodilatation with liver failure, and severe right heart failure and low left ventricle filling in context of severe pulmonary hypertension. Her chronic renal failure worsened, and the consulting renal team agreed with the assessment that her renal failure was due to a combination of hepato-renal syndrome and pre-renal azotemia in the context of her low flow state. No hemodialysis was pursed for the worsening acidemia because of her hemodynamic instability. Compounding her renal and liver failure, she developed progressive respiratory distress and hypoxemia, for which she was intubated and placed on assist control mechanical ventilation. Patient was confirmed to be DNR in conversation with her daughter, and after being apprised of the poor prognosis given multi-organ system failure, her daughter elected for terminal extubation. The patient was placed on a morphine drip, extubated, and, after several hours with family and friends, she died peacefully with her family and friends present. Medications on Admission: Diltiazem 120 mg QD Nadolol 20 mg po BID Lactulose 15 cc TID Phytonadione 5 mg po QD Protonix 40 mg Q am Ursodiol 600 mg Q AM and 300 mg Q pm Linezolid (not on rehab record though pt just dc'd [**2198-11-15**])x 7 d. last day [**2198-11-21**] Discharge Disposition: Expired Discharge Diagnosis: Cirrhosis with portal hypertension and hepatic encephalopathy renal failure severe pulmonary hypertension Discharge Condition: Expired Discharge Instructions: None Followup Instructions: None Completed by:[**2198-11-28**] ICD9 Codes: 5849, 4280, 2762, 5856, 4168
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7965 }
Medical Text: Admission Date: [**2156-3-16**] Discharge Date: [**2156-3-20**] Date of Birth: [**2100-10-27**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: decreased energy Major Surgical or Invasive Procedure: [**2156-3-16**] AVR ( [**Street Address(2) 11688**]. [**Male First Name (un) 923**] Regent mechanical) History of Present Illness: 55 year old man with a known childhood murmur who was echoed during a recent admission for pneumonia and found to have severe aortic stenosis. Referred for AVR after cath showed clean coronaries. Past Medical History: bicuspid aortic valve, aortic stenosis, aortic insufficiency, valvular induced cardiomyopathy, moderate pulmonary hypertension (52/23), recent pneumonia Social History: Last Dental Exam: 2 years ago Lives with: fiance Occupation: teamster trucker Tobacco: none ETOH: rarely Family History: non-contributory Physical Exam: Pulse: 82 O2 sat: 96% B/P Left: 96/57 Height: 73" Weight: 90.9kg General: Well-developed male in no acute distress Skin: Dry [x] intact [xx] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur II/VI SEM radiating to carotids and across precordium Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema/Varicosities: None [x] Neuro: Grossly intact [x] Pulses: Femoral Right:2+ Left:2+ DP Right:2+ Left:2+ PT [**Name (NI) 167**]:2+ Left:2+ Radial Right:2+ Left:2+ Carotid Bruit Right:- Left:- Pertinent Results: Conclusions PRE-CPB:1. The left atrium is moderately dilated. No spontaneous echo contrast is seen in the left atrial appendage. No thrombus is seen in the left atrial appendage. 2. No atrial septal defect is seen by 2D or color Doppler. 3. There is moderate symmetric left ventricular hypertrophy. The left ventricular cavity is moderately dilated. Doppler parameters are most consistent with Grade II (moderate) left ventricular diastolic dysfunction. 4. Right ventricular chamber size and free wall motion are normal. 5. There are simple atheroma in the descending thoracic aorta. 6. The aortic valve is bicuspid. There is severe aortic valve stenosis (valve area 0.8-1.0cm2). Moderate (2+) aortic regurgitation is seen. The severity of aortic regurgitation may be underestimated. The aortic regurgitation jet is eccentric, directed toward the anterior mitral leaflet. 7. The mitral valve appears structurally normal with trivial mitral regurgitation. There is bilateral retraction of the mitral valve. 8. There is a small to moderate sized pericardial effusion. 9. A moderate left pleural effusion is seen. Drs. [**Last Name (STitle) **] and [**Name5 (PTitle) **] were notified in person of the results. POST-CPB: On infusions of epi, neo. AV pacing , then a pacing. Well-seated mechanical valve in the aortic position. Coronary flow seen in LMCA and RCA. Trace AI consistent with washing jets. Preserved ventricular function on inotropic support. LVEF is now 40%. Trace MR. Aortic contour is normal post decannulation. I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 5209**], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2156-3-16**] 14:13 Brief Hospital Course: Mr. [**Known lastname 30814**] was admitted on [**2156-3-16**] and underwent AVR( mech AVR #23 St. [**Male First Name (un) 923**]) with Dr. [**Last Name (STitle) **]. See operative note for details. Post operatively he remained intubated and was transferred to the CVICU in stable condition on epinephrine, phenylephrine, propofol, and lidocaine drips. He awoke neurologically intact, was weaned from the ventilator and extubated. Vasoactive medications were weaned after hemodynamic stability was achieved. Betablockers, diuretics and statin therapies were initiated and titrated. Chest tubes and temporary pacing wires were removed per protocol. Coumadin therpay was intiated for mechanical AVR. He was evaluated and treated by physical therapy for strength and conditioning. Mr. [**Known lastname 30814**] was cleared for discharge to home on POD#4 with an INR of 2.0 by Dr. [**Last Name (STitle) **]. Medications on Admission: lasix 20mg daily zocor 40mg daily KCL 20mEq daily coreg 3.125mg daily Amox 500mg (cont. after dental d/t symptoms from pna) ASA Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 3. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain. 4. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours) as needed for pain. Disp:*65 Tablet(s)* Refills:*0* 5. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 7. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 9. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO once a day. 10. Coumadin 2.5 mg Tablet Sig: as directed Tablet PO once a day: goal INR 2.5-3.0 for mechcanical aortic valve. take 2.5 mg on sunday then as directed by Dr. [**Last Name (STitle) 83774**]. Disp:*60 Tablet(s)* Refills:*2* 11. Outpatient [**Name (NI) **] Work PT/INR for coumadin dosing indication mechanical aortic valve - goal INR 2.5-3.0 with results to [**Hospital1 **] heart center coumadin clinic fax # [**Telephone/Fax (1) 31080**] attn coumadin clinic and Dr [**Last Name (STitle) 6254**] - first draw monday [**2156-3-22**] Discharge Disposition: Home With Service Facility: [**Location (un) 1110**] VNA Discharge Diagnosis: Aortic stenosis, aortic insufficiency s/p Aortic valve replacement (Mech -#23mm St. [**Male First Name (un) 923**]) valvular-induced cardiomyopathy pulmonary hypertension recent Pneumonia chronic systolic/diastolic heart failure Discharge Condition: alert and oriented ambulating with steady gait Sternal pain managed with dilaudid Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month until follow up with surgeon No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Followup Instructions: Surgeon Dr. [**Last Name (STitle) **] at [**Hospital1 **] [**4-8**] @ 9:00 AM [**Telephone/Fax (1) 6256**] Please call to schedule appointments Primary Care Dr. [**First Name (STitle) **] in [**1-31**] weeks Cardiologist Dr. [**Last Name (STitle) 6254**] in [**1-31**] weeks Labs: PT/INR for coumadin dosing indication mechanical aortic valve - goal INR 2.5-3.0 with results to [**Hospital1 **] heart center coumadin clinic fax # [**Telephone/Fax (1) 31080**] attn coumadin clinic and Dr [**Last Name (STitle) 6254**] - first draw monday [**2156-3-22**] Completed by:[**2156-3-20**] ICD9 Codes: 4241, 4254, 4168, 4280
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7966 }
Medical Text: Admission Date: [**2148-2-26**] Discharge Date: [**2148-3-7**] Date of Birth: [**2077-7-1**] Sex: M Service: MEDICINE Allergies: Quinolones / Morphine Attending:[**First Name3 (LF) 905**] Chief Complaint: CC: Unresponsive, hypotensive Major Surgical or Invasive Procedure: Intubation/Extubation Central Line placement Arterial Line placement PICC line placment. History of Present Illness: HPI: 70yo male w/hx of Multiple Sclerosis and chronic indwelling foley who was brought to ED via EMS after having a witnessed syncopal event on [**2-26**]. While eating dinner, he lost conciousness and his head fell back and his arms went up. He was noted by his wife and son to be gurgling. His family denies any prodromal complaints aside from fatigue a few days prior. The EMS team found him to be unresponsive with some emesis in his mouth. Pt brought to ED, intubated for airway protection. Received Vanco/Cefepime/Clinda initially and an additional 2Liters of NS. MICU course notable for hypotension unresponsive to IVF requiring intermittient Levophed gtt. Additionally a CT head postive for L post/temp intraparenchymal bleed which was then re-read as an AVM. CT Angiogram of the Chest was performed and revealed a R subsegmental non-occlusive thrombi with a chronic appearance. While in the MICU the pt failed [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 104**] stim test, developed aspiration pneumonia, had labile blood pressures requiring Nitroprusside gtt, and [**11-21**] positive bld cx for Staph Epi. Pt ruled out for MI, Echo was nml, and EKG with old AV delay and type I 2nd degree AV block (Wenkebach)with a normal rate. Past Medical History: 1. Multiple Sclerosis 2. Hypertension 3. Neurogenic Bladder (chronic indwelling catheter) 4. Hyperlipidemia 5. GERD 7. s/p L foot 1st, 3rd and 4th metatarsal fractures 8. s/p L knee arthroscopy, resection of plica [**2-/2139**] 9. Bradycardia with first deg AV block 10. BPH Social History: occasional EtOH use; no tobacco or an IV recreational drug use; worked as a judge, currently lives at home with good social support Family History: Non contributory Physical Exam: T99.6, Tc 98.6, 140-170/55-72, 72-80, 12, 95% 3LNC GEN: NAD, A & O x 3 HEENT: PERRL, EOMI, OP: clear CV:Reg rate, S2, S2 PULM:Bilat course BS, crackles at bases ABD:Distended, soft +BS EXT:+1 Bilat lower ext edema Neuro: grossly intact, strength 4/5, able to get to edge of bed but difficulty ambulating. Pertinent Results: [**2148-2-26**] 11:00PM TYPE-ART TEMP-37.8 RATES-/14 TIDAL VOL-650 PEEP-5 O2-40 PO2-185* PCO2-40 PH-7.41 TOTAL CO2-26 BASE XS-1 INTUBATED-INTUBATED VENT-SPONTANEOU [**2148-2-26**] 03:49PM WBC-9.9 RBC-3.24* HGB-10.1* HCT-29.2* MCV-90 MCH-31.0 MCHC-34.4 RDW-13.8 [**2148-2-26**] 03:49PM GLUCOSE-202* UREA N-33* CREAT-1.0 SODIUM-147* POTASSIUM-3.5 CHLORIDE-113* TOTAL CO2-23 ANION GAP-15 [**2148-2-26**] 03:53PM LACTATE-3.4* [**2148-2-26**] 05:03AM CORTISOL-23.3* [**2148-2-26**] 05:30AM CORTISOL-24.7* [**2148-2-26**] 03:13AM ALT(SGPT)-20 AST(SGOT)-21 LD(LDH)-197 CK(CPK)-67 ALK PHOS-67 AMYLASE-368* TOT BILI-0.3 [**2148-2-26**] 03:13AM LIPASE-32 [**2148-2-26**] 03:13AM CK-MB-NotDone cTropnT-0.01 [**2148-2-26**] 03:13AM CALCIUM-7.6* PHOSPHATE-3.5 MAGNESIUM-2.1 [**2148-2-26**] 03:13AM URINE BLOOD-TR NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-SM [**2148-2-25**] 10:15PM FIBRINOGE-525* [**2148-2-25**] 10:15PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2148-2-26**] 03:49PM PLT COUNT-130* Brief Hospital Course: 70yo male with hx of Multiple Sclerosis and chronic indwelling foley catheter a/w syncope, aspiration pneumonia, and possible intraparenchymal CNS bleed. 1. Hypotension/Syncope: Hypotension resolved while in MICU. [**Month (only) 116**] have been related to septic physiology on presentation. CTA with non-occlusive segmental thrombi in R pulm art. which was thought to be chronic and not related to primary event. Echo w/ nml EF and wall motion, and valves, CT head with AVM stable on repeat imaging and confirmed by MRI/MRA, EEG w/o epileptiform activity. Pt has h/o vaso-vagal symptoms and was eating at the time of the event which is the most likely cause. 1st degree AV block with Wenckebach intermittently would not be a cause of syncope since his heart rate was always normal. Neurosurgery consultation recommended anticoagulation with Hep gtt while in house given the PE and pt is immobile, but no long term anticoagulation is recommended (pt is a fall risk, risk of CNS bleed, and PE is an incidental finding)Bilateral LENIS were negative. We specifically discussed with the patient about all the risks and benefits of being anticoagulated and also not being anticoagulated. He understood everything and agreed with the plan. His outpt neurologist at [**Hospital1 2025**] was also contact[**Name (NI) **] and is aware of his hospitalization. 2. ARF: Likely due to hypotension/ATN vs UTI. Normalized with fluids. 3. ID: Bilateral aspiration PNA, + MRSA, and possible bacteremia. Intubated for two days. Blood cultures only [**11-21**] grew Coag neg staph, thought to be a contaminant. MRSA grew in sputum. Total body macular rash developed while pt was on Zosyn and Ceftriaxone. -initially covered w/Vanco/Zosyn Dced upon transfer to floor. Was on Clinda for two days but spiked through it to 103. Started Flagyl/Aztreonam/Vanc [**3-1**] given allergy to quinolone and ? rash to cephalosporins. -DC A-line and DC Central Line [**2-28**], sent tip for culture. -Surveillance cultures were all negative. Repeat CXR with slight improvement. -Pt has chronic indwelling foley but U/A has been negative. 4. Neuro: Multiple Sclerosis, and h/o CNS AVM. Pt seen by neurology and neurosurgery early in hospital course. Pt was deconditioned, weak, and fatigued for most of his stay with limited mobility. Will need aggressive PT and cont treatment for MS. [**Name13 (STitle) **] been on Cytoxan in the past and is followed by [**Hospital1 2025**] Neurologist. 5. Code: Full 6. Dispo: to rehab 7. Communication: Wife = (o)[**Telephone/Fax (1) 96660**] or (h)[**Telephone/Fax (1) 96661**] PCP([**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 1728**])[**Telephone/Fax (1) 96662**]. (call between 6A and 6P)- Neurologists: Dr. [**First Name4 (NamePattern1) 401**] [**Last Name (NamePattern1) 45435**] [**Hospital1 2025**] [**Telephone/Fax (1) 88304**] and Dr. [**Last Name (STitle) **] at [**Hospital1 112**]. Medications on Admission: ASA 81 qd Colace Senna Nexium 40 qd Enalapril 10 qd Lipitor 10 qd HCTZ 25 qd Baclofen 20 [**Hospital1 **] Ativan prn Neurontin Detrol Cytoxan Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 2. Docusate Sodium 150 mg/15 mL Liquid Sig: One (1) PO BID (2 times a day). 3. Dorzolamide-Timolol 2-0.5 % Drops Sig: Two (2) Drop Ophthalmic [**Hospital1 **] (2 times a day). 4. Latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 5. Gabapentin 400 mg Capsule Sig: Two (2) Capsule PO TID (3 times a day). 6. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 7. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection ASDIR (AS DIRECTED): Regular Sliding scale. 8. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Baclofen 10 mg Tablet Sig: Three (3) Tablet PO QAM (once a day (in the morning)). 10. Enalapril Maleate 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 11. Baclofen 10 mg Tablet Sig: Four (4) Tablet PO QPM (once a day (in the evening)). 12. Lorazepam 1 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. 13. Baclofen 10 mg Tablet Sig: Three (3) Tablet PO Q NOON (). 14. Amlodipine Besylate 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 15. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 9 days. 16. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 17. Oxycodone HCl 5 mg Tablet Sig: Two (2) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 18. Zolpidem Tartrate 5 mg Tablet Sig: 1-2 Tablets PO HS (at bedtime) as needed. 19. Vancomycin HCl 10 g Recon Soln Sig: One (1) gm Intravenous Q24H (every 24 hours) for 9 days. 20. Aztreonam in Dextrose(IsoOsm) 1 g/50 mL Piggyback Sig: One (1) gm Intravenous three times a day for 9 days. 21. Heparin Sodium 5,000 unit/0.5 mL Syringe Sig: One (1) Injection three times a day: For DVT prophylaxis. Discharge Disposition: Extended Care Facility: [**Hospital 100**] Rehab-MACU Discharge Diagnosis: 1. Aspiration Pneumonia 2. MRSA Pneumonia 3. Syncope 4. Stable CNS AVM 5. Subacute Pulmonary Embolus 6. Multiple Sclerosis 7. 1st degree AV block, without bradycardia Discharge Condition: Stable to Rehab Discharge Instructions: Please see your PCP [**Name Initial (PRE) 176**] 1-2 weeks of discharge. Followup Instructions: 1. Please see your PCP [**Name Initial (PRE) 176**] 1-2 weeks 2. Provider: [**Name10 (NameIs) 8741**] [**Name11 (NameIs) **], MD Where: [**Hospital6 29**] ORTHOPEDICS Phone:[**Telephone/Fax (1) 1228**] Date/Time:[**2148-3-13**] 3:00 3. Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 11642**], MD Where: [**Hospital6 29**] ORTHOPEDICS Phone:[**Telephone/Fax (1) 1228**] Date/Time:[**2148-3-14**] 2:20 [**Name6 (MD) 251**] [**Name8 (MD) **] MD [**MD Number(1) 910**] ICD9 Codes: 5070, 5849, 431
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7967 }
Medical Text: Admission Date: [**2138-2-1**] Discharge Date: [**2138-2-19**] Date of Birth: [**2066-10-28**] Sex: M Service: MEDICINE Allergies: Morphine / Demerol Attending:[**First Name3 (LF) 613**] Chief Complaint: transferred for OSH with hemothorax Major Surgical or Invasive Procedure: chest tube placement right chest wall intubation hemodialysis placement and removal of left groin hemodialysis catheter History of Present Illness: 71 M admitted to thoracic surgery with right hemothorax likely related to supratherapeutic [**Hospital 31291**] transfered to MICU because of respiratory failure, hypotension, and other comorbidities. . The patient was transferred [**2138-2-1**] from [**Hospital 1562**] hospital with spontaneous hemothorax on right with no prior history of trauma. He had intially complained shortness of breath and dyspnea on exertion for the past 2-4 weeks. He also reports intermittent diarrhea w/ small amount of blood, with INR of >4 the week prior to admission, which was been held 4 days prior to admission(was 1.0 on initial presentation). Denies chest pain or fever or chills. He had a right sided pleural effusion at [**Hospital1 1562**] by CXR, and had right thoracentesis and was diagnosed with hemothorax and transferred to [**Hospital1 18**]. . At [**Hospital1 18**] he was intially scheduled to go to OR and have VATS vs thoracotomy, but deveoped resp failure and hypoxia and was intubated on [**2-3**]/05while on the floor ([**Hospital Ward Name **] 10) with suspected mucous plug. A chest tube was placed instead. He was requiring Levophed temporarily while intubated but this was weaned off, and he was extubated [**2138-2-5**]. The chest tube is scheduled to be pulled on [**2138-2-6**]. . Of note, his hospital course include ongoing HD for ESRD followed by the nephrology service. The patient had thrombosed RUE and LUE AV fistulas which will require fistulogram. He has been getting HD via groin line. He had a TTE to evaluate for CHF showing NL EF. He had required 3U of PRBC's for bloody drainage of hemothorax, but there is no report of bloody stools or hematuria. On [**2138-2-6**] he was noted to spike a temp to 101.0. This temp spike resolved transiently per-HD on [**2-6**]. He was transferred from SICU to MICU for further medical managmeent Past Medical History: 1. type II diabetes mellitus x 25yrs 2. end stage renal disease secondary to DM, s/p RUE brachiocephalic v fistula ([**8-/2133**], revised [**12-17**]), s/p failed renal transplant ([**12-17**]) -> failed, hemodialysis since [**2135**] 3. CAD s/p MI ([**3-16**]), s/p 4v-CABG ([**3-16**])->revised; h/o positive stress and stent of OM2 [**5-/2136**] 4. CHF (but w/ NL EF by TTE [**2138-2-4**]) 5. Sternal dehiscence-> osteomyelitis (coag neg Staph), s/p sternal debridement ([**5-19**]) 6. Hypertension 7. Elevated Cholesterol 8. H/O broken L ankle -> rehab -> RLE DVT ([**4-19**]), s/p IVC filter 9. s/p R cataract extraction 10. Chronic myelogenous leukemia since '[**36**] on Gleevec 11. Osteoporosis 12. DVT [**4-/2136**], was on Coumdin Social History: Lives with his wife [**Name (NI) 622**]. previous Etoh abuse history (quit in '[**31**]) quit tobacco 30 years ago, no current Etoh or tobacco use. Family History: Mom and sister w/ [**Name2 (NI) 499**] Ca, Brother w/ prostate Ca, no family h/o cardiac disease Physical Exam: Tc=99.1 Tm=101.0, BP=(121/51)90s-150s/40's-50s, HR=100-120(102), RR=20, O2=99% on 4L NC; I/O's=357/0(+357) PE: GEN: Patient appears comfortable, lethergic, but in NAD HEENT: nonicteric, mucosa slightly dry CHEST: course exp BS's ant/lat; no wheezes noted CV: RRR, no appreciable abnormal heart sound ABD: good BS's, obese, soft, NT, ND EXT: 2+ pitting LE edema bileraterally NEURO: Oriented to person; patient is generally weak and not cooperative w/ exam; no frank asterixis noted Pertinent Results: [**2138-2-6**] 03:15AM BLOOD WBC-13.7* RBC-2.88* Hgb-8.3* Hct-25.4* MCV-88 MCH-29.0 MCHC-32.9 RDW-14.9 Plt Ct-182 [**2138-2-5**] 03:33AM BLOOD WBC-17.9* RBC-3.15* Hgb-9.4* Hct-27.1* MCV-86 MCH-29.9 MCHC-34.8 RDW-14.8 Plt Ct-238 [**2138-2-4**] 02:46PM BLOOD WBC-22.8*# RBC-3.35* Hgb-9.9* Hct-28.9* MCV-86 MCH-29.6 MCHC-34.3 RDW-14.4 Plt Ct-239 [**2138-2-6**] 04:00AM BLOOD PT-12.9 PTT-29.8 INR(PT)-1.1 [**2138-2-6**] 03:15AM BLOOD Plt Ct-182 [**2138-2-5**] 03:33AM BLOOD Plt Ct-238 [**2138-2-5**] 03:33AM BLOOD PT-12.8 PTT-31.5 INR(PT)-1.0 [**2138-2-6**] 03:15AM BLOOD Glucose-137* UreaN-75* Creat-8.2*# Na-148* K-5.8* Cl-113* HCO3-23 AnGap-18 [**2138-2-5**] 03:33AM BLOOD Glucose-84 UreaN-59* Creat-7.1* Na-146* K-4.7 Cl-110* HCO3-24 AnGap-17 [**2138-2-6**] 03:15AM BLOOD Calcium-8.5 Phos-4.9* Mg-2.2 [**2138-2-5**] 03:33AM BLOOD Calcium-8.1* Phos-4.4 Mg-2.4 [**2138-2-6**] 06:24AM BLOOD Type-ART pO2-126* pCO2-35 pH-7.31* calHCO3-18* Base XS--7 [**2138-2-6**] 06:24AM BLOOD Lactate-0.8 [**2138-2-6**] 06:24AM BLOOD freeCa-1.02* [**2138-2-3**] 10:42PM BLOOD CK(CPK)-65 [**2138-2-3**] 04:49PM BLOOD CK(CPK)-66 [**2138-2-3**] 09:28AM BLOOD CK(CPK)-84 [**2138-2-3**] 10:42PM BLOOD CK-MB-NotDone cTropnT-0.62* [**2138-2-3**] 04:49PM BLOOD CK-MB-5 cTropnT-0.52* [**2138-2-3**] 09:28AM BLOOD CK-MB-NotDone cTropnT-0.43* CXR: [**2-6**]: The right-sided pleural densities are similar to what has been noticed on the preceding study and also the chest tube position is unchanged. No pneumothorax has developed after instrument removal. [**2-3**] - CTA neg for PE, loculated R hydropneumothorax; also w/ large L sided-effusion w/ assoc atelectesis . [**2-4**] - TTE w/ EF>55%(suboptimal, mod LAE, mild [**Last Name (un) **], 1+ AR) . EKG's [**2-1**] - NSR at 88 bpm, 1 mm STD's and TWI's V4-V6, TWI's I & AVL [**2-3**] - NSR at 84 bpm, resolved TWI's and STD's V4-V6; still w/ TWI's I & AVL (ols changes compared to [**5-/2136**]) [**2138-2-7**]: IMPRESSION: 1) AV fistulogram demonstrated complete thrombosis of the brachiocephalic vein fistula. Multiple stenoses are present throughout the outflow cephalic vein. A significant stenosis was identified within the right brachiocephalic vein. 2) Successful lysis of the thrombosed fistula using a total of 10 mg of t-PA. 3) Venoplasty of the outflow cephalic vein stenoses using an 8-mm balloon and of the severe right brachiocephalic stenosis using a 12-mm balloon, all with good angiographic success and restoration of forward flow. [**2138-2-10**] Chest, Abd, Pelvis CT: 1) No evidence of abscess, and no definite evidence of pneumonia. The lung examination is somewhat limited by respiratory motion. There is airspace opacity along the tract of the prior chest tube which may represent contusion vs. consolidation. 2) There are bilateral pleural effusions, loculated, which have increased in the interim since the prior exam. The left effusion is large and the right effusion is moderate, and there is associated atelectasis. [**2138-2-11**] Head CT: IMPRESSION: 1. No evidence of acute intracranial hemorrhage or mass effect. 2. Scattered areas of hypodensity within both thalami and the basal ganglia having an appearance consistent with chronic lacunar infarction. [**2138-2-14**] RUQ U/S: IMPRESSION: Tumefactive sludge within the gallbladder. No ultrasonographic evidence of cholecystitis. Limited visualization of the pancreas due to overlying bowel gas. [**2138-2-15**] CXR: Left-sided PICC line is in distal SVC. There are small bilateral pleural effusions and associated bibasilar atelectases, essentially unchanged since the prior film of [**2138-2-11**]. No new lung lesions. Brief Hospital Course: 71 year old man type II diabetes mellitus, coronary artery disease s/p CABG, congestive heart failure (nml EF), CML, end stage renal disease s/p failed renal transplant on hemodialysis, transferred from outside hospital with hemothorax to Transplant surgery SICU team. Hospitalization complicated by mutiple issues: 1. Hemothorax: The patient was initially transferred for VATS and thoracotomy by the thoracic surgery team. He developed respiratory failure requiring intubation on [**2138-2-3**], and transfer to the MICU. A chest tube was placed. Studies were not done on the initial specimen showing a spun Hct >50%. The cause of the hemothorax was unknown. He was ruled out for PE by negative CTA. There was no history of trauma or previous history of COPD or bled formation. Pleural effusions reaccumulated after removal of the chest tube. A thoracentesis was done which showed an exudative effusion on the right, the side of the hemothorax, and a transudative effusion on the left. Gram stain and culture were negative; however, the patient was on antibiotics (levofloxacin) at the time of the tap for treatment of post-intubation tracheobronchitis. Cytolgy showed no malignant cells. The patient was extubated [**2138-2-5**], and supplemental O2 requirements weaned. By the time of discharge he had stable small bilateral pleural effusions by CXR and was saturating well on room air, not short of breath. The effusions were attributed to CHF and chronic renal failure; the right appearing exudative as a complication of the high blood count. 2. Hypoxia: Postextubation the patient required supplemental O2. He was treated with a 7 days course of levofloxacin 250mg Q48hrs for treatment of tracheobronchitis. The initial decompensation requiring intubation was thought to be due to mucus plugging. CHF status remained stable. He was continued on aspirin, metoprolol, and a statin for secondary prophylaxis. 3. Fevers: postextubation on [**2138-2-6**] he was noted to spike a fever to 101.0. CXR, chest CT, abdominal CT, blood cultures, urinalysis, and urine cultures were nondiagnostic. There was no sign of pneumonia or abscess. He was treated for a day with Zosyn and Vancomycin for concern of hospital acquired or aspiration pneumonia. Sputum grew gram negative rods E. coli and Enterobacter. As no findings were seen on CXR or chest CT, this was attributed to tracheobronchitis and treated with a 7day course of levofloxacin. 4. Delirium: the patient developed a delirium complicated by agitation requiring a 1:1 sitter, Zyprex and Haldol, soft restraints. The delirium resolved with treatment of his multiple medical issues. He was continued on Zyprexa qHS. 5. Nutrition: During his delirium he had an NG tube placed, and he was sustained on tubefeeds. A swallow study was done once the patient was more alert and initially showed risk of aspiration. He was started on a nectar-thickened diet. Two days prior to discharge a repeat swallow study was done. The patient passed. He was discharged on a diabetic, renal, heart healthy, low sodium diet of thin liquids and regular solids. 6. Hypotension: in the ICU the patient became hypotensive and required a small dose of levophed. He was also treated with stress dose steroids. This resolved prior to discharge from the ICU. 7. Pancreatitis: On [**2138-2-12**], after initiating a po diet, the patient developed nausea and epigastric pain. LFTs showed mildly elevated transaminases, normal alk phos and total bilirubin, and moderately elevated lipase and amylase. RUQ ultrasound showed sludging in the gallbladder. It was felt he developed a pancreatitis secondary to gallbladder sludging while on tubefeeds. He was made NPO, treated with gentle ivf's. Nausea and abdominal pain resolved. Diet was advanced slowly, to clears, then to full diet. He was tolerating a full diet as described above prior to discharge. 8. History of DVT: the patient had a DVT diagnosed in [**4-18**]. He completed his course of anticoagulation and has an IVC filter in place. He was treated with DVT prophylaxis with heparin SC. No further anticoagulation was indicated. His dialysis line was noted to have thromboses. This was corrected by interventional radiology procedure. A temporarily groin line was placed for dialysis. This was pulled and the A-v fistula was used 4 times for dialysis prior to discharge. 9. Cardiac: He has known CAD s/p CABG and stent and CHF. Echo was done and showed mild [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 1915**], 1+MR, otherwise normal. He was treated with aspirin, metoprolol and statin. He ruled out for acute MI, and no further acute cardiac issues developed. 10. End stage renal disease: He was continued on M,W,F hemodialysis. 11. Type II diabetes mellitus: he was monitored with QID fingersticks and treated with a regular insulin sliding scale. A standing regimen of insulin was not initiated as the patient's diet fluctuated with tubefeeds, then NPO, then slowly advancing diet. He was continued on prednisone 5mg daily for his failed renal transplant. 12. Chronic myelogenous leukemia: Diagnosed in [**2136**], the patient was previously on Gleevec. This was held in the setting of his acute pulmonary issues. His counts remained stable throughout the hospitalization. Hematoloyg/Oncology was consulted. They recommended holding the patient's Gleevec until he follows up with outpatient Oncology given his persistant state of fluid overload (he still had small pleural effusions), modestly elevated LFTs and recent course of pancreatitis. He will be following up with Dr. [**Last Name (STitle) 410**] in Heme/Onc for further care. He should bring all records regarding his history of CML and iron overload to that appointment. 13. Elevated CK: On [**2138-2-10**] the patient was noted to have an elevated CK to 1300. There was no CK-MB or Trop elevation to suggest a cardiac etiology. It was felt this was likely muscular and resulted from IM haldol injection. Subsequent IM injections were held, and the CK trended down to normal. 14. Dispo: the patient was discharged to rehab. He was evaluated by physical therapy and occupational therapy prior to discharge. He will follow up with his primary care physician Dr [**Last Name (STitle) 15170**]. He should also plan to follow-up with his endocrinologist regarding diabetes care, nephrologist regarding his end stage renal disease, and Dr. [**Last Name (STitle) 410**] regarding his chronic myelogenous leukemia. He is a full code. Communication is with the patient and his wife [**Telephone/Fax (1) 32904**]. Medications on Admission: Meds at Home: Vicodin prn, Neurontin 100 QD, Nephrocaps, Metoprolol 25 [**Hospital1 **], Gleevec 400 [**Hospital1 **], Prednisone 5 QD, Tums prn, Coumadin 7.5/10 alternating, Paxil 10 QD, RISS (+/- NPH?) . Meds on Transfer: Ipratropium Bromide Neb Q6H, Lorazepam 0.5-1 mg IV Q4H:PRN, Albuterol 0.083% Neb Soln 1 NEB IH Q4-6H:PRN, Calcium Acetate 667 mg PO TID W/MEALS, Famotidine 20 mg IV Q24H, Paroxetine HCl 20 mg PO DAILY, Fentanyl Citrate 25-100 mcg IV Q4H:PRN, Phenylephrine HCl 0.5-5 mcg/kg/min IV DRIP TITRATE, Prednisone 5 mg PO DAILY, Insulin SC Discharge Medications: 1. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Calcium Acetate 667 mg Tablet Sig: One (1) Tablet PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 3. Paroxetine HCl 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Albuterol Sulfate 0.083 % Solution Sig: 1-2 puffs Inhalation Q4-6H (every 4 to 6 hours) as needed for shortness of breath or wheezing. 5. Ipratropium Bromide 0.02 % Solution Sig: One (1) puff Inhalation Q6H (every 6 hours) as needed for shortness of breath or wheezing. 6. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal [**Hospital1 **] (2 times a day) as needed for constipation. 7. Epoetin Alfa 20,000 unit/2 mL Solution Sig: Five (5) thousand units Injection ASDIR (AS DIRECTED): To be dosed at dialysis. 8. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 10. Insulin Regular Human 100 unit/mL Solution Sig: One (1) units Injection ASDIR (AS DIRECTED): regular insulin per sliding scale: see attached scale. 11. Zinc Sulfate 220 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 12. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO once a day. 13. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) as needed for to groin. 14. Olanzapine 5 mg Tablet, Rapid Dissolve Sig: 0.5 Tablet, Rapid Dissolve PO HS (at bedtime). 15. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Discharge Disposition: Extended Care Facility: [**Hospital **] Hospital of [**Location (un) **] & Islands - [**Location (un) 6251**] Discharge Diagnosis: Primary: pleural effusions conjestive heart failure end stage renal disease on hemodialysis type II diabetes mellitus coronary artery disease pressure ulcers pancreatitis chronic myelogenous leukemia respiratory failure Secondary: h/o osteomyelitis/ sternal dehiscence osteoporosis h/o DVT [**4-18**], [**4-19**] s/p cataract surgery hypercholesterolemia hypertension Discharge Condition: stable Discharge Instructions: Please take all medications as prescribed. Please participate in all rehabilitation activities. If you develop fever >101.3, chest pain, shortness of breath, abdominal pain, or persistant nausea, please call your primary care physician [**Name Initial (PRE) **]/or return to the emergency department. Followup Instructions: Please follow-up with Dr. [**First Name4 (NamePattern1) 449**] [**Last Name (NamePattern1) 410**] in Hematology/Oncology. [**Telephone/Fax (1) 3760**]. Please bring all records from your oncologist regarding your CML, history of chronic transfusions, and iron overload. Please also plan to follow up with your primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 15170**]. You can call [**Telephone/Fax (1) 19657**] to make an appointment. You should be seen within the next 1-2 weeks to review your hospital course. You will continue on Mon, Wed, Fri hemodialysis The following appointments have been made for you: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 5026**], MD Where: [**Hospital6 29**] HEMATOLOGY/BMT Phone:[**Telephone/Fax (1) 3237**] Date/Time:[**2138-3-12**] 1:00 Provider: [**Name10 (NameIs) 2502**],[**Name11 (NameIs) **] HEMATOLOGY/ONCOLOGY-CC9 Where: [**Hospital 4054**] HEMATOLOGY/ONCOLOGY Phone:[**Telephone/Fax (1) 22**] Date/Time:[**2138-3-12**] 1:00 [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 617**] ICD9 Codes: 4280, 2930
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Medical Text: Admission Date: [**2128-9-20**] Discharge Date: [**2128-9-26**] Date of Birth: [**2051-10-4**] Sex: M Service: CSURG Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1267**] Chief Complaint: Unstable Angina Major Surgical or Invasive Procedure: CABG scheduled for [**2128-9-21**] History of Present Illness: 77 year-old male with history of hypertension and type II diabetes who presents with 2 week history of exertional angina. During the past two years, he had increasing fatigue with exertion. He developed shortness of breath on exertion over the past 2 months. Two weeks ago, he developed chest tightness on walking 3 blocks that improved with rest. He had a exercise stress test on [**9-15**] changes in the precordial leads and a reversible anterior wall defect. On [**9-20**], he had chest pain when walking to see his PCP. [**Name10 (NameIs) **] was sent for cardiac catherization at that time and had chest pain at rest in the catherization lab. This study showed left main disease and diffuse 3 vessel disease. A balloon pump was placed and he was scheduled for CABG. On review of systems, he has had nausea and diaphoresis over the past 3 weeks. He denies orthopnea or PND. Past Medical History: Hypertension that is well controlled with ACEI Type II diabetes that is well controlled (A1c = 6.2) GERD for which he takes PPI Hiatal hernia BPH for which he takes finesteride s/p appendectomy s/p cholecystectomy s/p bilateral knee arthroscopy h/o difficult intubation with appendectomy without any problems with later surgeries Social History: He lives at home with his wife. There are 6 steps in his house. He does not smoke, he drinks socially 1-2x per year, he does not use recreational drugs. Family History: He has a significant family history of CAD. His father had a CABG in his late 70s. Two brothers also had a CABG at the ages of 60 and 80, resepctively. Physical Exam: General: Alert and oriented, in no acute distress. HEENT: EOMI, moist mucus membranes Cardiac: RRR, S1, S2, no murmurs, rubs, or gallops. No JVD, no carotid bruits, no peripheral edema. Pulm: CTA in anterior fields, no wheezes or rhonchi. Abdomen: Bowel sounds present, nondistended, nontender, soft. Extremities: 2+ dorsalis pedis and tibialis anterior pulses, no cyanosis. Pertinent Results: [**2128-9-20**] 05:23PM WBC-7.6 RBC-3.81* HGB-12.2* HCT-33.2* MCV-87 MCH-32.0 MCHC-36.7* RDW-13.8 [**2128-9-20**] 05:23PM NEUTS-71.3* LYMPHS-20.7 MONOS-4.3 EOS-3.0 BASOS-0.8 [**2128-9-20**] 05:23PM HYPOCHROM-2+ ANISOCYT-1+ POIKILOCY-1+ MACROCYT-1+ MICROCYT-1+ POLYCHROM-NORMAL OVALOCYT-1+ BURR-1+ BITE-OCCASIONAL [**2128-9-20**] 05:23PM PLT COUNT-230 [**2128-9-20**] 05:23PM PT-14.5* INR(PT)-1.3 [**2128-9-20**] 05:00PM TYPE-ART O2 FLOW-2 PO2-112* PCO2-44 PH-7.35 TOTAL CO2-25 BASE XS--1 INTUBATED-NOT INTUBA [**2128-9-20**] 05:00PM GLUCOSE-125* [**2128-9-20**] 05:00PM HGB-11.0* calcHCT-33 O2 SAT-98 [**2128-9-20**] 12:00PM INR(PT)-1.0 Brief Hospital Course: 77 year-old male with HTN and DM type II who presented with unstable angina. Cardiac catherization showed left main disease and diffues 3VD. A balloon pump was placed and he was scheduled for CABG. 1. CAD: He was continued on ASA 325 qd. He was started on captopril 12.5 tid (in lieu of lisinopril 5 qd), atorvistatin 40 mg qd, metoprolol 12.5 mg [**Hospital1 **], heparin drip with goal PTT 60-80 for a ballon pump, and a nitroglycerin drip 0.5-5 mg/kg/min. Due to his chest pain at rest, will check 3 sets of cardiac enzymes to rule out acute MI. His ejection fraction is 55% and he appears euvolemic, therefore, his pump function seems adequate. He is scheduled for a CABG [**9-21**]. 2. Diabetes: Will not continue outpatient glipizide or glucophage. He was started on an insulin sliding scale. 3. GERD: Will continue PPI pantoprazole. 4. BPH: Will continue outpatient finesteride 5 mg qd. 5. FEN: He can have cardiac healthy and diabetic diet. He will be NPO after midnight for CABG. Will monitor electrolytes. 6. PPX: Bowel regimen: Senna, docusate, bisacodyl; DVT: heparin; GI ulcer: pantoprazole. 7. Access: He has peripheral IVs. He will need central line and A-line for CABG. 8. Dispo: He is sheduled for CABG. If he has chest pain overnight, he will likely need an emergent CABG. Will check UA, CXR, and EKG for pre-op evaluation. He has been type and crossed for 4 units. Medications on Admission: Lisinopril 5 mg po qd ASA 325 mg po qd Glucophage 1000 mg qd Glipizide 5 mg po 2 tab qd Finesteride 5 mg po qd Rabeprazole 200 mg po qd Discharge Medications: 1. Glipizide 5 mg Tablet Sig: Two (2) Tablet PO QD (once a day). 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO twice a day as needed for constipation. Disp:*60 Capsule(s)* Refills:*0* 3. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO QD (once a day). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 4. Clopidogrel Bisulfate 75 mg Tablet Sig: One (1) Tablet PO QD (once a day). Disp:*30 Tablet(s)* Refills:*2* 5. Finasteride 5 mg Tablet Sig: One (1) Tablet PO QD (once a day). 6. Acetaminophen-Codeine 300-30 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed. Disp:*75 Tablet(s)* Refills:*0* 7. Furosemide 20 mg Tablet Sig: One (1) Tablet PO QD (once a day) for 7 days. Disp:*7 Tablet(s)* Refills:*0* 8. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 9. Aciphex 20 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day: resume pre op medication. 10. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO once a day for 7 days. Disp:*7 Capsule, Sustained Release(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: CAD sp CABG X 3 [**2128-9-21**] GERD BPH Hiatal hernia Discharge Condition: stable Discharge Instructions: Please call physician if experiencing redness/drainage from the wound, chest pain/shortnes of breath, persistent nausea/vomiting. Do not lift > 10 lbs for 6 weeks. Do not swim or bath for 6 weeks. [**Month (only) 116**] shower. Follow cardiac healthy diet. Follow up with PCP regarding new medications (Lasix X 1 week, lopressor, plavix, lipitor). You will need laboratory tests while on taking lipitor. Followup Instructions: Please follow up with Dr. [**Last Name (STitle) **] in 4 weeks; call the office for an appointment. Call the office for an appointment. Follow up with PCP regarding medications in [**12-26**] weeks (lipitor, lopressor, plavix). Completed by:[**2128-9-27**] ICD9 Codes: 4111, 4019
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Medical Text: Admission Date: [**2186-7-1**] Discharge Date: [**2186-7-2**] Date of Birth: [**2130-11-30**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5893**] Chief Complaint: Dyspnea Major Surgical or Invasive Procedure: [**2186-7-1**] CVL placement History of Present Illness: Mr. [**Known lastname 52653**] is a 55 yo M with end-stage sarcoid on 3LNC at baseline, transferred from Radius with shortness of breath, tachypnea, hypoxia and fevers. According to reports from Radius has has been hypoxic for several days with O2 sats 91-92% on 100% NRB with desaturation to 86% with minimal exertion, patient refusing to come to hospital. . In the ED T99.2 BP 145/84 RR 20-30 HR 92-140 96% on 100%NRB. He was noted to be significantly hypoxic and tachypnic and was intubated due to concern for increasing work of breathing. He was given 2.5LNS, levofloxacin 750mg IV, cefepime 2g IV x1, decadron 10mg IV x1 and versed 2mg IV x1. Past Medical History: 1. Hepatitis C, diagnosed as part of the lung transplant workup at the [**Hospital1 756**]. He is followed by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] in GI. He is hepatitis B core surface antibody positive and surface antigen negative. In addition, he has hepatitis C antibody plus type 2b with a viral load in [**8-/2185**], of 5.5 million. He had grade 2 fibrosis on [**2184-4-28**]. He is not thought to be a candidate currently for interferon treatment given his sarcoidosis. He has transaminitis. 2. Sarcoidosis. He is followed by Dr. [**Last Name (STitle) 2168**]. The patient has been obtaining PFTs from Dr. [**Last Name (STitle) **], and he is currently on azathioprine and prednisone with prophylaxis Bactrim. 3. Sleep apnea. 4. Erectile dysfunction. 5. Emotional lability and anxiety. 6. Status post mandible fracture [**8-20**]. 7. Status post multiple rib and clavicle fractures over the past year secondary to fall. 8. Spinal stenosis: diagnosed on MRI and is followed by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 363**], [**First Name3 (LF) **] orthopedic physician at the [**Hospital1 18**]. The diagnosis was established as part of a workup for progressive lower leg weakness, which led to multiple falls and currently an inability to ambulate. 9. Shingles in [**12/2184**] on the right side of the face with residual neuropathic pain. Social History: Has been living in a rehab facility since recent admission in [**2186-4-13**]. Previously lived in an apartment in [**Location (un) 1459**] with his 27 yo daughter who is s/p traumatic brain injury in a motor vehicle accident. Has another daughter from whom he is estranged. Recently divorced from his wife of 33 years who he says did "not want to take care of him." Patient is a former food salesman, selling restaurant supplies to pizzerias. Has been unemployed for about a year, no longer on unemployment. Recently obtained some disability benefits. Reports a 10 pack year smoking history, but quit 20 years ago. Reports no history of ethanol use or IV drug use. Pt had previous admission in which he was on high doses of methadone and benzodiazepenes that were verified by PCP to be prescribed by an outpatient physician to treat his pain from spinal stenosis; pt believed to withdraw from both on previous admissions. Family History: Noncontributory of pulmonary disease. Physical Exam: Physical Exam (per Dr. [**First Name8 (NamePattern2) 4311**] [**Last Name (NamePattern1) 4312**]) Vitals: T97.6 BP 93/68 HR 100-115 RR 24 99% on CMV 100% TV 500 RR 20 PEEP 10 Gen - sedated, intubated, non responding to verbal or physical stimulation HEENT: NC AT, intubated, NG tube in place, pupils 2mm equal and reactive to light CV- distant heart sounds unable to appreciate murmur Lungs - coarse vented breath sounds, crackles bilaterally, expiratory wheezing Abd - multiple scattered bruises diffusely over abdomen, soft, ND, no apparent guarding, BS + Ext: somewhat cachectic lower extremities, 2+ pitting edema, right foot warm to palpation, left foot cool, DP's by doppler Pertinent Results: On admission [**2186-7-1**]: Na 142 K4.7 Cl 102 HCO 33 BUN 29 creat 0.5 Gluc 93 CK 29 MB - Trop <0.01 AST 100 ALT 102 AP 317 WBC 13.2 HCT 32.1 PLT 307 29% bands UA: leuk neg, mod blood, nitr neg, [**2-15**] granular casts, [**11-2**] hyaline casts . [**2186-7-1**] EKG:sinus tachycardia at 125bpm, normal axis, normal intervals, poor baseline, no apparent ST segment or T wave changes. Compared with [**2186-4-7**] sinus tachycardia is new otherwise no clear change. . Micro: [**3-1**] Blood Cx: pending . Imaging: [**2186-7-1**] CXR: (prelim dictation) extensive pulm fibrosis and emphysema unchanged, no effusion, no PTX, ETT terminates 4.5cm above carina, RIJ at cavo-atrial junction, OG tube in esophagus. Otherwise no acute cardiopulmonary changes. . [**2186-4-8**] CTA chest: 1. Small PE of segmental/subsegmental right upper lobe branch. This was communicated by Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 24949**] with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 3766**] by telephone in the AM on [**2186-4-10**]. 2. New minimally displaced fracture of the lateral right ninth rib. Multiple additional bilateral healing rib fractures. 3. Healing left distal clavicle fracture. 3. Resolution of right upper lobe pneumonia. 4. Chronic severe pulmonary fibrosis in the setting of sarcoidosis. . [**2185-11-8**] ECHO: The left atrium is normal in size. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF>55%). The right ventricular cavity is dilated. Right ventricular systolic function appears depressed. There is abnormal septal motion/position consistent with right ventricular pressure/volume overload. The ascending aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened. There is no aortic valve stenosis. Mild (1+) aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. There is moderate pulmonary artery systolic hypertension. Significant pulmonic regurgitation is seen. There is a trivial/physiologic pericardial effusion. Compared with the prior study (images reviewed) of [**2185-10-6**], right ventricular systolic function now appears depressed. Brief Hospital Course: SIRS/Sepsis: Patient met SIRS criteria based on tachycardia and bandemia of 29%. Most likely cause is PNA given underlying severe sarcoidosis, other consideration is infected midline which has been in place for unclear duration of time. Vancomycin IV was started to cover for possible line infection. Meropenem was started to provide coverage for resistant pseudomonas seen on recent sputum culture. Patient's urinalysis was unremarkable. Urine cultures were obtained. PICC line was discontinued on arrival to ICU. Patient had central line placed in ED. IVF fluids were administered to maintain CVP 8-10. With progressive hypoxia patient became hypotensive requiring norepinephrine and phenylephrine to maintain MAP > 65 on his second day of admission. Additional fluid boluses had no effect on hypotension and tachycardia. Pressors were discontinued only after the family made the decision to make him CMO. Hypoxic respiratory failure: In the setting of fever and recent pseudomonas-positive sputum culture, pneumonia superimposed on underlying sarcoidosis is most likely etiology. No clear infiltrate on CXR although difficult to interpret in the setting of already severe pulmonary fibrosis. Sputum and blood culture were obtained. Due to his increased susceptibility patient was treated empirically with vancomycin and meropenem for possible PNA, with levoquin added for double PSA coverage and atypical coverage. He was also covered empirically for PJP, although he had been on bactrim prophylaxis, and ETT PCP DFA was ordered. Patient also received frequent nebulizer therapies. Patient was intubated on arrival to ED and became progressively more hypoxic during his admission. Pt ultimately required maximum ventilator settings to keep his SpO2 above 80%. Multiple blood gases obtained illustrated his further deterioration. Patient was given trial of pressure controlled ventilation, volume controlled ventilation and APRV at varying levels of PEEP, but all failed to improve oxygen saturations. Pt was then placed in prone position so as to improve O2 sats, with no effect. Patient's daughter was present and the status of patient was discussed. She informed other family members who then met at the hospital for a family meeting. Family meeting was conducted with physicians and nurses present. They were in acceptance of pts deteriorating state and at that point did not want any resuscitative measures. Patient was started on comfort measures and remained ventilated. . End stage sarcodiosis: Patient has severe sarcoidosis at baseline; is currently on high dose steroids. Pt was continued on high dose steroids, and PCP prophylaxis with bactrim until the decision was made to take comfort measures only. Pt was kept on mechanical ventilation. . Chronic pain/spinal stenosis: home medications (ms contin and percocet) were held. Pt was sedated with fentanyl/midazolam. . Communication: daughter [**Name (NI) **] [**Last Name (NamePattern1) 52655**] is HCP H:[**Telephone/Fax (1) 52656**] c: [**Telephone/Fax (1) 52657**] . Code status - On presentation to the [**Name (NI) **] pt was full code. After discussion of the patient's status with his daughter/HCP the decision was made to declare him DNR. Once other family members were notified of his health status and given the opportunity to come to the hospital the decision was made to offer Comfort Measures Only and withdrawal all supportive care. Medications on Admission: -Albuterol Sulfate 2.5 mg/3 mL neb q4 hours and q7 hours prn -Atrovent Nebs Q4Hours and Q 7 hours prn -Solu-medrol 60mg IV Q6hrs -Novalog sliding scale QACHS -mucomyst 10% 3ML INH QID -Clonazepam 1 mg PO TID prn -NPH insulin [**Hospital1 **] (unclear dosing had been on 12QAM and 6QPM during last admit) -Nexium 40mg daily -dulcolax 10mg pr qday prn -colace 100mg po bid -milk of magnesia 30ML daily -MS Contin 45mg [**Hospital1 **] -percocet 1-2 tabs TID prn -zocor 20mg daily -heparin SQ 5000mg TID -Azathioprine 150 mg PO DAILY -cymbalta 90mg po daily -ASA 325mg daily -Sennakot 1 [**Hospital1 **] -Bactrim DS 1 tab QMWF -trazodone 25mg qhs prn -vitamin b1 100mg daily -risperdal 1mg [**Hospital1 **] -haldol 1mg po BID prn -lactulose 30mg po tid prn -saline nasal spray 2 sprays each nostril QID -Mirtazapine 15 mg PO HS -roxanol 10mg po q3hrs prn -fleet enema pr daily prn -MTV daily -primaxin IV 250mg Q6 hours Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: Primary: Sarcoidosis, pneumonia, hypoxic respiratory failure Discharge Condition: expired Discharge Instructions: Patient has expired Followup Instructions: none ICD9 Codes: 0389, 486, 4589, 4168
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Medical Text: Admission Date: [**2200-12-28**] Discharge Date: [**2200-12-31**] Date of Birth: [**2129-6-25**] Sex: M Service: CCU HISTORY OF PRESENT ILLNESS: Mr. [**Known lastname 5850**] is a 71-year-old male with an extensive cardiac history. His last cardiac catheterization was [**7-25**] during which he had a stent to his D1 and presented with unstable angina. Patient describes stable angina as substernal chest pain with walking "one city block". He states his chest pain was relieved with rest. Today the patient describes sudden onset of substernal chest pain at rest while having a bowel movement around 2 pm. Per patient report and wife, had an ETT at Dr.[**Name (NI) 5765**] office on Friday that was within normal limits. Today, his chest pain was [**8-2**] consistent with previous angina associated with nausea, dry heaves, positive shortness of breath, and perfuse diaphoresis. The patient called EMS, his wife was not home. His blood pressure at the time was 168/92 with a pulse of 90. Patient had missed his am medications. The patient was given aspirin, sublingual nitroglycerin, albuterol, and his chest pain decreased to [**3-2**]. At the outside hospital Emergency Department, the patient was started on Plavix, Integrilin, and Heparin, intravenous nitroglycerin, morphine sulfate, and Lopressor. His electrocardiogram showed anterior ST elevations, and he was taken to the catheterization laboratory. At the catheterization laboratory, he was shown to have a complex bifurcation stenosis at the left anterior descending artery/D1. Balloon angioplasty was performed to the D1 and left anterior descending artery with residual 30% stenosis in each. Patient was chest pain free status post procedure. He was then transferred to [**Hospital1 69**] for further management. At [**Hospital1 69**], the patient was asymptomatic with no chest pain, no shortness of breath, and his vital signs were stable. PAST MEDICAL HISTORY: 1. CABG in [**2181**], LIMA to the left circumflex, saphenous vein graft to the PDA. Cardiac catheterization [**2200-4-23**] performed for dyspnea on exertion, patent LIMA to the left circumflex, patent saphenous vein graft to the PDA, 80% stenosis of the proximal left anterior descending artery. The patient had balloon angioplasty, but no stenting of this lesion as the stent could not be passed. Cardiac catheterization on [**2200-8-10**] performed for continued dyspnea on exertion. The patient had PCI of the left main into the diagonal with atherectomy and stenting of a long segment of disease from the distal left main to a major high first diagonal branch and proximal left anterior descending artery. The previously treated mid left anterior descending artery on [**4-24**] was widely patent. The patient had PTCA of ostial left anterior descending artery, pulmonary capillary wedge pressure was 7. 2. Diabetes x20 years, diet controlled. No hemoglobin A1C on CCC records. 3. Left kidney atrophy since childhood, question infectious versus congenital anomaly. 4. Hypertension. 5. Chronic renal insufficiency. 6. Chronic vascular diabetic nephropathy with a baseline creatinine of 1.2-1.5. 7. High cholesterol. 8. Carotid stenosis. 9. Barrett's esophagus with esophageal strictures. 10. Gout. 11. Mild aortic insufficiency. 12. High homocysteine levels. 13. Osteoarthritis. MEDICATIONS ON ADMISSION: 1. Lipitor 10 q am, 40 q pm. 2. Atenolol 125 q day. 3. Aspirin 325 q day held for recent EGD x2 weeks. 4. Plavix 75 q day. 5. Allopurinol 100 q day. 6. Imdur 60 q day. 7. Folic acid 3 [**Hospital1 **]. 8. [**First Name5 (NamePattern1) 233**] [**Last Name (NamePattern1) 1002**] 20 mEq q day. 9. Lasix 20 q day. 10. Norvasc 10 q day. 11. Prevacid 30 q day. 12. Lotensin 10 q day. 13. Vitamin E. 14. Vitamin B1, B6, and B12. 15. Vioxx. SOCIAL HISTORY: The patient is a retired construction worker. He drinks two gin and tonics or vodka tonics each night. No history of DT's or withdrawal seizures per patient and per wife. [**Name (NI) **] tobacco history. Lives with wife. She is a nurse. REVIEW OF SYSTEMS: Two-pillow orthopnea, negative PND, negative change in baseline lower extremity edema, no fevers, chills, upper respiratory symptoms, no diarrhea, no abdominal pain. PHYSICAL EXAMINATION ON ADMISSION: Blood pressure 150-170/60-80, heart rate 80-90, normal systolic, respiratory rate 19-22, sat 99% on 2 liters nasal cannula. Weight is 94.5 kg. In general, alert and oriented times three, anxious in appearance, chest pain free. HEENT: Pupils constricted, equal bilaterally, status post bilateral cataract surgery. Extraocular muscles are intact. Heart regular, rate, and rhythm, S1, S2, [**1-29**] soft systolic murmur at the left upper sternal border. Lungs are clear anteriorly. Anterior chest wall with rib tenderness to palpation. Abdomen is benign. Extremities: 2+ pitting edema bilaterally, per patient is baseline. Distal pulses not palpable, DP and PT pulses dopplerable bilaterally. Groin hematoma: Right groin status post catheterization, indurated, nontender, 4 x 4 cm hematoma. Neurologic is alert and oriented times three. DATA ON ADMISSION: Hematocrit 39.4, white count 11.3, platelet count 201. Chemistries: 138, 4, 103, 23, 16, and 1.3. Of note, creatinine was 1.6 at outside hospital. Glucose 145. PT 12.9, PTT 44.2, INR 1.1. Calcium 8.2, magnesium 1.0, phosphorus 2.7, albumin 4.3. Cardiac enzymes: CK 189 at outside hospital. At [**Hospital1 188**], 2,149, MB of 3.1 at outside hospital to 169 at [**Hospital1 1444**]. Troponin went from 0.03 at the outside hospital to greater than 50 at [**Hospital1 346**]. Of note, the outside hospital laboratories were at 4 pm and the [**Hospital1 190**] laboratories were at 8 pm. ELECTROCARDIOGRAMS: When performed by the EMT, the electrocardiogram showed sinus rhythm with a right bundle branch, left axis deviation, [**Street Address(2) 1766**] elevations in the anterior leads and 2-[**Street Address(2) 2051**] elevation in the inferior and lateral leads at the outside hospital, normal sinus rate at 72 with a right bundle branch block, ST elevations V1 and V2 with [**Street Address(2) 1766**] elevations in II, III, and aVF, V4 through V6 and aVL with [**Street Address(2) 1766**] depressions. At [**Hospital1 190**], sinus with a normal axis and normal intervals, no bundle branch block, 1-[**Street Address(2) 1766**] depressions in the lateral leads, [**Street Address(2) 4793**] depressions in the inferior leads and borderline left ventricular hypertrophy. ASSESSMENT AND PLAN: This is a 71-year-old male with recurrent myocardial infarction secondary to stenosis, plaque of the left anterior descending artery territory. The patient is status post angioplasty to the left anterior descending artery and D1. Electrocardiogram changes resolving. The patient is chest pain free. The patient is transferred to the [**Hospital1 69**] CCU for closer monitoring, groin hematoma status post catheterization, history of bleeding. 1. From a cardiac standpoint, the patient was continued on Integrilin for 18 hours, aspirin, and Plavix. Heparin was held secondary to the groin hematoma. The patient was given initially metoprolol 5 mg IV x3 for a heart rate normal sinus in the 90s. He was then given 75 mg po Lopressor. He was started on Captopril 12.5 tid and a nitroglycerin drip to keep his blood pressure between 110-120 systolic and to decrease preload and therefore cardiac stress. His CKs were continued to be cycled. Daily electrocardiograms were checked, and he was continued on his statin. From a pump standpoint, the patient had an echocardiogram on the 6th that showed decreased ejection fraction of 35-40%. Of note, the patient's last ejection fraction was 50% on [**2200-4-24**] with this echocardiogram showing severe hypokinesis of the left ventricle, anterior wall, and septum. From the rhythm standpoint, patient was continued on Telemetry with normal sinus rhythm. He was placed on Lopressor [**Hospital1 **]. On Telemetry, he was noted to have NSVT, highest 4. EP was consulted as this patient has a known low ejection fraction and myocardial scarring along with NSVT. The EP consult, they performed a signal average electrocardiogram which was positive by [**1-26**] criteria with a QRS of greater than 114 and a LAF of greater than 38. It was decided that the patient should follow up after discharge on the 29th at 1:10 pm to have more formal EP studies. 2. Renal: History of chronic renal insufficiency with baseline creatinine of 1.2-1.6. The patient was given postcatheterization hydration at 75 cc of normal saline per hour. He was also treated with Mucomyst 600 po x2 and his magnesium was repleted for a magnesium of 1.0, he received 4 grams of magnesium sulfate x1. His magnesium corrected to 1.5 on [**2200-12-30**]. 3. Neurologic: The patient was noted to be agitated on evenings and required Ativan prn and a few doses of 1 mg of Haldol for agitation. He however, had no episodes of DT's or withdrawal seizures. He was placed on a CWA scale, but never had a CWA level of greater than 10. The patient was discharged to home on [**2200-12-31**]. He had no further episodes of chest pain or shortness of breath. He had worked with Physical Therapy and ambulated well without decrease in sats and was able to walk stairs without significant elevation in blood pressure or heart rate. DISCHARGE MEDICATIONS: 1. Imdur 60 q day. 2. Metoprolol 100 qid. 3. Captopril 12.5 tid. 4. Folic acid 3 mg [**Hospital1 **]. 5. Plavix 75 q day. 6. Atorvastatin 50 q day. 7. Allopurinol 100 q day. 8. Aspirin 325 q day. 9. Protonix 40 q day. 10. Multivitamin. 11. Thiamine. 12. Vitamin E. [**First Name11 (Name Pattern1) 1730**] [**Last Name (NamePattern1) 1731**], M.D. [**MD Number(1) 1732**] Dictated By:[**Last Name (NamePattern1) 5851**] MEDQUIST36 D: [**2201-1-25**] 19:12 T: [**2201-1-27**] 07:41 JOB#: [**Job Number 5852**] ICD9 Codes: 4271, 4241, 4019
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Medical Text: Admission Date: [**2188-7-1**] Discharge Date: [**2188-8-2**] Date of Birth: [**2121-12-3**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1377**] Chief Complaint: Small Bowel Obstruction Incarcerated Umbilical Hernia Major Surgical or Invasive Procedure: Exploratory Laparotomy Adhesiolysis Repair of Umbilical Hernia Re-exploration of recent laparotomy History of Present Illness: 66 yoF with multiple medical problems [**Name (NI) 78191**] CHF, HCV Cirrhosis, CKD comes with altered mental status from a nursing home. On exam noted to have two large hernias, one in the R inguina and the other umbilical. KUB in ED showed multiple small bowel loops the largest of which are 4 cm. Past Medical History: 1. HCV cirrhosis currently undergoing transplant work-up, had SBP in [**5-6**] 2. Diabetes mellitus type 2: Per old records, pt had diagnosis of diet controlled type 2 diabetes. 3. Umbilical hernia 4. [**Date Range **] in [**5-6**]: EKG c/w anteroseptal MI with new ST elevations in V2-3. Elevated troponins but not cath candidate. Echo confirmed anteroseptal WMA and pt was medicallly managed. 5. diastolic CHF 6. CKD Social History: From [**Location (un) 5354**], lived alone there and now moved in with her brother here in [**Name (NI) 86**]. Presented to the ED directly from the airport upon arrival in [**Location (un) 86**] several weeks ago for possible liver txplnt. Former smoker, 20 pack-years, quit 10 years ago. Former moderate EtOH consumption. Denies current EtOH use. Denies illicit drug use/IVDU. Family History: Father died of MI at age 62, brother had MI at age 60, brother also has DM. Physical Exam: N: grossly non verbal, responds in all four extremites to deep pain stimulation. Icteric, PERLA. CV: RRR, tachy at times, no MRG R: CTA B/L short quick inspiratory effort, non compliant with deep breath ABD: soft, protuberant with ascites, large umbilical hernia with early erythematous skin changes, tender to palpation, non-reducible. Large R inguinal hernia, soft, minimal erythema, fluid filled, partially reducible with immediate return, mildly tender to palpation. No obvious scars from previous surgery. EXT: minimal edema, pulses palpable throughout. Pertinent Results: [**2188-7-1**] 10:05AM AMMONIA-198* LACTATE-5.3* [**Month/Day/Year 3143**]-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-SM UROBILNGN-12* PH-6.5 LEUK-NEG WBC-6.6 RBC-2.67*# HGB-9.0* HCT-26.9* MCV-101*# MCH-33.8* MCHC-33.6 RDW-18.6* 10:35AM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG cTropnT-0.16* LIPASE-29 ALT(SGPT)-47* AST(SGOT)-62* CK(CPK)-88 ALK PHOS-159* TOT BILI-5.2* [**2188-7-1**] 08:12PM TYPE-ART PO2-191* PCO2-37 PH-7.38 TOTAL CO2-23 BASE XS--2 LACTATE-3.7* freeCa-1.09* GLUCOSE-104 UREA N-26* CREAT-1.4* SODIUM-144 POTASSIUM-4.3 CHLORIDE-113* TOTAL CO2-21* ANION GAP-14 CALCIUM-8.7 PHOSPHATE-3.9 MAGNESIUM-1.4* WBC-6.1 RBC-2.04* HGB-6.8* HCT-20.5* MCV-101* MCH-33.4* MCHC-33.2 RDW-18.3* PLT COUNT-72* PT-21.2* PTT-45.3* INR(PT)-2.0* ECG Study Date of [**2188-7-1**] 10:16:44 AM Sinus tachycardia. Baseline artifact. Poor R wave progression. Compared to the previous tracing of [**2188-5-18**] sinus tachycardia and artifact are new. CHEST (PORTABLE AP) Study Date of [**2188-7-1**] 10:13 AM IMPRESSION: No evidence of pneumonia. CT HEAD W/O CONTRAST Study Date of [**2188-7-1**] 10:15 AM IMPRESSION: No acute intracranial process. PORTABLE ABDOMEN Study Date of [**2188-7-1**] 10:27 AM IMPRESSION: Findings suggestive of small bowel obstruction. CT may be performed to further evaluate. ABDOMEN U.S. (COMPLETE STUDY) Study Date of [**2188-7-28**] 2:32 PM IMPRESSION: 1. Heterogeneous liver with no focal masses seen. 2. No biliary dilatation. 3. Splenomegaly. 4. Right pleural effusion and a small amount of perihepatic ascites. Brief Hospital Course: This is a 66 yo F with HCV cirrhosis and minimal reserve initially admitted with hepatic encephalopathy, and small bowel obstruction. # Small Bowel Obstruction: On [**2188-7-1**] the patient went to the OR for repair of umbilical hernia and reduction of small bowel obstruction. On [**2188-7-7**], she had Re-exploration of above laparotomy for Bacterial peritonitis, extremely high peritoneal ascites white count of 19,000. In that her liver failure continued to progress, and she was vasopressor-dependent and had poor urine output, there was concern for an intra-abdominal pathology source fueling this peritonitis. Upon repeat laparotomy, there was no evidence of any compromise or bowel death or obstruction; bowel was inflamed and edematous, as would be expected from peritonitis, but there was no evidence of any compromise nor incarcerated hernia. She was treated with a course of zosyn/vanco, was weaned off pressors and was transferred out of the SICU onto the liver medical service. # Altered Mental Status: She was confused and at times inappropriate and agitated. Pt attempted to remove Foley and PICC on several occasions. This was thought not entirely due to hepatic encphalopathy as she was stooling well on standing lactulose and rifaximin with decrease in asterixis. She had soft restraints and a 1:1 sitter. Her mental status was improving. She was evaluated by Psych on [**2188-7-14**]. They recommended Haldol as needed initially, and then standing doses of Haldol after PRN was not sufficient. Psych also recommended using lactulose for her hepatic encephalopathy. On [**7-28**] the patient appeared somnolent and her standing Haldol dose was [**Month/Year (2) 8910**] with an improvement in her mental status. She remained intermittantly confused, but was minimally agitated for the remainder of her hospital course. # Liver Failure/ HCV Cirrohsis: Pt was followed by the Transplant team but determined not to be a transplant candidate. She received lactulose enemas daily. She was having high ascitic output, at times as much as 8 liters/day. With the high JP output, her urine output was low (Hypovolemia). JP output was replaced with saline. She was also ordered for Albumin to help with the ascites. She was unable to tolerate NGT feedings and she had a high residual. Tubefeedings were stopped and she was started on TPN while on the surgical service. She was seen by Speech and Swallow and cleared for nectar thick liquids and ground consistency solids, however, due to her poor PO she was continued on TPN. Her bilirubin continued to climb and this was thought due to TPN. # Hyperbilirubinemia: Total bilirubin was 5.2 on admission, and with minor fluctuations, rose to 18.0 on [**7-24**]. Bilirubin continued to rise daily to 28 on [**7-29**]. No further labs were obtained after that time. # Renal Failure: Upon callout from the surgical ICU, her creatinine began to rise. She had large volume output of ascites from lap site that continued so it was intially postulated that she was likely intravascularly dry due to inadequate intake and high volume output from abdomen and stool. Her renal function, did not, however improve with fluid and albumin challenge and thus renal was consulted for probable HRS. Given the trajectory of her renal failure and development of oliguria/anuria, hemodialysis was considered. In discussion with her health care proxy, however, it was decided that rather than to initiate HD, team would focus on comfort care. # Anemia/GIB: She had post-op Anemia and received PRBCs as needed for [**Month/Day (4) **] loss anemia. Her HCT on POD 1 was 20 and rose to 26. Her HCT remained stable and low in the 23-24 range. Thrombocytopenia was also noted. INR remained elevated. On [**7-26**] the patient was found to have guiac positive emesis and a drop in her hematocrit from 25-->19. She was transferred to the ICU and transfused 3 U pRBCs. Endoscopy showed evidence of [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Last Name (NamePattern1) **] tear with stimata of recent bleeding. She was sabilized and returned to the hepatorenal service on [**7-27**]. Her hematocrit was stable for 24 hours until she had a large heme positive stool and her hct dropped again from 25-->20. She again was transfused 2u with an approptiate response with stable hematocrit thereafter. # DNR/DNI/CMO: On [**2188-7-30**], the issue of resusitation orders were discussed with the patient's brother [**Name (NI) **] [**Name (NI) 78192**]. During this discussion, it was determined that in light of her ineligability for transplant, DNR/DNI orders should be made. The issue of her imminent renal failure was also approached and this lead to the decision by her brother that dialysis should not be initiated. On [**2188-7-31**], the patient was made CMO and all unnecessary medical therapy was stopped. Pt remained on lactulose to maintain mental status. The patient died peacefully on the morning of [**8-2**]. Medications on Admission: -Acetaminophen 500 mg 1 tab PO Q6 hrs PRN pain -Albuterol Sulfate 2.5 mg/3 mL [**Male First Name (un) **] for neb. inhalation Q4 hrs PRN -Aspirin 325 mg tab PO daily -Ciprofloxacin 250 mg tab PO q24 hrs -Folic Acid 1 mg tab PO daily -Furosemide 40 mg 1 tab PO daily -Hexavitamin 1 Cap by mouth DAILY -Lactulose 10 gram/15 mL syrup 30 ML PO TID (titrate to 3 BM daily) -Metoprolol 25 mg 0.5 tab PO BID -Pantoprazole Delayed Release (E.C.) 40 mg 1 tab PO daily -Spironolactone 100 mg 1 Tab PO daily -Insulin Regular Human 100 unit/mL solution 0-10 Solution(s) sliding scale. Discharge Medications: 1. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q6H (every 6 hours) as needed. 2. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical PRN (as needed). 3. Rifaximin 200 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 4. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) as needed. 5. Lactulose 10 gram/15 mL Syrup Sig: Forty Five (45) ML PO QID (4 times a day). 6. Ondansetron HCl (PF) 4 mg/2 mL Solution Sig: One (1) Injection Q8H (every 8 hours) as needed for nausea. 7. Pantoprazole 40 mg Recon Soln Sig: One (1) Recon Soln Intravenous Q12H (every 12 hours). Discharge Disposition: Expired Discharge Diagnosis: Incarcerated Right Inguinal Hernia Umbilical Hernia Small bowel Obstruction Hepatic Encephalopathy Cirrhosis Renal Failure Cardiopulmonary arrest Discharge Condition: Deceased Followup Instructions: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MD [**MD Number(1) 1379**] Completed by:[**2188-8-20**] ICD9 Codes: 5856, 2851, 5849, 5715, 4280, 4589, 412
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Medical Text: Admission Date: [**2200-7-31**] Discharge Date: [**2200-8-4**] Date of Birth: [**2141-7-30**] Sex: M Service: CARDIOTHORACIC Allergies: Penicillins Attending:[**First Name3 (LF) 165**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: [**2200-7-31**] - Coronary artery bypass graft x4, left internal mammary artery to left anterior descending artery and saphenous vein grafts to diagonal, obtuse marginal, and posterior descending arteries. Mitral valve repair with size 28 CG Feature Complete Ring. History of Present Illness: This is a 59-year-old patient who presented with recent myocardial infarction, was investigated, and was found to have severe 3-vessel disease with a diminished ejection fraction of 40%. Intraoperative echocardiogram also showed at least moderate mitral regurgitation. The plan was to proceed with coronary bypass grafting and mitral valve repair. Past Medical History: Coronary artery disease s/p CABG Myocardial infarction prior stent/angioplasty Right bundle branch block Stroke [**2192**] ( post-cath)-residual memory impairment/right sided weakness Hypertension obesity asthma Obstructive sleep apnea-Bipap depression dyslipidemia Seizures Noncompliance Social History: Lives with: self in [**Hospital3 **] Occupation: disabled/past clothes buyer(TJX) Tobacco:no ETOH:no Recreation drugs: no Family History: History:father with MI at 70 Physical Exam: Pulse: 98 Resp: 16 O2 sat: 97%-RA B/P Right: 122/76 Left: Height: 5'6" Weight: 240lbs General:Obese man/NAD Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] No M/R/G Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema: no Varicosities: None [x] Neuro: Grossly intact, strength 5/5 on right [**4-11**] on left-upper and lower extremities. Gait normal Pulses: Femoral Right: 2+ Left: 2+ DP Right: 2+ Left: 2+ PT [**Name (NI) 167**]: 2+ Left: 2+ Radial Right: 2+ Left: 2+ Carotid Bruit no Right: Left: Pertinent Results: ECHO [**2200-7-31**] No atrial septal defect is seen by 2D or color Doppler. Overall left ventricular systolic function is moderately depressed (LVEF=30-40 %). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened. Trace aortic regurgitation is seen. A mitral valve annuloplasty ring is present. Trivial mitral regurgitation is seen. There is no pericardial effusion. IMPRESSION: Moderately depressed left ventricular systolic function. No pericardial effusion. [**2200-8-4**] 05:20AM BLOOD WBC-16.6* RBC-3.25* Hgb-9.3* Hct-28.2* MCV-87 MCH-28.6 MCHC-33.0 RDW-14.2 Plt Ct-385 [**2200-8-3**] 07:15AM BLOOD WBC-18.0* RBC-3.04* Hgb-9.0* Hct-27.3* MCV-90 MCH-29.7 MCHC-33.1 RDW-14.3 Plt Ct-265 [**2200-7-31**] 02:20PM BLOOD PT-14.5* PTT-33.1 INR(PT)-1.3* [**2200-8-4**] 05:20AM BLOOD Glucose-100 UreaN-28* Creat-0.8 Na-133 K-3.9 Cl-97 HCO3-28 AnGap-12 [**2200-8-3**] 07:15AM BLOOD UreaN-26* Creat-0.8 Na-135 K-4.5 Cl-97 Brief Hospital Course: Mr. [**Known lastname 26258**] was admitted to the [**Hospital1 18**] on [**2200-7-31**] for surgical management of his coronary artery disease. He was taken to the operating room where he underwent coronary artery bypass grafting to four vessels and a mitral valve repair. Please see operative note for details. Postoperatively he was taken to the intensive care unit for monitoring. Over the next 24 hours, he had awoke neurologically intact and was extubated. On postoperative day one he was transferred to the step down unit for further recovery. Aspirin, a statin and beta blocker were resumed. He was gently diuresed towards his preoperative weight. The physical therapy service was consulted for assistance with his postoperative strength and mobility. Postoperative course was uneventful and the patient was discharged on POD 4. He was discharged to [**Hospital 3548**] [**Hospital 3549**] Rehab, as he lives alone. He did develop some sternal drainage, and was discharged on keflex. Medications on Admission: Celexa 20' Ambien 10' Proventil 3.7' Trileptal 300' ASA 325' Toprol XL 100' Niaspan 2gm' Lisinopril 20' MVI Prozac 20' Crestor 20' Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*60 Tablet(s)* Refills:*0* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 5. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for pain/fever. 6. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 7. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed for constipation. 8. Oxcarbazepine 150 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 9. Fluoxetine 20 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 10. Rosuvastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 12. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 13. Niacin 500 mg Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO BID (2 times a day). 14. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO Q12H (every 12 hours). 15. Furosemide 40 mg Tablet Sig: One (1) Tablet PO twice a day for 2 weeks. 16. Celexa 20 mg Tablet Sig: One (1) Tablet PO once a day. 17. Keflex 500 mg Capsule Sig: One (1) Capsule PO four times a day for 7 days. Disp:*28 Capsule(s)* Refills:*0* Discharge Disposition: Extended Care Facility: [**Doctor First Name 3548**] [**Doctor Last Name 3549**] Nursing & Rehabilitation Center - [**Location (un) 1110**] Discharge Diagnosis: Coronary artery disease s/p CABG Myocardial infarction prior stent/angioplasty Right bundle branch block Stroke [**2192**] ( post-cath)-residual memory impairment/right sided weakness Hypertension obesity asthma Obstructive sleep apnea-Bipap depression dyslipidemia Seizures Noncompliance Discharge Condition: Alert and oriented x3 nonfocal Ambulating with steady gait Incisional pain managed with percocet Incisions: Sternal - healing well, no erythema or drainage Leg -Left - healing well, no erythema or drainage. Edema -trace in LEs Discharge Instructions: 1) Please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. Look at your incisions daily for redness or drainage 2) Please NO lotions, cream, powder, or ointments to incisions 3) Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart 4) No driving for approximately one month until follow up with surgeon 5) No lifting more than 10 pounds for 10 weeks 6) Please call with any questions or concerns [**Telephone/Fax (1) 170**] Followup Instructions: Dr. [**Last Name (STitle) **] (for Dr. [**First Name (STitle) **] in 3 weeks at [**Hospital1 **] for wound check and post-op follow-up : [**Telephone/Fax (1) 6256**] Thursday, [**9-4**], 9am Dr. [**First Name (STitle) **],[**First Name3 (LF) **] J. [**Telephone/Fax (1) 77271**] in 3 weeks [**Telephone/Fax (1) 6256**] Dr. [**Last Name (STitle) 1295**] [**Telephone/Fax (1) 6256**] in 2 weeks [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2200-8-4**] ICD9 Codes: 4240, 2851, 4019, 2724, 311
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Medical Text: Admission Date: [**2118-8-17**] Discharge Date: [**2118-9-1**] Date of Birth: [**2118-8-17**] Sex: M Service: NB INTERIM SUMMARY OF [**8-15**]. HISTORY: Baby [**Name (NI) **] [**Known lastname **], Twin number 1, was born on [**2118-8-17**] to a 30-year-old gravida 2, para 0, now 2 mother, with insulin dependent diabetes mellitus, who had surgery for an ovarian torsion 1 month prior to delivery. She received betamethasone at that time. She was readmitted to the hospital with preterm labor on the day of delivery, as well as the question of placental abruption, so she was taken for cesarean section. Baby [**Name (NI) **] [**Known lastname **] was born at 31-1/7 weeks gestation. His Apgar scores were 7 and 8. PRENATAL LABS: Mom had [**Name2 (NI) **] type B positive, antibody screen negative, hepatitis B surface antigen negative, rubella immune, RPR nonreactive, GBS status unknown. PHYSICAL EXAMINATION ON ADMISSION: Notable for a pink, active, nondysmorphic infant who was well-perfused and with decreased aeration on CPAP. He had moderate increased work of breathing. His head and neck exam were normal. His cardiac exam was normal without murmurs. His testes were palpable high in the inguinal canal. His hips were normal. His anus was patent. His birth weight was 2,260 gm. HOSPITAL COURSE BY SYSTEMS: 1. RESPIRATORY: He was intubated shortly after birth for respiratory distress syndrome secondary to surfactant deficiency and received 2 doses of surfactant over the first day of his life. He was weaned on the ventilator and extubated to CPAP which he was on briefly on day of life 2. Over days of life 3 and 4, he was transitioned off CPAP to nasal cannula and eventually to room air by day of life [**3-7**]. Initially, he had no significant apnea nor bradycardia, but has had a few mild spells beginning on day of life 9. He has not received any caffeine. At the time of this interim summary, his last spell was on the [**8-30**]. He remains on room air. 1. CARDIOVASCULAR: He has had a normal cardiovascular exam with normal perfusion and [**Month (only) **] pressures throughout his stay. A soft murmur was heard on day of life 2, but this resolved and has not been appreciated on subsequent examinations. 1. FLUIDS, ELECTROLYTES AND NUTRITION: He was initially on IV fluids with normal electrolytes, and glucoses 66 and 115 on the first day of life. He had a high potassium of 7 on day of life 2 which was a heel stick and was repeated with a serum level of 4.3. Feeds were initiated on day of life 3 and were slowly advanced to full enteral volume by day of life 6. He is currently on Similac Special Care 26 with ProMod. He has received maternal breast milk, but at the time of this interim summary, his mother had received IV contrast for imaging of a clot next to her abdominal incision from delivery and had to be discarding her pumped breast milk. He is receiving all gavage feeds and has had no issues with feeding intolerance. He has had normal urine output. 1. GI: He has been receiving his gavage feeds over an hour and a half secondary to emesis. He had one 12 cc aspirate on the [**8-30**] that was partially digested and was subtracted from his total volume. He has had no other gastrointestinal issues throughout his stay. He had a bilirubin of 11.6 on the [**8-21**], and single phototherapy was initiated. He was on phototherapy for 3 days, and his phototherapy was discontinued on day of life 7 with a rebound bilirubin of 6.1. 1. HEMATOLOGY: His initial hematocrit was 50 percent with 29 neutrophils and 0 bands. 1. INFECTIOUS DISEASE: He received 48 hours of ampicillin and gentamicin secondary to his respiratory distress and prematurity. His antibiotics were discontinued at 48 hours of life when [**Month (only) **] culture was negative. He has had no other infectious disease issues. 1. NEUROLOGY: He had a head ultrasound on day of life 7 that was normal. PRIMARY PEDIATRICIAN: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 53433**], MD, phone number [**Telephone/Fax (1) 57438**]. INTERIM DISCHARGE DIAGNOSES: Prematurity at 31-1/7 weeks. Twin gestation. Rule out sepsis. Hyperbilirubinemia. Respiratory distress syndrome. Reviewed By: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 53043**], [**MD Number(1) 53044**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2118-9-1**] 09:32:21 T: [**2118-9-1**] 10:02:56 Job#: [**Job Number **] ICD9 Codes: 7742, V053, V290
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Medical Text: Admission Date: [**2109-9-24**] Discharge Date: [**2109-9-28**] Date of Birth: [**2054-12-13**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1406**] Chief Complaint: chest pain Major Surgical or Invasive Procedure: s/p coronary artery bypass grafting x 5 (Left internal mammary artery grafted to 1st Diagnal/saphenous vein grafted to distal left anterior descending/posterior descending artery/posterior left ventricle/ 2 obtuse marginal)on [**2109-9-24**] History of Present Illness: Mr. [**Known lastname 5239**] is a 54 year old man who initially presented to the [**Hospital3 **] ED with chest pain for the past 2 weeks. He describes it as a band-like burning pressure which does not radiate. He has it several times per day and it is non-exertional. On the day of presentation he awoke feeling unwell. He later was smoking a cigarette and became acutely diaphoretic, lightheaded and "disoriented" according to the patient. He decided to come to the ED. He cannot recall if he was experiencing chest pain during this episode. In the OSH ED, ECG was sinus bradycardia at [**Street Address(2) 17364**] or T wave changes. His Troponin was 1.62 without CK done. He was placed on heparin and integrilin gtts, and was given aspirin 325mg x 1, plavix 600mg x 1, atorvastatin 80mg x 1. Metoprolol was held due to bradycardia. He has been having intermittent episodes of the chest pressure all day, lasting for minutes and self-resolving. He has some shortness of breath at rest but does not note any orthopnea. He does not exercise and walks very little. He does not have shortness of breath or chest pain on exertion but does notice calf pain when walking several hundred yards. He underwent cardiac cath this AM which revealed triple vessel coronary artery disease and cardiac surgery was consulted. Past Medical History: Diabetes mellitus type I Social History: Tobacco history: smokes 1ppd x 40 years ETOH: drinks [**12-15**] glasses of wine twice a week and "too much" [**Doctor Last Name 17365**] irish cream on a daily basis Illicit drugs: marijuana occasionally Works as a property manager. Lives with mother and sister. [**Name (NI) **] a girlfriend. Previously divorced, has 3 children Family History: No family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. Reports that his mother recently underwent pacemaker insertion due to syncope. Physical Exam: Admission Physical Exam Pulse: 69 Resp: 18 O2 sat: 100% RA B/P Right: 110/56 Left: Height: 66" Weight: 70.9 kg General: Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x]upper dentures, lower teeth poor Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [] Extremities: Warm [x], well-perfused [x] Edema Varicosities: None [x] Neuro: Grossly intact Pulses: Femoral Right: 2+ Left: 2+ DP Right: 1+ Left: 1+ PT [**Name (NI) 167**]: 1+ Left: 1+ Radial Right: cath site Left: 2+ Carotid Bruit Right: no Left: no Pertinent Results: [**2109-9-24**] PRE-CPB: 1. The left atrium is normal in size. No spontaneous echo contrast is seen in the left atrial appendage. No thrombus is seen in the left atrial appendage. 2. No atrial septal defect is seen by 2D or color Doppler. 3. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is mildly depressed (LVEF= 50 %). 4. Right ventricular chamber size and free wall motion are normal. 5. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. 6. There are three aortic valve leaflets. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. 7. Mild (1+) mitral regurgitation is seen. Mild posterior MAC is seen. POST-CPB: On infusion of phenylephrine, a-pacing. Preserved biventricular systolic function. Mitral regurgitation remains 1+. Aortic contour normal post decannulation. [**2109-9-26**] 04:30AM BLOOD WBC-10.9 RBC-2.97* Hgb-9.2* Hct-26.2* MCV-88 MCH-31.1 MCHC-35.2* RDW-13.2 Plt Ct-173 [**2109-9-26**] 04:30AM BLOOD Glucose-181* UreaN-16 Creat-1.0 Na-133 K-4.5 Cl-101 HCO3-30 AnGap-7* Brief Hospital Course: The patient was admitted to the hospital and brought to the operating room on [**2109-9-24**] where the patient underwent coronary artery bypass grafting x 5 with the left internal mammary artery to the second diagonal artery and reverse saphenous vein grafts to the posterior descending artery, posterior left ventricular branch artery, second obtuse marginal artery, and left anterior descending artery. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. POD 1 found the patient extubated, alert and oriented and breathing comfortably. The patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. Beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. The patient was transferred to the telemetry floor for further recovery. Chest tubes and pacing wires were discontinued without complication. The patient was evaluated by the physical therapy service for assistance with strength and mobility. By the time of discharge on POD ___ the patient was ambulating freely, the wound was healing and pain was controlled with oral analgesics. The patient was discharged home with visitng nurse services in good condition with appropriate follow up instructions. Medications on Admission: Lantus 24 units SC BID Humalog Sliding Scale Discharge Medications: 1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 3. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 5. ferrous sulfate 300 mg (60 mg Iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 6. ascorbic acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 7. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). Disp:*30 Tablet(s)* Refills:*2* 8. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 9. thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 10. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day for 5 days. Disp:*5 Tablet(s)* Refills:*0* 11. potassium chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO once a day for 5 days. Disp:*5 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 12. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*65 Tablet(s)* Refills:*0* 13. Lantus 100 unit/mL Solution Sig: Twenty Four (24) units Subcutaneous twice a day. Discharge Disposition: Home with Service Discharge Diagnosis: Coronary artery disease s/p coronary artery bypass grafting x 5 (Left internal mammary artery grafted to 1st Diagnal/saphenous vein grafted to distal left anterior descending/posterior descending artery/posterior left ventricle/ 2 obtuse marginal)on [**2109-9-24**] -IDDM -NSTEMI [**2109-9-16**] Discharge Condition: Alert and oriented x3 nonfocal Ambulating with steady gait Incisional pain managed with Incisions: Sternal - healing well, no erythema or drainage Leg Left - healing well, no erythema or drainage. Edema-trace Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. Look at your incisions daily for redness or drainage Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Followup Instructions: You are scheduled for the following appointments Surgeon: Dr. [**Last Name (STitle) **] on [**10-16**] at 1pm Cardiologist: You will need a referral from Dr. [**Last Name (STitle) 17369**] for a cardiologist Please call to schedule appointments with your Primary Care Dr. [**Last Name (STitle) 17369**] in [**3-18**] weeks [**Telephone/Fax (1) 17368**] **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Completed by:[**2109-9-28**] ICD9 Codes: 3051
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Medical Text: Admission Date: [**2188-5-10**] Discharge Date: [**2188-5-17**] Date of Birth: [**2129-6-19**] Sex: M Service: MEDICINE Allergies: Amoxicillin / Ibuprofen / Aspirin Attending:[**First Name3 (LF) 9554**] Chief Complaint: Pericardial effusion/tamponade Major Surgical or Invasive Procedure: Insertion of Pericardial drain Cardiac Catheterization showing lesion in left circumflex artery History of Present Illness: The patient is a 58 year old male with a history of "benign" colonic neoplasm, h/o positive PPD, bronchitis, HTN and hyperlipidemia who was transferred from [**Hospital 1263**] hospital s/p tamponade with large pericardial effusion s/p pericardial drain. Prior to admission, the patient had visited the ER with flu-like symptoms and placed on Zpack and advair. He also initially reported noticing a swollen right ankle that was later described by [**Name8 (MD) **] MD [**First Name (Titles) 3**] [**Last Name (Titles) **] +1 pedal edema. He denies any arthralgias or rashes. He denies any contact with TB, recent travel or sick contacts. [**Name (NI) **] admits to having night sweats, chills and a cough with rusty sputum for the past few weeks with increased shortness of breath and orthopnea, no chest pain. He denies any recent weight loss and denies ever having a colonic neoplasm, benign or malignant, with a recent colonoscopy at [**Hospital 1263**] hospital 1 month ago. He does admit to having smoked 1 ppd for 5-7 years but quit 20 years ago. He also admits to having been exposed to asbestos as a former shipyard worker for 10 years 20 years ago. His first troponin was 0.02 and then 2.8 at [**Doctor Last Name 1263**]. Echo was positive for tamponade with a negative CT for dissection. On [**2187-5-9**], underwent pericardiocentesis with 1800 cc fluid obtained with negative cytology with cell block pending. Opening wedge was 28 and final wedge 12. Pericardial fluid: protein 7.7 LDH 339 WBC 7 Hct 21% Amylase 63 AFB pending, fungal pending, culture pending, GS pending EKG [**2188-5-8**]: Electrical alternans, normal axis. low voltage. Past Medical History: Bronchitis HTN s/p MVA Hyperlipidemia h/o pleural effusion h/o "benign" colonic neoplasm? -documented by MDs at [**Doctor Last Name 1263**] where colonoscopy was performed but denied by patient hemorrhoids diverticulosis h/o positive PPD - born in the US, likely exposed as child in [**State 3908**] Social History: The patient works for [**Company 2318**]. He is married. He is a former smoker having smoked 1 ppd for 5-7 years in the past. He admits to occasional EtOH. He also admits reluctantly to a history of cocaine use but will not elaborate. He admits to having tested for HIV in the past. He was formerly exposed to asbestos as a former shipyard worker from [**2153**]-[**2163**]. Family History: Mother - deceased from bone cancer, ?CHF Father - Alcoholic, deceased at young age from alcoholism Physical Exam: P=112 BP=130/94 RR=28 95% Gen- Mildly anxious, appears upset, AOX3 HEENT - PERLA, EOMI, positive nontender submandibular [**Doctor First Name **] with palpable, nontender thyroid, no supraclavicular, anterior/posterior cervical [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 3495**] - Regular rate and rhythm, no murmurs/rubs or gallops Lungs - Clear to auscultation bilaterally Abdomen - Pericardial drain in place with clean, intact site with no pus, Soft, no hepatosplenomegaly, active bowel sounds, nontender/nondistended Ext - No C/C/E Pertinent Results: Echo [**2188-5-11**]: Left Ventricle - Ejection Fraction: 35% to 40% (nl >=55%) Conclusions: 1. LV function is moderately depressed with an estimated ejection fraction of 35-40%. There is akinesis of the mid to distal septum. Due to poor apical windows, other focal wall motion abnormalities cannot be excluded. 2. There are no hemodynamically signficant valve abnormalites. 3. There is a small pericardial effusion with some pericardial thickening. There is no RV or RA collapse. There is no echo evidence of cardiac tamponade. 4. The RV appears at least mildly dilated with at least mildly depressed systolic function. CHEST (PORTABLE AP) [**2188-5-10**] 7:02 PM IMPRESSION: [**Month/Day/Year **] small pleural effusion. Enlarged cardiac silhouette consistent with the patient's history of pericardial effusion. Brief Hospital Course: The patient is a 58 year old African-American male with a history of positive PPD, ?colonic neoplasm who presented to [**Hospital 1263**] hospital with large pericardial effusion s/p pericardiocentesis on [**2188-5-8**] with pericardial drain transferred to [**Hospital1 18**] for medical management. 1. Pericardial effusion: He had a pericardial drain in place on transfer. This was pulled out 1 day after admission when output had decreased to a minimal amount of serosanguinous fluid. All cultures of fluid from [**Doctor Last Name **] hospital were negative (AFB, fungal, aerobic), and cell block/cytology was also negative. He had multiple repeat echos while in-house to assess for reaccumulation or change. There was no reaccumulation, and effusion was trivial at time of discharge. Given that he had a positive PPD (placed while in-house), sputum was sent x 3 for AFB smear and was negative. Although the cause of his effusion was still unclear at time of discharge, it was likely a viral myocarditis/pericarditis (given malignancy and TB virtually excluded). Given his positive PPD, the decision was made to treat with Isoniazid (and vitamin B6) prophylactically). He will have his LFt's checked monthly through his PCP while on this therapy. He was also instructed no to drink alcohol while on this medication. 2. CAD: He was noted to have a depressed EF (to 30-35%) on TTE. He underwent a ETT-MIBI that showed EF=35% with global HK, no fixed/reversible defects. The decision was made to take him for cardiac catheterization (?3vd or other balanced lesions contributing to global HK). Catheterization showed 70% lesion of left circumflex. No stent was inserted, for patient had a ?[**Doctor Last Name **] allergy. He was desensitized for [**Doctor Last Name **] prior to discharge and will return for stenting of left circumflex. He was started on a beta blocker, ACEI, [**Last Name (LF) 4532**], [**First Name3 (LF) **], lipitor prior to discharge. Of note, TTE on the day prior to discharge showed an improved EF of 40%. He never had any anginal symptoms while in-house. 3. Hypertension: He was on HCTZ on admission. This was stopped, and he was maintained on ACEI/BB and discharged on these medications. His bp remained under good control throughout hospitalization. 4. Tachycardic: He was tachycardic to 100-110's. This persisted even after removal of the pericardial drain. He was started on a beta blocker with some improvement in the tachycardia 6. Dispo: He was discharged after [**First Name3 (LF) **] desensitization and will return for cardiac catheterization 2-3 days after discharge. He was instructed about the importance of taking his [**First Name3 (LF) **] and [**First Name3 (LF) 4532**] daily to avoid in stent thrombosis (and to avoid resensitization to [**First Name3 (LF) **]). Medications on Admission: Meds on Admission: MVI HCTZ ALL: [**First Name3 (LF) **]-hives/rash Discharge Medications: 1. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 2. Toprol XL 100 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO once a day. Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* 3. Clopidogrel Bisulfate 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*5* 4. Atorvastatin Calcium 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 5. Aspirin 325 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 6. Outpatient Lab Work Please check AST, ALT, alkaline phosphatase, total bilirubin once a month and fax results to Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 51132**], fax ([**Telephone/Fax (1) 101287**] 7. Isoniazid 300 mg Tablet Sig: One (1) Tablet PO once a day for 9 months. Disp:*30 Tablet(s)* Refills:*8* 8. Vitamin B-6 50 mg Tablet Sig: One (1) Tablet PO once a day for 9 months. Disp:*30 Tablet(s)* Refills:*8* Discharge Disposition: Home Discharge Diagnosis: Primary Diagnosis: 1. Pericardial tamponade/effusion 2. Congestive Heart Failure, EF=30% Secondary Diagnoses: 1. Hypretension Discharge Condition: Good Discharge Instructions: 1. Please take all your medications as described in this discharge paperwork. We made the following changes to your medication regimen. - We added Toprol XL 100 mg daily, to help with your heartrate and blood pressure - We added Lisinopril, a medication to help with your blood pressure. Please take 10 mg daily - We stopped your hydrochlorothiazide. - We added Isoniazid, a medication to be taken for your possible exposure to tuberculosis. You should take this medication for 9 months. Do not drink alcohol while on this medication, for this could cause serious liver damage. In addition, you should have your liver function tested monthly while on this medication. You should also take Vitamin B6 daily while on this medication - Please take Lipitor, a medication to help lower your cholesterol, 20 mg daily - Please take Aspirin 325 mg daily. Also take [**Telephone/Fax (1) **] 75 mg daily. It is extremely important that you take these medications every day. If you miss a dose, you risk clotting off the stents in your heart which could cause death. In addition, missing aspirin doses may result in becoming allergic to this medication again. 2. Please follow up with your PCP and cardiology as described below. 3. Please call your PCP if you are experiencing chest pain, shortness of breath, fever, chills, lightheadedness, dizziness, or with any other concerns. Followup Instructions: 1. Please follow up with your PCP, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 51132**] ([**Telephone/Fax (1) 89769**]) within 1-2 weeks of discharge. He should check your liver function tests at this time while you are on Isoniazid and Lipitor. You will need to get your liver function tested monthly (results faxed to ([**Telephone/Fax (1) 101288**]. 2. Please plan on coming in for your cardiac catheterization on Monday, [**2188-5-19**], to [**Hospital Ward Name **] 4. Do not eat breakfast on this morning. Cardiology (Dr. [**Last Name (STitle) 5021**] will call you to schedule this and confirm date and time. [**First Name8 (NamePattern2) 2064**] [**Last Name (NamePattern1) **] MD [**MD Number(2) 2139**] ICD9 Codes: 4280, 4019, 2724
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Medical Text: Admission Date: [**2181-11-30**] Discharge Date: [**2181-12-3**] Service: SURGERY Allergies: Gentamicin Attending:[**First Name3 (LF) 148**] Chief Complaint: abdominal pain, jaundice, change in mental status, fevers Major Surgical or Invasive Procedure: ERCP [**2181-12-1**] History of Present Illness: 81 year-old female who is s/p open cholecystectomy on [**2181-11-18**] who presents from an extended care facility with fevers to 103, change in mental status, abdomnal pain and jaundice. On arrival she was unresponsive. A central line was placed in the ED and volume recussitation was started. Past Medical History: PMHx: DM, HTN, Hyperthyroid, Depression, Loss of hearing, s/p TAH/BSO, s/p L hip Social History: At extended care facility. Daughters are healthcare proxy. The [**Name2 (NI) 64485**] is DNR/DNI. Family History: Non-contributory. Physical Exam: Temp 100.8 HR 76 BP 101/27 The patient is quite jaundiced. She is minimally reponsiver withdrawing only to pain. Lungs are clear, heart is tachy but regular without obvious murmur. Abdomen is soft and nondistended with right upper quadrant tenderness. Incisions are clean and dry. A foley is inplace and the urine is quite turbid. Ext. warm, perfused, palpable DP bilaterally. Pertinent Results: [**2181-11-30**] 08:21PM LACTATE-2.7* [**2181-11-30**] 08:10PM GLUCOSE-92 UREA N-78* CREAT-2.6*# SODIUM-148* POTASSIUM-3.7 CHLORIDE-112* TOTAL CO2-24 ANION GAP-16 [**2181-11-30**] 08:10PM CK(CPK)-30 [**2181-11-30**] 08:10PM ALT(SGPT)-487* AST(SGOT)-531* ALK PHOS-1481* AMYLASE-39 TOT BILI-8.7* DIR BILI-7.8* INDIR BIL-0.9 [**2181-11-30**] 08:10PM LIPASE-41 [**2181-11-30**] 08:10PM CK-MB-NotDone cTropnT-0.01 [**2181-11-30**] 08:10PM ALBUMIN-2.5* CALCIUM-10.7* PHOSPHATE-4.4 MAGNESIUM-1.7 [**2181-11-30**] 08:10PM WBC-16.8* RBC-3.85* HGB-10.2* HCT-31.8* MCV-83 MCH-26.6* MCHC-32.2 RDW-23.0* [**2181-11-30**] 08:10PM URINE RBC->50 WBC->50 BACTERIA-MANY YEAST-NONE EPI-0-2 [**2181-11-30**] 08:10PM URINE BLOOD-LG NITRITE-POS PROTEIN-30 GLUCOSE-NEG KETONE-NEG BILIRUBIN-MOD UROBILNGN-NEG PH-6.5 LEUK-MOD [**2181-11-30**] 08:10PM URINE COLOR-Amber APPEAR-Cloudy SP [**Last Name (un) 155**]-1.014 Brief Hospital Course: The patient was admitted on [**12-1**]. An ERCP was perfored in the ICU on admission. This procedure required intubation. Consent for both the intubation and ERCP was obtained from the patient's daughter (healthcare proxy). ERCP revealed bile without pus in the biliary tree. There were no filling defects suggestive of obstruction. A subsequent CT scan revealed no source of abdomnal pathology and a diagnosis of urosepsis was made. Over the ensuing 48 hours blood pressure required norepinephrine for support. On [**12-3**] a meeting was held with the family and and the decision was made to remove the ETT and stop all pressors. She expired after withdrawl of support. Medications on Admission: lopressor, ASA, heparin, protinix, elavil, atrovent, albuterol, RISS Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: death Discharge Condition: dead Discharge Instructions: none Followup Instructions: none ICD9 Codes: 0389, 5990, 4019
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Medical Text: Admission Date: [**2194-1-23**] Discharge Date: [**2194-2-5**] Date of Birth: [**2138-6-4**] Sex: M Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2724**] Chief Complaint: back pain, leg weakness Major Surgical or Invasive Procedure: Thoracic instrumented fusion T1-12 History of Present Illness: HPI: Pt is a 55 yo male w/ PMHx sig for metastatic renal cancer to the thoracic spine, rheumatoid arthritis who presents as a transfer from an OSH for leg weakness. The patient was found to have a renal tumor in [**2190**] s/p resection. In [**6-21**] the patient was found to have an extradural mass at T5 that was felt to be metastases. The patient is also known to have a kyphotic collapse at T10. The patient was seen in Dr.[**Name (NI) 2845**] office several days ago where it was felt that the patient would need surgical instrumentation of the thoracic spine for stabilization. This was scheduled for the future. In the last couple of days, the patient has had increased difficulty walking and numbness in his legs. He was seen at an OSH and then transferred to [**Hospital1 18**] for further evaluation. Pt denies headache, vertigo, tinnitus, hearing loss, dysarthria, dysphagia, visual changes, shortness of breath, chest pain, abdominal pain, joint pain, bleeding, nausea, vomiting, fevers, chills, night sweats, bowel/bladder incontinence, rash : deferred Past Medical History: Past Medical History: rheumatoid arthritis x 20 years, renal ca s/p nephrectomy, metastatic spine disease Social History: Social History: Lives with a friend and his wife. 2 ppd x 30-40 years. Recovering alcoholic. Past history of drug abuse, clean for last two years. Family History: Family History: father deceased at 63 yo of heart disease. Physical Exam: General: lying in bed NAD HEENT: NCAT, moist mucous membranes Neck: supple Pulmonary: CTA b/l Cardiac: regular rate and rhythm, with no m/r/g Carotids: no blood flow murmur Abdomen: soft, nontender, non distended, normal bowel sounds Extremities: radial deviation of MCP joints of both hands. Neurological Exam: Mental status: A & O x3, relays coherent history. Fluent speech with no paraphasic or phonemic errors. Adequate comprehension. Follows simple and multi-step commands. Repetition intact (no ifs, ands or buts). Able to name low and high frequency objects. Cranial Nerves: I: Not tested II: PERRL, 4-->2mm with light. VFF. III, IV, VI: EOMI. no nystagmus. V, VII: facial sensation intact, facial strength VIII: hearing intact b/l to finger rubbing. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: SCM [**5-19**] XII: Tongue midline without fasciculations. Motor: Normal bulk. Normal tone. No pronator drift. Delt Tri [**Hospital1 **] WE WF FE FF IP QD Ham DF PF [**Last Name (un) 938**] EDB C5 C7 C6 C8 L2 L3 L4-S1 L4 L5 L5 RT: 5 5 5 5 5 5 5 3 5 3- 4 5 4 4 LEFT: 5 5 5 5 5 5 5 4+ 5 4+ 5 5 4+ 5 Sensation: Decreased pinprick from ~ T10 to R thigh but intact to pinprick on left. Impaired proprioception large movements at the ankle, decreased vibration in toes. Reflexes: Bic T Br Pa Ac Right 2 2 2 2 2 Left 2 2 2 2 2 Toes upgoing bilaterally. Coordination: FNF intact. Gait: deferred Pertinent Results: [**2194-1-24**] 07:00AM BLOOD WBC-8.0 RBC-4.64 Hgb-11.2* Hct-34.0* MCV-73* MCH-24.2* MCHC-33.1 RDW-13.8 Plt Ct-296 [**2194-2-3**] 05:35AM BLOOD Hct-26.1* [**2194-2-1**] 08:49AM BLOOD PT-13.5* PTT-45.8* INR(PT)-1.2* [**2194-2-1**] 02:04AM BLOOD Glucose-146* UreaN-27* Creat-0.7 Na-131* K-4.5 Cl-101 HCO3-26 AnGap-9 [**2194-2-1**] 02:04AM BLOOD Calcium-7.7* Phos-2.1* Mg-1.9 CT [**2194-1-22**]: IMPRESSION: Enhancing lytic mass involving the left posterior elements of T5 with left lateral epidural extension and near complete extension into the left T4/5 foramen. Severe destructive changes of the T9 vertebral body and the T10 vertebral body with focal kyphosis measuring approximately 50 degrees. Approximately 2-cm anterior spondylolisthesis of T8 on T10. This is causing severe canal stenosis and likely compression of the cord. High-density material seen within and around the destroyed T9 vertebral body and right posterior elements with some well-circumscribed bony defects of the T9 body on the left. These findings likely represent prior corpectomy with graft material or polymethylmethacrylate placement. The lytic lesions causing the bony destructive changes at these levels likely represent metastases given the prior right nephrectomy. Differential diagnostic possibility would also include myeloma. Mild anterior wedge deformity of the T11 vertebral body. Brief Hospital Course: Pt was admitted to the hospital for increasing leg weakness and pain. He had pain management and was readied for the OR. On [**2194-1-28**] he went to Or where under general anesthesia he underwent thoracic instrumented fusion T1-12. H etolerated this procedure well, was kept intubated and transferred to ICU post op for close monitoring. He was extubated on POD#1. He required PCA pain management. He had 2 JP drains placed intraop and output was followed closely along with hematocrit. The first drain was removed [**2194-1-31**] and second [**2194-2-1**] without any difficulties. He was then transferred to the floor. Diet and activity were advanced. he pain was well controlled. His leg strength improved. He was evaluated by PT. On discharge he was noted to have some serosangous drainage from his wound no redness, fluid collection or edema. His staples should stay in an additional 7 days. Medications on Admission: Medications: Celexa 20 mg PO DAILY, Methadone 50 mg/50 mg/20 mg, Cyclobenzaprine, Dilaudid 4 mg PO DAILY. Discharge Medications: 1. Citalopram 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed. 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 4. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 6. Methadone 10 mg Tablet Sig: Two (2) Tablet PO QHS (once a day (at bedtime)). 7. Methadone 10 mg Tablet Sig: Five (5) Tablet PO Q 6 AM AND Q 6 PM (). 8. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). 9. Famotidine 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 10. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 11. Insulin Regular Human 100 unit/mL Solution Sig: One (1) Injection ASDIR (AS DIRECTED). 12. Multivitamin,Tx-Minerals Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours) as needed. 14. Dexamethasone 2 mg Tablet Sig: 0.5 Tablet PO Q8H (every 8 hours) for 2 days. 15. Dexamethasone 2 mg Tablet Sig: 0.5 Tablet PO Q12H (every 12 hours) for 2 days. 16. Dexamethasone 2 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily) for 2 days. Discharge Disposition: Extended Care Facility: [**Hospital3 1107**] [**Hospital **] Hospital - [**Location (un) 38**] Discharge Diagnosis: Renal cell carcinoma metastatic to thoracic spine Discharge Condition: Neurologically improved Discharge Instructions: DISCHARGE INSTRUCTIONS FOR SPINE CASES ?????? Do not smoke ?????? Keep wound clean / No tub baths or pools until seen in follow up/ change dressing daily / take daily showers ?????? No pulling up, lifting> 10 lbs., excessive bending or twisting for two weeks. ?????? Limit your use of stairs to 2-3 times per day ?????? Have a family member check your incision daily for signs of infection ?????? Take pain medication as instructed; you may find it best if taken in the a.m. when you wake for morning stiffness and before bed for sleeping discomfort ?????? Do not take any anti-inflammatory medications such as Motrin, Advil, aspirin, Ibuprofen etc. ?????? Increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? Clearance to drive and return to work will be addressed at your post-operative office visit CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING: ?????? Pain that is continually increasing or not relieved by pain medicine ?????? Any weakness, numbness, tingling in your extremities ?????? Any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? Fever greater than or equal to 101?????? F ?????? Any change in your bowel or bladder habits Followup Instructions: Have your staples removed at rehab on [**2194-2-12**]. PLEASE CALL [**Telephone/Fax (1) **] TO SCHEDULE AN APPOINTMENT WITH DR. [**Last Name (STitle) **] TO BE SEEN IN 6 WEEKS. YOU WILL NEED XRAYS PRIOR TO YOUR APPOINMENT Completed by:[**2194-2-5**] ICD9 Codes: 486
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Medical Text: Admission Date: [**2190-4-20**] Discharge Date: [**2190-5-6**] Date of Birth: [**2154-7-21**] Sex: M Service: Transplant HISTORY OF PRESENT ILLNESS: Mr. [**Known lastname **] is a 35-year-old male with a history of diabetes times 30 years who had an unrelated living kidney transplant two years prior and now presents for a pancreas transplant. One year prior he had received a pancreas transplant which, secondary to arterial thrombosis, had to be removed on the day of the operation. PAST MEDICAL HISTORY: (Past medical history is significant for) 1. Insulin-dependent diabetes mellitus. 2. Hypertension. 3. End-stage renal disease. 4. History of hepatitis A. 5. Seizure disorder. PAST SURGICAL HISTORY: 1. Status post renal transplant two years ago. 2. Status post pancreas transplant one year ago. 3. Status post removal of pancreas transplant. 4. Status post open kidney biopsy. MEDICATIONS ON ADMISSION: (Medications on admission included) 1. Neoral 150 mg p.o. twice per day. 2. CellCept 1 g p.o. twice per day. 3. Prednisone 10 mg p.o. once per day. 4. Dilantin 200 mg p.o. twice per day. 5. Diltiazem 240 mg p.o. once per day 6. Phenobarbital 30 mg p.o. three times per day. 7. Pepcid 20 mg p.o. once per day. 8. Lasix 40 mg to 80 mg p.o. once per day. 9. Atenolol 50 mg p.o. once per day. 10. Celexa 10 mg p.o. once per day. ALLERGIES: Allergy to CODEINE (which causes nausea and vomiting). SOCIAL HISTORY: The patient has smoked one and a half pack of cigarettes per day. The patient does not use ethanol, and denies any illicit drug use. PHYSICAL EXAMINATION ON PRESENTATION: On examination, the patient was afebrile. Vital signs were unchanged and stable. He was comfortable. Pupils were equal, round, and reactive to light. The oropharynx was clear with no lesions. The neck was supple. No lymphadenopathy or bruits. The chest was clear to auscultation bilaterally. The heart was regular. The abdomen was soft and nontender with well-healed surgical scars; one midline and one in the right lower quadrant. His extremities had no edema. Dorsalis pedis and posterior tibialis pulses were palpable. PERTINENT LABORATORY VALUES ON PRESENTATION: Laboratories on admission included a hematocrit of 39.7 and platelets of 327. INR was 0.9. Blood urea nitrogen was 28 and creatinine was 1.3. All other laboratories were within normal limits. Glucose was 158 on admission. Urinalysis was negative. PERTINENT RADIOLOGY/IMAGING: A chest x-ray showed no infiltrate or congestive heart failure. Electrocardiogram revealed a normal sinus rhythm with no ischemia. HOSPITAL COURSE: On the day of admission, the patient was taken to the operating room where he underwent a pancreas transplant. He received all of the appropriate immunosuppression and antibiotic prophylaxis prior to going to the operating room. He also received intravenous immunoglobulin 30 mg intravenously in the operating room. He tolerated the procedure well. There was 600 cc estimated blood loss and 10,000 cc of crystalloid provided. Postoperatively, he remained stable. He was transferred to the Postanesthesia Care Unit extubated. His early glucose control was excellent with blood sugars ranging from 99 to 110. He was then transferred to the floor for the remainder of his recovery. The patient's early postoperative course early on was uncomplicated. He received a steroid taper as per protocol. He began his immunosuppression and was receiving intravenous immunoglobulin per protocol. He was also maintained on intravenous heparin early postoperatively, and his glucose was under good control. On postoperative day three, the patient's hematocrit was 26 and he was transfused one units of packed red blood cells. By postoperative day seven, the patient's diet had been advanced. He was ambulating. He did complain of some mild left abdominal pain but reported flatus and had a bowel movement. Also, he continued to have good glycemic control. On postoperative day eight, he continued to have this abdominal pain. A computerized axial tomography was ordered to rule out an abscess. There was some free fluid in the pelvis, and evaluation by the Interventional Radiology Service felt they could not access this percutaneously. The patient was stated on Unasyn empirically as well. The pain continued to worsen. The patient underwent an ultrasound study of the graft which showed good arteriovenous flow. The patient then became hyperglycemic over the next 24 hours with a high of 403. The decision was made to take the patient to the operating room for a exploratory laparotomy and washout. In the operating room there was no evidence of any abscess. The graft appeared viable with no evidence of necrosis. The patient was washed out with copious amounts of antibiotic irrigation and was transferred to the Postanesthesia Care Unit in stable condition. Following this procedure, the patient remained stable. He continued to complain of some pain which was now more in the epigastric region. A computed tomography angiogram was performed of the chest to rule out a pulmonary embolus, and this was negative. The patient's diet was then slowly advanced. He continued to have occasional glucose levels that were elevated, but this was covered with subcutaneous insulin. He continued to improve. His abdominal improved. His diet was advanced. He was ambulating and was stable for discharge. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 1331**] Dictated By:[**Last Name (NamePattern1) 3835**] MEDQUIST36 D: [**2190-5-6**] 11:40 T: [**2190-5-6**] 17:42 JOB#: [**Job Number 35894**] ICD9 Codes: 5180
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Medical Text: Admission Date: [**2120-7-24**] Discharge Date: [**2120-8-2**] Date of Birth: [**2058-8-3**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2969**] Chief Complaint: recurrant adenoCA of the lung Major Surgical or Invasive Procedure: thoracotomy for right lower lobectomy History of Present Illness: Mr. [**Known lastname 7011**] is a very pleasant 61-year-old gentleman with a prior history of stage IIIB carcinoma of the left upper lobe diagnosed by Dr. [**Last Name (STitle) 20042**] in the remote past and treated with chemoradiotherapy. He was recently also diagnosed with CLL and then was found to have a second lung primary in [**2117**], treated with video-assisted local resection. This was found to be an adenocarcinoma. A followup shows increasing infiltrative appearance of the right lower lobe, prompting a bronchoscopy done earlier this month, which unfortunately confirms recurrent adenocarcinoma. The patient notes somewhat worsening dyspnea on exertion. Past Medical History: coronary artery disease, status post CABG in [**2115-11-15**]; inguinal hernia repair; some degree of obstructive lung disease; non-small cell cancer as above; and emphysema. Social History: previous smoker Family History: noncontributory Physical Exam: His weight is 156.6 pounds, pulse 52 and regular, blood pressure 103/69, and his room air saturation is 94%. HEENT: He has no scleral icterus. LYMPHATICS: There is no palpable cervical or supraclavicular adenopathy. CHEST: Breath sounds are diminished at the right base, and air entry is otherwise equivalent here. He has a well-healed sternotomy as well as VATS incisions on the right chest. HEART: Regular rhythm and rate without a murmur or gallop. EXTREMITIES: He has no peripheral cyanosis, clubbing, or edema. Pertinent Results: [**2120-8-1**] 10:30AM BLOOD WBC-27.2* RBC-3.76* Hgb-11.6* Hct-34.7* MCV-92 MCH-30.9 MCHC-33.5 RDW-15.1 Plt Ct-353 [**2120-7-30**] 07:55AM BLOOD Glucose-117* UreaN-20 Creat-0.8 Na-138 K-4.2 Cl-101 HCO3-27 AnGap-14 Brief Hospital Course: Patient was taken to the OR on [**2120-7-24**] for bronchoscopy, mediastinoscopy, and thoracotomy for RLL lobectomy. Frozen section of mediastinal LN were negative for lung CA but CLL involvement could not be ruled out. In the PACU, Neo was required to maintain blood pressure and the patient was admitted to the SICU post-op. Urine output was good, but blood pressure did not improve despite several fluid boluses. Epidural d/c'd in PACU as it was not working. Pain controlled with Dilaudid PCA. POD 2 Levofloxacin added for ?PNA on CXR. Neo still necessary to maintain BP on POD 2. Cortisol stim test was negative. Transfused 1U PRBC on POD 3 for a HCT which was steadily trending down, and again 1U PRBC on POD4. Mitodine started POD5 and Neo gtt could be stopped. Patient was transfered to floor on POD 5. Episode of rapid AFib late POD 4, controlled with metoprolol. CT #2 also d/c'd on POD5. CT #1 d/c'd POD6, post-pull CXR showed substantial PTX. New CT placed POD 6 with poor placement (along diaphragm). CT replaced on POD 7. Late POD 7, patient again in rapid AFib, did not convert with lopressor, Amiodorone started. CT water sealed POD 8 able to d/c O2. CT d/c'd on POD 9, post-pull CXR showed very small R apical PTX and R pleural effusion. Pt discharged home on POD 9 with a total of 14 days Levoquin and PO amiodorone. Medications on Admission: Altace 10mg po daily Lipitor 10mg po daily Atenolol 25 mg po daily ASA 81 mg po daily. Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3-4H (Every 3 to 4 Hours) as needed. Disp:*120 Tablet(s)* Refills:*0* 3. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 4. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day): Take 2 tablets 3 times a day until [**8-5**]. Then take 2 tablets 2 times a day until [**8-12**]. Then take 2 tables once a day until seen in clinic. Disp:*60 Tablet(s)* Refills:*1* 5. Atorvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Levofloxacin 250 mg Tablet Sig: Three (3) Tablet PO Q24H (every 24 hours) for 7 days. Disp:*21 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Bronchioalveolar carcinoma, s/p Right lower lobectomy Discharge Condition: good Discharge Instructions: Amiodorone 400mg TID until [**8-5**], 400mg [**Hospital1 **] [**Date range (1) 20043**], 400mg qday until seen in clinic. Call Dr.[**Doctor Last Name 4738**] office for: fever, shortness of breath, chest pain, drainage from incision site. You may remove the dressing Sunday morning then you may shower. No tub baths or swimming for 3-4 weeks. You may keep the chest tube sites covered with small dressings as needed. Do not remove small strips on incision site, let them fall off. No lifting more than 5 pound for 2 weeks, them as per lung surgery booklet. Restart regular medicine as previous except hold Atenolol & Altace until seen by Dr. [**Last Name (STitle) **]. Take new medication as directed for pain. No driving if taking narcotic medication. Can transition to tylenol when able Followup Instructions: Call Dr.[**Name (NI) **] office [**Telephone/Fax (1) 170**] for a follow up appointment in [**9-27**] days. You will need to arrive 45 minutes prior to your appointment and report to [**Location (un) **] [**Hospital Ward Name 23**] Clinical center radiology for a chest XRAY. ICD9 Codes: 486
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7980 }
Medical Text: Admission Date: [**2197-6-5**] Discharge Date: [**2197-6-14**] Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: Positive ETT Major Surgical or Invasive Procedure: [**2197-6-7**] Three Vessel Coronary Artery Bypass Grafting(LIMA to LAD with vein grafts to Ramus and PLV) and Aortic Valve Replacement utilizing a 23 millimeter CE pericardial tissue valve. History of Present Illness: Mr. [**Known lastname 1683**] is a pleasant 82 year old gentleman with known coronary artery disease, prior MI and PCI in the past. An ETT in [**2197-5-22**] depressions but negative for chest pain. Nuclear imaging showed a dilated LV with an ejection fraction of 24%. There was a large inferior and inferolateral fixed defect with a large reversible apical defect. Based upon the above results, he was referred for repeat cardiac catheterization. On admission, he denied chest pain, SOB, fatigue, syncope, palpitations and pedal edema. He reported one episode of dizziness which lasted only several seconds approximately one week prior to this admission. Past Medical History: Ischemic Cardiomyopathy, EF 24% CAD and AS History of MI and RCA stent [**2188**] Hyperlipidemia HTN BPH Prior Hernia repairs Social History: Married with 3 children. He denies tobacco and excessive ETOH. Family History: Denies premature CAD. Physical Exam: Vitals: BP 127/76, HR 75, RR 14, SAT 97%on room air General: well developed elderly male in no acute distress HEENT: oropharynx benign, Neck: supple, no JVD, Heart: regular rate, normal s1s2, 3/6 systolic murmur Lungs: clear bilaterally Abdomen: soft, nontender, normoactive bowel sounds Ext: warm, no edema, no varicosities Pulses: 2+ distally Neuro: alert and oriented, nonfocal Pertinent Results: [**2197-6-5**] 11:20AM BLOOD WBC-8.4 RBC-4.24* Hgb-13.0* Hct-38.1* MCV-90 MCH-30.6 MCHC-34.0 RDW-12.7 Plt Ct-234 [**2197-6-5**] 11:20AM BLOOD PT-15.5* PTT-65.0* INR(PT)-1.4* [**2197-6-5**] 11:20AM BLOOD Glucose-174* UreaN-12 Creat-0.9 Na-134 K-3.9 Cl-102 HCO3-22 AnGap-14 [**2197-6-5**] 11:20AM BLOOD ALT-14 AST-24 CK(CPK)-71 AlkPhos-61 Amylase-81 TotBili-0.8 [**2197-6-5**] 11:20AM BLOOD %HbA1c-5.9 [Hgb]-DONE [A1c]-DONE [**2197-6-13**] 07:10AM BLOOD Hct-36.9* [**2197-6-11**] 04:55AM BLOOD WBC-13.4* RBC-3.90*# Hgb-11.9* Hct-34.0* MCV-87 MCH-30.6 MCHC-35.1* RDW-14.4 Plt Ct-108*# [**2197-6-13**] 07:10AM BLOOD UreaN-23* Creat-1.3* K-3.9 [**2197-6-11**] 04:55AM BLOOD Glucose-104 UreaN-21* Creat-1.0 Na-133 K-3.7 Cl-95* HCO3-26 AnGap-16 [**2197-6-10**] 08:53AM BLOOD HEPARIN DEPENDENT ANTIBODIES- negative Brief Hospital Course: Mr. [**Known lastname 1683**] was admitted and underwent cardiac catheterization which was significant for severe three vessel coronary artery, including left main disease, and severe ischemic cardiomyopathy. Coronary angiography demonstrated a right dominant system with an 80% left main lesion; 60% mid LAD stenosis; diffuse diagonal disease; 85% lesion in the first OM; and 95% PLV stenosis. The RCA stents were widely patent. Left ventriculography showed an LVEF of 25% and no mitral regurgitation. Angiography was also notable for a self limited retrograde dissection of the commom iliac artery which required no intervention. Based on the above results, cardiac surgery was consulted for surgical revascularization and further evaluation was performed. An echocardiogram showed moderate to severe aortic stenosis with [**First Name8 (NamePattern2) **] [**Location (un) 109**] of 0.7cm2 with peak and mean gradients of 35 and 19 mmHg respectively. The LVEF was estimated between 35-40%. A carotid ultrasound demonstrated minimal disease of both internal carotid arteries. The rest of his preoperative hospital course was unremarkable except for occasional runs of asymptomatic NSVT. He remained pain free on medical therapy. On [**6-7**], Dr. [**Last Name (STitle) **] performed three vessel coronary artery bypass grafting and a pericardial aortic valve replacement. Following the operation, he was brought to the CSRU for invasive monitoring. Within 24 hours, he awoke neurologically intact and was extubated. Initially hypoxic, required steady diuresis. He maintained stable hemodynamics and was gradually weaned from inotropic support. He was intermittently transfused with PRBC to keep hematocrit near 30%. Amiodarone was initially utilized to prevent atrial arrhythmias. His CSRU course was otherwise uneventful and he transferred to the SDU on postoperative day three. His platelet count dropped as low as 70K. HIT assays were checked and negative for heparin PF4 antibodies. Throughout his hospital stay, he remained thrombocytopenic but his platelet count did improve prior to discharge. He experienced some urinary retention for which he was started on Flomax. Prior to discharge, his foley was *****. His postoperative course was otherwise uneventful. He continued to maintain stable hemodynamics and remained in a normal sinus rhythm. Given no occurence of atrial arrhythmias, Amiodarone was eventually discontinued. Given his depressed LV function, he was maintained on Coreg, Captopril and diuretics. He tolerated medical therapy. Due to continued clinical improvements, he was cleared for discharge on postoperative day 7. He had a 400cc residual and had a foley catheter placed prior to d/c. He will follow up with Dr. [**Last Name (STitle) 770**] of urology in 1 week for foley removal. Medications on Admission: Zocor 40qd, Captopril 25 qd, Terazosin 5 qd, Aspirin 325 qd, MVI, Vit E, Vit C Discharge Medications: 1. Terazosin 5 mg Capsule Sig: One (1) Capsule PO HS (at bedtime). Disp:*30 Capsule(s)* Refills:*2* 2. Tamsulosin 0.4 mg Capsule, Sust. Release 24HR Sig: One (1) Capsule, Sust. Release 24HR PO HS (at bedtime). Disp:*30 Capsule, Sust. Release 24HR(s)* Refills:*2* 3. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 4. Multivitamin Capsule Sig: One (1) Cap PO DAILY (Daily). Disp:*60 Cap(s)* Refills:*2* 5. Vitamin E 400 unit Capsule Sig: One (1) Capsule PO DAILY (Daily). Disp:*60 Capsule(s)* Refills:*2* 6. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 7. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 8. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO every 6-8 hours as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 9. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*100 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 10. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation [**Hospital1 **] (2 times a day). Disp:*1 MDI* Refills:*2* 11. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation QID (4 times a day). Disp:*1 MDI* Refills:*2* 12. Carvedilol 3.125 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 13. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 14. Furosemide 40 mg Tablet Sig: One (1) Tablet PO once a day for 14 days. Disp:*14 Tablet(s)* Refills:*0* 15. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO once a day for 14 days. Disp:*14 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital1 1474**] VNA Discharge Diagnosis: CAD and AS - s/p CABG and AVR History of MI and RCA stent [**2188**] Hyperlipidemia HTN BPH Right Iliac Dissection Prior Hernia repairs NSVT Urinary Retention Thrombocytopenia Discharge Condition: Good Discharge Instructions: Patient may shower, no baths. No creams, lotions or ointments to incisions. No driving for at least one month. No lifting more than 10 lbs for at least 10 weeks from the date of surgery. Monitor wounds for signs of infection. Please call with any concerns or questions. Followup Instructions: Dr. [**Last Name (STitle) **], cardiac surgeon in [**4-26**] weeks Dr. [**Last Name (STitle) 6700**], PCP [**Last Name (NamePattern4) **] [**2-24**] weeks Dr. [**Last Name (STitle) **], cardiologist in [**2-24**] weeks [**Hospital Ward Name 121**] 2 in 2 weeks for wound check Completed by:[**2197-6-14**] ICD9 Codes: 4241, 2875, 2724, 4019, 412
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7981 }
Medical Text: Admission Date: [**2101-2-25**] Discharge Date: [**2101-3-4**] Date of Birth: [**2045-11-1**] Sex: F Service: MEDICINE Allergies: Latex Exam Gloves Attending:[**First Name3 (LF) 1974**] Chief Complaint: Hyperglycemia, back pain Major Surgical or Invasive Procedure: none. History of Present Illness: Ms. [**Known lastname **] is a 55 yo F w/PMHx sx for autoimmune hepatitis on chronic prednisone, IDDM, CAD, seizure d/o, hypertension, asthma, hx RCC, and ET who presents with hyperglycemia. . Patient recently admitted to [**Hospital1 18**] from [**Date range (1) 65044**] with URI and asthma exacerbation and received nebulizers and steroids. Her fingersticks during that admission were in the 200-300s. She had multiple episodes of chest pain while hospitalized, with negative workup for ischemia, with episodes relieved by oxycodone. She improved her peak flows to 300 and was subsequently discharged. At home, patient fell on her back [**2-11**] dizziness thought to be from diarrhea and vomiting, with assoc subjective fevers and chills. SHe was then seen at [**Hospital1 65045**] in [**Location (un) 260**] MA where she was admitted from [**Date range (1) 65046**], and given the diagnosis of an L1 compression fracture. She was taken off her prednisone during this admission per her report, and was sent home without pain medications. Today, she presented to [**Company 191**] complaining of [**10-19**] lower back pain. Patient was also sent home on 65u lantus qhs, decreased from her baseline of 100u qhs. Patient's BS at home have ranged from 300s-500s. She also notes urinary incontinence, which is her baseline from her early 40s, but denies stool incontinence. She also notes numbness, tingling and weakness of her legs. She states that her back pain is relieved only by muscle relaxants and narcotics. Pt also notes polyuria, polydipsia, and extreme thirst. She also notes dizziness on standing. She denies dysuria. She does admit to diffuse abdominal pain, occasional difficulty breathing. She denies chest pain. Pt's baseline BS per her report are in the 200s. . In the ED patient was found to have blood sugars in the 400s. Patient was also found to have an anion gap of 15, with trace ketones in the urine. Patient's EKG showed old ST depressions in V1-V3 with TWI< unchanged from prior. Her UA was negative for infection. Her CXR was unremarkable as well. She was admitted for management of her blood sugars. . ROS: Positive for polyuria, polydipsia, abd pain, fevers, chills, thirst, shortness of breath, abdominal pain, urinary frequency. Negative for headache and dysuria, or fecal incontinence. Past Medical History: 1. Autoimmune hepatitis diagnosed in [**2098**], cirrhosis diagnosed in [**4-/2099**]: h/o encephalopathy, ascites, jaundice 2. DM 3. Asthma 4. Coronary artery disease s/p MI [**2097**] 5. Epilepsy [**2-11**] to being hit by a car at age 5. Was on phenobarb and dilantin for most of life, but self d/c'd these meds approx. 7 years ago and has been seizure free since then. 6. HTN 7. Renal cell cancer 8. Psoriasis 9. s/p cholecystectomy in [**2099**] 10. s/p hysterectomy and b/l oophorectomy 11. Right ankle surgery. 12. Depression 13. Anxiety 14. Recurrent UTIs 15. Thrombocytosis Social History: Lives in [**Location 260**], Mass. alone. Recently moved back to area from [**State 33977**] 9/[**2099**]. 3 children live locally. Denies EtOH or other illicit drug use. Has extensive tobacco hx, approx. 60-70pack year, but quit several years ago. Not currently working as she is on disability [**2-11**] to her health. Her son works as her HHA (she pays him) Family History: Mother deceased, SLE. . Father deceased, gastric ca. Physical Exam: Vitals: T 98.3 BP 138/70 HR 69 RR 20 96RA GEn: well-appearing, NAD HEENT: OP clear Neck: supple Lung: CTA bilaterally Cor: RRR, nml S1S2 Abd: obese, diffusely tender, no rebound or guarding Ext: no edema, decreased sensation Pertinent Results: [**2101-2-25**] 06:50PM WBC-10.5 RBC-4.42 HGB-14.5 HCT-42.5 MCV-96 MCH-32.8* MCHC-34.1 RDW-15.4 [**2101-2-25**] 06:50PM NEUTS-83.6* BANDS-0 LYMPHS-11.0* MONOS-3.2 EOS-0.1 BASOS-2.1* [**2101-2-25**] 06:50PM PLT SMR-VERY HIGH PLT COUNT-808* [**2101-2-25**] 06:50PM GLUCOSE-446* UREA N-37* CREAT-0.9 SODIUM-135 POTASSIUM-5.6* CHLORIDE-101 TOTAL CO2-19* [**2101-2-25**] 06:50PM ALT(SGPT)-32 AST(SGOT)-30 LD(LDH)-354* CK(CPK)-20* ALK PHOS-52 TOT BILI-0.6 [**2101-2-25**] 06:50PM CK-MB-NotDone cTropnT-<0.01 [**Month/Day/Year 4338**] L-spine: L1 compression fracture with mild retropulsion of bone fragments posteriorly resulting in moderate spinal canal narrowing. There is also an epidural hematoma, which travels inferiorly from this level and terminates posterior to L2. There is no further spinal canal narrowing due to this epidural hematoma. CT C-spine: 1. No cervical spine fracture or malalignment. 2. Very mild degenerative changes as noted above. 3. Atherosclerotic calcification at the right carotid artery bifurcation. T/L- spine xray: Anterior wedge compression fracture of the L1 vertebral body, grossly unchanged in appearance compared to the CT scan of two days prior Brief Hospital Course: 1) Hyperglycemia: Patient with blood sugars in the 400-500s initially, with anion gap metabolic acidosis. Patient with type 2 DM, so unlikely to be DKA, but does have evidence of ketones in urine, likely [**2-11**] starvation. Blood sugars not as elevated as would be expected in HHNS, and no signs of renal failure or severe dehydration. Likely etiology of hyperglycemia is insulin deficiency from change in insulin regimen at OSH. BS on arrival normalized to 200s. No clear infection. She was initially placed on insulin gtt and then transitioned to lantus and humalog with SS. On this regimen, her blood sugars were improved in 100-200s though not perfectly controlled. . 2) Altered mental status: Likely due to hyperglycemia. REsolved. . 3) Low back pain: Patient diagnosed with L1 fracture at OSH, no records here. Likely [**2-11**] compression fracture from chronic steroid use. Due to question of weakness on exam, [**Month/Day (2) 4338**] L-spine obtained which showed L1 fracture with retropulsion of fragments into spinal canal and hematoma. Neurosurgery was consulted and recommended conservative management given many comorbities. She was placed in a TLSO brace which she needs to have on any time her head is greater than 30 degreess or upright. . 4) Autoimmune hepatitis: LFTs stable. Continued on prednisone and imuran. . 5) Asthma. Continue Montelukast, combivent. . 6) Hx seizures.: Continued on keppra. . 7) HTN. -continued propanolol, aldactone. . 8) CAD: Stable, continued on outpt regimen. Medications on Admission: Keppra 750 mg [**Hospital1 **] Singulair 10 mg qd Imuran 100 mg qAM Lexapro 20 mg qd Omeprazole 40 mg qd Montelukast 10 mg qd Novolog 20/30/30 Lantus 100 qhs Propranolol 40 mg [**Hospital1 **] Aldactone 25 mg [**Hospital1 **] Oxycodone prn Prednisone 20 mg qd Discharge Medications: 1. Heparin (Porcine) 5,000 unit/mL Solution Sig: 5000 (5000) units Injection TID (3 times a day). 2. Levetiracetam 500 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). 3. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Azathioprine 50 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 5. Escitalopram 10 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 6. Omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 7. Propranolol 40 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Spironolactone 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Prednisone 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Oxycodone 40 mg Tablet Sustained Release 12HR Sig: One (1) Tablet Sustained Release 12HR PO Q12H (every 12 hours). 11. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 12. Sodium Chloride 0.65 % Aerosol, Spray Sig: [**1-11**] Sprays Nasal QID (4 times a day) as needed. 13. Cyclobenzaprine 10 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) as needed for pain. 14. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 15. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 16. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 17. Lactulose 10 g/15 mL Syrup Sig: Thirty (30) ML PO TID (3 times a day). 18. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 19. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID (2 times a day). 20. Albuterol-Ipratropium 103-18 mcg/Actuation Aerosol Sig: [**1-11**] Puffs Inhalation Q6H (every 6 hours). 21. Lantus 100 unit/mL Solution Sig: One Hundred Four (104) units Subcutaneous at bedtime. 22. Humalog 100 unit/mL Solution Sig: Twenty Two (22) units Subcutaneous before breakfast. 23. Humalog 100 unit/mL Solution Sig: Thirty Two (32) units Subcutaneous before lunch, dinner. 24. Humalog 100 unit/mL Solution Sig: per sliding scale units Subcutaneous QACHS. 25. Cepacol 5.4 mg Lozenge Sig: One (1) loz Mucous membrane four times a day as needed for cough for 1 weeks. 26. Robitussin-DM 10-100 mg/5 mL Syrup Sig: One (1) teaspoon PO four times a day as needed for cough for 1 weeks. Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: L1 Vertebral fracture Hyperglycemia Diabetes, type 2 uncontrolled Autoimmune hepatitis. Discharge Condition: Good. Discharge Instructions: Take medications as prescribed. You need the TLSO brace on anytime the head of bed is greater than 30 degrees or you are out of bed. Please call Dr. [**Last Name (STitle) **] with any fevers, worsening back pain, new weakness or numbness. Followup Instructions: Please call Dr. [**Last Name (STitle) **] (neurosurgery) at ([**Telephone/Fax (1) 88**] to see when you have an appointment set up. His office is already instructed to set up an appointment in [**4-15**] weeks and you will need an xray of the spine at that time, but you should call to find out the date. Please follow up with Dr. [**Last Name (STitle) **] once you leave rehab. Provider: [**Name10 (NameIs) **] [**Last Name (NamePattern4) 2424**], MD Phone:[**Telephone/Fax (1) 2422**] Date/Time:[**2101-3-10**] 11:30 Provider: [**Name10 (NameIs) **] [**Name8 (MD) 8222**], MD Phone:[**Telephone/Fax (1) 3294**] Date/Time:[**2101-3-14**] 10:00 ICD9 Codes: 5715, 4019, 412
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7982 }
Medical Text: Admission Date: [**2176-11-26**] Discharge Date: [**2176-12-3**] Date of Birth: [**2126-1-28**] Sex: M Service: SURGERY Allergies: Lactose Attending:[**First Name3 (LF) 598**] Chief Complaint: S/P MVC abdominal pain Major Surgical or Invasive Procedure: [**2176-11-26**] 1. Diagnostic laparoscopy. 2. Exploratory laparotomy. 3. Control of liver hemorrhage. 4. Ileocecectomy with primary ileocolic anastomosis. History of Present Illness: Mr. [**Known lastname **] is a 50 year old male who was the restrained passenger in an MVC today. He has a history of Down's syndrome and was agitated and grabbed the driver of a [**Doctor Last Name **] resulting in a motor vehicle collision. He was brought to [**Location (un) 620**] where he was noted to be hypotensive and complaining of abdominal pain. FAST was negative. Non-contrast CT scans of the head, C-spine, and torso revealed only a small amount of fluid in the right paracolic gutter. He was transferred to [**Hospital 61**] for further evaluation. Currently he reports some abdominal pain. I spoke with the manager of his group home who reports that he has been feeling well lately and has had no other complaints. Of note, he was given IV antibiotics at [**Location (un) 620**] to cover for a possible infectious source as a cause of his agitation and hypotension. He also received 3 L of IV fluid there. Blood pressure was in the 60s to 70s for EMS. Past Medical History: Down's syndrome hypercholesterolemia hypothyroidism pernicious anemia intermittent explosive disorder senile dementia heart murmur requiring antibiotic ppx prior to dental procedures Social History: He lives in a group home ([**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]). No etoh or tobacco. Family History: Unknown. Physical Exam: Temp:97.3 HR:52 BP:79/40 Resp:20 O(2)Sat:100 Constitutional: Awake and alert HEENT: Has some facial bruising, Pupils equal, round and reactive to light, Extraocular muscles intact Oropharynx within normal limits Chest: Clear to auscultation Cardiovascular: Regular Rate and Rhythm Abdominal: Soft. Left flank ecchymoses. Diffuse mild tenderness to palpation without rebound or Pelvic: Normal tone no gross blood. Pelvis is stable Extr/Back: No TLS tenderness to palpation Neuro: Awake and alert. Moves all extremities. No focal deficit. Sensation intact. Follows commands Pertinent Results: [**2176-11-26**] 01:10PM WBC-7.0# RBC-3.06* HGB-10.8*# HCT-32.4* MCV-106* MCH-35.2* MCHC-33.2 RDW-13.4 [**2176-11-26**] 01:10PM NEUTS-88.5* LYMPHS-8.4* MONOS-2.4 EOS-0.2 BASOS-0.4 [**2176-11-26**] 01:10PM PLT COUNT-231 [**2176-11-26**] 01:10PM PT-13.7* PTT-22.7 INR(PT)-1.2* [**2176-11-26**] 01:10PM ALT(SGPT)-49* AST(SGOT)-63* CK(CPK)-186 ALK PHOS-116 TOT BILI-0.3 [**2176-11-26**] 01:10PM LIPASE-29 [**2176-11-26**] 01:10PM GLUCOSE-95 UREA N-17 CREAT-0.9 SODIUM-142 POTASSIUM-3.8 CHLORIDE-111* TOTAL CO2-22 ANION GAP-13 COMPLETE BLOOD COUNT WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2176-12-3**] 06:35 3.4* 3.54* 10.9* 32.2* 91 30.7 33.7 20.2* 151 DIFFERENTIAL Neuts Bands Lymphs Monos Eos Baso Atyps Metas [**2176-11-26**] 13:10 88.5* 8.4* 2.4 0.2 0.4 BASIC COAGULATION (PT, PTT, PLT, INR) PT PTT Plt Ct INR(PT) [**2176-12-3**] 06:35 151 BASIC COAGULATION (FIBRINOGEN, DD, TT, REPTILASE, BT) Fibrino [**2176-11-27**] 00:49 184 Source: Line-aline LAB USE ONLY [**2176-12-3**] 06:35 Chemistry RENAL & GLUCOSE Glucose UreaN Creat Na K Cl HCO3 AnGap [**2176-12-3**] 06:35 113*1 12 0.7 137 3.0* 102 30 8 [**2176-11-26**] CT Abd : 1. Focal ileocolic stranding and focal cecal wall thickening suggestive of mesenteric hematoma and focal bowel wall contusion, respectively. Trace amount of hemoperitoneum. 2. Acute fractures of the right posterior ribs 10 and 11. 3. Bilateral dependent consolidations and ground-glass opacities, likely atelectasis, although superimposed aspiration not excluded. 4. No other traumatic injury to the torso. [**2176-11-26**] TTE : Suboptimal image quality. Normal biventricular cavity sizes with preserved global and regional biventricular systolic function. No pericardial effusion. Mild-moderate tricuspid regurgitation [**2176-11-27**] MRI C spine : 1. There is no evidence of ligamentous disruption identified or prevertebral soft tissue abnormality seen. No evidence of intraspinal hematoma, cord compression, or abnormal signal within the spinal cord. 2. Degenerative changes at the atlanto-odontoid joint and the remaining cervical spine as described above. Brief Hospital Course: Mr. [**Known lastname **] was evaluated by the Trauma team in the Emergency Room and taken to the Operating Room emergently for a diagnostic laparotomy followed by exploratory laparotomy ( see formal Op note for details). He tolerated the procedure relatively well and returned to the Trauma ICU in stable condition with a stable hematocrit following transfusion of 3 units of packed red blood cells. Post op in the ICU he had persistent problems with hypotension despite adequate resuscitation and eventually was treated with steroids for adrenal insufficiency which immediately normalized his blood pressure and his pressors were weaned off. He was weaned and extubated from the respirator on post op day 2 and was able to deep breath and cough without difficulty thereafter. Following transfer to the Surgical floor he continued to make steady progress. His surgical wound was healing well without evidence of erythema or drainage and he was gradually tolerating a regular diet after his bowel function resumed. He did require 2 more blood transfusions as his hematocrit drifted down on [**2176-12-1**] without evidence of active bleeding. Prior to discharge his hematocrit was 32. His steroids were tapered off ending on [**2176-12-3**] and his blood pressure ranged between 100-110/70. [**Known firstname **] was also evaluated by the Physical Therapy service and they recommended a short term rehab prior to his return home in order to improve his gait and activity tolerance. After a relatively uncomplicated stay he was discharged to rehab on [**2176-12-3**]. Medications on Admission: Gemfibrozil 600 mg [**Hospital1 **] Hydrocortisone 2.5% ointment topically as directed Lactaid 4500 units daily Levothyroxine 88 mcg daily MVI 1 tab daily Neurontin 400 mg TID Peridex 0.12% as directed [**Hospital1 **] Robitussin DN 2 tsp QID prn TUMS 500 mg [**Hospital1 **] Discharge Medications: 1. heparin (porcine) 5,000 unit/mL Solution Sig: 5000 (5000) units Injection TID (3 times a day). 2. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 3. gabapentin 400 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 4. gemfibrozil 600 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. levothyroxine 88 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day. 7. multivitamin Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital3 1107**] [**Hospital **] Hospital - [**Location (un) 38**] Discharge Diagnosis: 1. Avulsion of small bowel mesentery. 2. Injury to cecum. 3. Liver laceration. 4. Acute blood loss anemia 5. Adrenal insufficiency Discharge Condition: Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Mental Status: Clear and coherent at baseline Discharge Instructions: * You were admitted to the hopsital with internal injuries to your abdomen following your car accident which required an operation. Please call your doctor or nurse practitioner or return to the Emergency Department for any of the following: *You experience new chest pain, pressure, squeezing or tightness. *New or worsening cough, shortness of breath, or wheeze. *If you are vomiting and cannot keep down fluids or your medications. *You are getting dehydrated due to continued vomiting, diarrhea, or other reasons. Signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *You see blood or dark/black material when you vomit or have a bowel movement. *You experience burning when you urinate, have blood in your urine, or experience a discharge. *Your pain in not improving within 8-12 hours or is not gone within 24 hours. Call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *You have shaking chills, or fever greater than 101.5 degrees Fahrenheit or 38 degrees Celsius. *Any change in your symptoms, or any new symptoms that concern you. Please resume all regular home medications , unless specifically advised not to take a particular medication. Also, please take any new medications as prescribed. Please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. Avoid lifting weights greater than [**6-10**] lbs until you follow-up with your surgeon. Incision Care: *Please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *Avoid baths until your follow-up appointment. *You may shower, and wash surgical incisions with a mild soap and warm water. Gently pat the area dry. *If you have staples, they will be removed at your follow-up appointment. Followup Instructions: Call the Acute Care Clinic at [**Telephone/Fax (1) 600**] for a follow up appointment in [**3-6**] weeks. Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1239**], [**Name Initial (NameIs) **].O. Phone:[**Telephone/Fax (1) 719**] Date/Time:[**2176-12-13**] 1:00 [**First Name8 (NamePattern2) **] [**Name8 (MD) **] MD [**MD Number(2) 601**] Completed by:[**2176-12-3**] ICD9 Codes: 2851, 2762, 2449, 2720
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Medical Text: Admission Date: [**2113-3-23**] Discharge Date: [**2113-3-27**] Date of Birth: [**2043-2-2**] Sex: F Service: NEUROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 57490**] Chief Complaint: cyanosis, apnea Major Surgical or Invasive Procedure: EEG [**2113-3-24**] CT head [**2113-3-23**] MRI/MRA head and neck [**2113-3-24**] History of Present Illness: This is a 70 year old woman with a history of frontotemporal dementia who was well until today at about 12 noon when her granddaughter heard her choking and coughing. She ran into the bedroom where the patient had been sleeping. She apparently was leaning over to her right side, frothing at the mouth with her jaw clenched. She looked blue in the face. Her eyes were open and she was staring straight ahead evidently. Her granddaughter tried the [**Name (NI) **] maneuver because she thought she was choking. Her body appeared limp throughout. It is not clear if she had tongue biting. She is always incontinent of urine and stool and was in a diaper this morning. It doesn't appear that she had tonic- clonic movements. Unfortunately I do not have her EMS notes so I do not know what her oxygenation level was. Apparently intubation was tried in the field but failed because her jaw was unable to be opened. She was brought to the ED where she was successfully intubated. She was placed on propofol drip. She has never had seizures before. Past Medical History: hypertension, hypercholesterolemia, multiple lacunar strokes including pontine, frontotemporal dementia, hyperthyroidism Social History: has 7 children, one was just deceased. She is cared for by her children and grandchildren. Family History: father had a question of [**Name (NI) 2481**] Physical Exam: General appearance: well appearing intubated Heart: regular rate and rhythm without murmurs, rubs or gallops Lungs: clear to auscultation bilaterally. Abdomen: soft, NT Extremities: no clubbing, cyanosis or edema Skull & Spine: Neck is supple Mental Status: She follows midline and simple appendicular commands (squeeze hand, close eyes). There is no verbal output. Cranial Nerves: EOMs appear intact to horizontal movements spontaneously. Pupils are slightly reactive 3 to 2.5mm bilaterally. fundi difficult to visualize well due to lack of cooperation. No obvious facial droop. Grimace is symmetric. Cough and gag is intact. Motor System: She moves all extremities spontaneously. There is a rhythmic flexion of the hip which seems voluntary. Her family states that this is baseline. Reflexes: Brisk in the upper extremities, normal at patellae and reduced at achilles. The plantars are mute bilaterally. Sensory: withdraws to noxious stimuli Pertinent Results: [**2113-3-23**] 02:57PM ALT(SGPT)-114* AST(SGOT)-170* LD(LDH)-820* CK(CPK)-124 ALK PHOS-101 AMYLASE-80 TOT BILI-0.4 [**2113-3-23**] 02:57PM LIPASE-33 [**2113-3-23**] 02:57PM cTropnT-<0.01 [**2113-3-23**] 02:57PM ALBUMIN-3.4 CALCIUM-8.4 PHOSPHATE-6.3*# MAGNESIUM-2.0 [**2113-3-23**] 02:57PM WBC-13.5*# RBC-4.92 HGB-13.3 HCT-42.1 MCV-86 MCH-26.9* MCHC-31.5 RDW-13.0 [**2113-3-23**] 02:57PM NEUTS-48.5* LYMPHS-45.9* MONOS-3.5 EOS-1.6 BASOS-0.5 [**2113-3-23**] 02:57PM HYPOCHROM-2+ [**2113-3-23**] 02:57PM PLT COUNT-435# [**2113-3-23**] 02:57PM PT-14.3* PTT-23.9 INR(PT)-1.3 EEG: FINDINGS: ABNORMALITY #1: Occasional low amplitude, sharp waves are seen across the right central parietal and parietal occipital regions. Occasional delta with mixed theta frequency slowing was also seen both synchronously and independently over the posterior quandrants. ABNORMALITY #2: The background rhythm is disorganized and slowed in the [**5-6**] Hz theta frequency range with intermittent generalized delta frequency slowing. BACKGROUND: As above. At times the background rhythm does reach an 8 Hz alpha frequency rhythm but this is not sustained. HYPERVENTILATION: Was not performed due to the patient's clinical condition. INTERMITTENT PHOTIC STIMULATION: Was not performed because this was a portable study. SLEEP: There are transitions in the record to suggest increased arousal, otherwise, normal transitions of the sleep architecture were not seen. CARDIAC MONITOR: Normal sinus rhythm with a rate of 72 bpm. IMPRESSION: This is an abnormal portable EEG due to presence of occasional sharp waves seen over the right anterior quandrant with intermittent slowing seen both synchronously and independently over the posterior quandrant. The presence of sharp waves in the right anterior quandrant suggest cortial dysfunction in this region and may predispose to an increased risk for seizures. The bilateral posterior quandrant, intermittent slowing suggests subcortical dysfunction in these regions. The background rhythm was also noted to be slowed and disorganized with occasional generalized slowing suggesting deep, midline subcortial dysfunction. These findings could reflect and early encephalopathy or excessive drowsiness. No clear seizure activity was identified during this recording. OBJECT: 70 YEAR OLD WOMAN WITH A HISTORY OF DEMENTIA FOUND UNRESPONSIVE. EVALUATE FOR SEIZURES. CT head: FINDINGS: Comparison with the prior head CT scan of [**2111-8-12**] re- demonstrates moderate cerebral atrophy, most evident in both frontal lobes. There is a moderate degree of low density within the periventricular white matter adjacent to both frontal horns, once again compatible with chronic small vessel ischemic changes. There is no new intracranial hemorrhage, mass effect, or shift of normally midline structures. There is a small amount of fluid seen within the left frontal air cell, right maxillary sinus, and sphenoid sinus, with more prominent quantity of fluid within the left maxillary sinus. These abnormalities could relate to the patient's intubated status. CONCLUSION: No acute intracranial pathology. MRI/MRA head and neck: Comparison was made with the previous MRI of [**2111-3-4**]. Again, bilateral frontal and temporal atrophy is identified, which has progressed since the previous MRI study. Hyperintense T2 signal predominantly in the frontal region is also again seen. There is no midline shift, mass effect, or hydrocephalus. On diffusion images, no evidence of acute infarct is seen. There are chronic lacunae visualized in the pons. No blood products seen on the susceptibility images. Fluid levels are visualized in both maxillary, sphenoid, and ethmoid sinuses. IMPRESSION: No evidence of acute infarct. Bifrontal and temporal atrophy, which has increased since the previous MRI study of [**2111-3-4**]. Subcortical white matter changes predominantly in the frontal region as before. MRA OF THE HEAD: The head MRA demonstrates normal flow signal within the arteries of anterior and posterior circulation. The right posterior cerebral artery is fetal in origin, a normal variation. IMPRESSION: Normal MRA of the head. Brief Hospital Course: Pt intubated in ED for airway protection and concerns for seizure versus stroke. CT and MRI ruled out any acute infract but was noteable for known fronto-temporal atrophy consistent with her dementia. She had an EEG which did not show any evidence of electrographic seizures. Laboratory workup revealed no evidence of metabolic or toxic cause for her event. She was quickly extubated and transferred to the floor where she remained stable and quickly to baseline functioning per her family. There was some ongoing concern for her ability to take PO's which has been followed closely by her PMD, Dr. [**First Name (STitle) **]. As well, there was also a question of airway obstruction during sleep (OSA) and the family agreed a sleep study would be informative at a later date (to be scheduled by Dr.[**Name (NI) 14065**] office). Pt was discharged in stable condition with plans to follow-up with Dr. [**First Name (STitle) **] in [**1-1**] weeks and with a home nurse visit the day after discharge. No adjustments to her medications were made. The final thought on the etiology of Ms [**Known lastname 103015**] event was that she had an acute episode of choking/airway obstruction. Medications on Admission: 1. Plavix 75mg daily 2. Risperdal 3.75mg daily 3. Metformin XR 500mg daily 4. Methimazole 5mg daily 5. Fluvoxamine 50mg in the morning and 100mg daily 6. Toprol XL 7. Lorazepam 0.5mg three times daily 8. Benadryl three times daily for hives 9. multivitamins 10. calclium 11. vitamin E 12. vitamin B12 13. Magnesium 14. pureed diet and thickened liquids Discharge Medications: -Metoprolol Succinate 100 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO daily (). -Methimazole 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). -Clopidogrel Bisulfate 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). -Metformin HCl 500 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). -Fluvoxamine Maleate 50 mg Tablet Sig: One (1) Tablet PO QAM (once a day (in the morning)). -Fluvoxamine Maleate 100 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). -Risperidone Oral -Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). -Lorazepam 0.5 mg Tablet Sig: 0.5 Tablet PO Q NOON (). Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: choking episode Discharge Condition: stable Discharge Instructions: Take all medications as prescribed. Follow-up with all appointments as recommended (please call Dr. [**Name (NI) 58830**] office ofr a follow-up appointment within 1-2 weeks). Followup Instructions: Please call Dr.[**Name (NI) 14065**] office for a follow-up appointment in [**1-1**] weeks. Completed by:[**2113-3-26**] ICD9 Codes: 4019, 2720
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Medical Text: Admission Date: [**2180-5-16**] Discharge Date: [**2180-5-22**] Service: CCU CHIEF COMPLAINT: Transferred for anterior myocardial infarction. HISTORY OF PRESENT ILLNESS: Mrs. [**Known firstname 47987**] is an 82-year-old woman who presented to [**Hospital3 1280**] Hospital on the morning of admission with chest pain. She said the chest pain began approximately 12 hours earlier, was substernal, and somewhere the anginal chest pain that she has been experiencing the past few days to weeks. The pain was different in that it occurred. Pain was different the evening the prior to admission, it was nonexertional and did not subside. Electrocardiograms at [**Hospital3 1280**] demonstrated ST elevations in V2 through V6, and T-wave inversions. She also has Q waves in II, III, and F, which likely represent old ischemia. The patient received IV nitrogen, Heparin, Plavix, and Integrilin, and was transferred to [**Hospital1 190**] for catheterization. Catheterization demonstrated discrete left anterior descending artery total occlusion. She had a Cypher stent placed with subsequent TIMI-III flow. Her hemodynamics were consistent with cardiogenic shock with pulmonary capillary wedge of 34, cardiac output of 3.32 and cardiac index of 2.02. Subsequent flow in her artery was evaluated at TIMI-II. Intra-aortic balloon pump was placed. The patient was transferred to the CCU. PAST MEDICAL HISTORY: 1. Hypertension. 2. Congestive heart failure. 3. Coronary artery disease. 4. Hypothyroidism. 5. Status post left hip fracture and open reduction internal fixation. Right hip with congenital deformity. 6. Osteoarthritis. 7. Hiatal hernia, large retrocardiac. 8. Gastroesophageal reflux disease. 9. Depression. OUTPATIENT MEDICATIONS: 1. Lasix 40 po q day. 2. Atenolol 25 po bid. 3. Lisinopril 10 mg po q day. 4. Synthroid 0.088 mg po q day. 5. Detrol LA 40 mg po q day. 6. Celexa 20 mg po q day. 7. Mellaril 25 mg po q hs. 8. Protonix 40 mg po q day. 9. Trazodone 25 mg po prn. FAMILY HISTORY: No coronary artery disease. SOCIAL HISTORY: Lives in Catholic Convent since the age of 23. No tobacco. PHYSICAL EXAMINATION: Temperature is 98.0, pulse 91-101, blood pressure 91/59, augmented diastolic 123, assisted systolic 106, respiratory rate 18, and O2 saturation 97%. P.A. pressure 31/21 with a mean of 25. General: Pleasant, awake, elderly woman in no acute distress. HEENT: Pupils are equal, round, and reactive to light. Extraocular movements are intact. Moist mucous membranes. Neck supple, obese. Cardiovascular: Regular, rate, and rhythm, no murmur. Pulmonary: Crackles on the left dependent side to 50%, and at the right base. Abdomen is soft, nontender, nondistended. Extremities warm, no edema, 1+ DPP bilaterally. Neurologic is alert, oriented, and appropriate. LABORATORIES: White count 12.5, hematocrit 37.2, platelets 303. Sodium 136, potassium 3.3, chloride 101, bicarb 24, BUN 13, creatinine 0.5, glucose 118, calcium 8.5, magnesium 1.8, phosphorus 4.0, albumin 3.3. CK peak of 3.925, decreased to 207 on [**5-20**]. HOSPITAL COURSE: Sister [**Name (NI) 47987**] was admitted to the Cardiac Care Unit for further management poststent given her cardiogenic shock. Hemodynamics: The patient was maintained on the intra-aortic balloon pump for 48 hours. Fluid was initially maintained as even. She subsequently underwent diuresis with her goal dry weight approximately 78 kg. Echocardiogram demonstrated an ejection fraction of 25-30%, moderately dilated left atrium, mildly dilated right atrium, severe regional left ventricular systolic dysfunction with akinetic with anterior to mid anterior septal, anterior apex, septal apex, lateral apex, which is dyskinetic. Physiologic mitral regurgitation 1+ tricuspid regurgitation, mild pulmonary artery systolic hypertension. On echocardiogram on [**2180-5-17**], there was a small to moderate sized pericardial effusion without signs of tamponade. Patient was initially maintained on anticoagulation for intra-aortic balloon pump with plans to transition her to long-term anticoagulation given her areas of akinesis and low ejection fraction. However, given findings of pericardial effusion, which was suggestive of possible hemorrhagic effusion. Anticoagulation was stopped. Patient underwent repeat echocardiogram on [**5-19**], which demonstrated an ejection fraction of 30-35%, and a small pericardial effusion without signs of tamponade. Decision was made that to indefinitely hold further anticoagulation with Coumadin. Ischemia: Patient was maintained on aspirin and Plavix x9 months for stent placement. She was started on a beta blocker, titrated to 75 mg po bid as well as an ACE inhibitor, lisinopril 5 mg po q day. Rhythm: Patient experienced transient right bundle branch block with left anterior fascicular block the first day postprocedure. She underwent placement of transvenous pacing wires on [**2180-5-16**]. She experienced no further block on [**2180-5-17**], and wires were removed on [**2180-5-18**]. Patient had some nonsustained ventricular tachycardia on the first 48 hours post myocardial infarction. She underwent evaluation by Electrophysiology staff, who recommended further evaluation with signal averaging studies. These are to be performed on [**2180-5-22**]. Results should be reviewed at her next cardiologist. The patient is also referred to Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 41364**] for further followup of her Electrophysiology issues. 2. Endocrine: The patient was continued on her outpatient Synthroid dose. The TFTs are within normal limits. 3. Heme: The patient underwent oozing from her groin line sites requiring blood transfusions. Her hematocrit remained stable, 33-34 in the days prior to discharge. 4. Neurological: Patient developed agitation and altered mental status on her second and third days of admission. Per patient's companions at the convent, this is her baseline and responded very well to treatment with Haldol. The patient with known baseline mental disorder and was maintained on her trazodone and Celexa in-house. 5. Diet: The patient will need to follow a low salt heart-healthy diet, less than 2 grams of sodium per day. Follow up arranged with [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 1075**] [**6-8**] at 11:45 am. DISPOSITION: Extended care facility. RECOMMENDATIONS: The patient will need Physical Therapy, monitoring of electrolytes every 2-3 days, and possible adjustment of her Lasix dose. She will need LFTs in six weeks, she was started on a statin drug, and follow up on her Electrophysiology studies done on the day of discharge. DISCHARGE MEDICATIONS: 1. Enteric coated aspirin 325 mg po q day. 2. Plavix 75 mg po q day. 3. Lisinopril 5 mg po q day. 4. Metoprolol 75 mg po bid. 5. Celexa 20 mg po q day. 6. Levothyroxine 88 mcg po q day. 7. Trazodone 25 mg po q day. 8. Colace 100 mg po q day. 9. Senna two tablets po bid prn. 10. Dulcolax 10 mg po q hs prn. 11. Haldol 2 mg IV q4h prn. 12. Lasix 40 mg po bid x3 days with subsequent decrease to 40 mg po q day. 13. Potassium chloride. 14. Protonix 40 mg po q day. DISCHARGE CONDITION: Good. DISCHARGE DIAGNOSES: 1. Acute anterior myocardial infarction. 2. Perimyocardial infarction arrhythmia. 3. Hypothyroidism. 4. Depression. 5. Hypertension. 6. Gastroesophageal reflux. [**First Name8 (NamePattern2) 870**] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 5219**] Dictated By:[**Last Name (NamePattern1) 7485**] MEDQUIST36 D: [**2180-5-22**] 12:00 T: [**2180-5-22**] 12:04 JOB#: [**Job Number 47988**] ICD9 Codes: 4271, 4280, 4019
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Medical Text: Admission Date: [**2118-1-15**] Discharge Date: [**2118-1-18**] Date of Birth: [**2055-1-4**] Sex: M Service: C-MEDICINE CHIEF COMPLAINT: Transferred from [**Hospital3 3765**] with unstable angina. HISTORY OF PRESENT ILLNESS: The patient developed seven out of ten chest pain this morning with radiation to his left arm while showering. The patient took Aspirin and three sublingual Nitroglycerin without relief. The patient then went to [**Hospital3 3765**] without resolution of his chest pain with the Nitroglycerin. The patient also reports feeling nauseous, diaphoretic and short of breath. The patient reports that over the last month, he has had intermittent shortness of breath that he was recently seen by his primary care physician for and the primary care physician felt that he had evidence of congestive heart failure. He was started on Lasix. The patient was also seen by his cardiologist, [**First Name8 (NamePattern2) **] [**Last Name (Titles) **], within the last week who also felt that he was developing congestive heart failure. At [**Hospital3 3765**], the patient was started on Heparin, intravenous Nitroglycerin, given 2 milligrams of Morphine, 5 milligrams of intravenous Lopressor and finally started on Integrelin. The patient's pain was two out of ten at transfer but upon arrival to [**Hospital1 69**] with a slight increase in intravenous Nitroglycerin the patient was made pain free. The patient subsequently vomited a moderate amount of bilious liquid. The patient was admitted to the PCU on Integrelin, Heparin, Nitroglycerin. PAST MEDICAL HISTORY: 1. Coronary artery disease. Cardiac catheterization in [**2104**], showed two vessel disease with 60% left circumflex and 90% right coronary artery. Cardiac catheterization on [**11/2112**], showed an ejection fraction of 24% with 1+ mitral regurgitation, 80% mid right coronary artery, 40% right posterior descending artery, 30% mid circumflex and a 30% distal circumflex. The patient had percutaneous transluminal coronary angioplasty with stent times two to the mid right coronary artery. The patient was also noted to have moderate systolic and diastolic dysfunction with global hypokinesis. 2. Carotid endarterectomy in [**2113**]. 3. Status post complete heart block with pacemaker placement. 4. History of hypertension. 5. History of high cholesterol. 6. Left bundle branch block on electrocardiogram. MEDICATIONS: 1. Lipitor 20 milligrams q.d. 2. Isosorbide 20 milligrams t.i.d. 3. Aspirin 325 milligrams q.d. 4. Zestril. MEDICATIONS ON TRANSFER: 1. Intravenous Nitroglycerin. 2. Intravenous Heparin. 3. Aspirin. 4. Lopressor. 5. Integrelin. 6. Morphine. ALLERGIES: No known drug allergies. SOCIAL HISTORY: Previously smoked one pack per day and has since quit in the last eight to ten years. The patient was a heavy drinker but also quit eight to ten years ago and previously would drink greater than a case of beer a week. The patient is employed as a kitchen designer. FAMILY HISTORY: No significant family history of coronary artery disease or diabetes mellitus. PHYSICAL EXAMINATION: Temperature is 97.3, pulse 60, blood pressure 112/61, respiratory rate 18, pulse oximetry 93% on four liters nasal cannula. In general, resting in bed, alert, oriented in no apparent distress. Head, eyes, ears, nose and throat - The oropharynx is clear. Anicteric sclera. Moist mucous membranes. Neck is supple with no jugular venous distention. Cardiovascular regular rate and rhythm, normal S1 and S2, no murmurs, gallops or rubs. The lungs are clear to auscultation bilaterally. The abdomen is soft, nontender, nondistended, normoactive bowel sounds. Extremities warm, 1+ pedal edema bilaterally, no femoral bruits, 2+ dorsalis pedis and posterior tibial pulses bilaterally. Neurologic - alert and oriented times three. LABORATORY DATA: On admission, white count 9.8, hematocrit 40.6, platelets 218,000, 89% neutrophils. Prothrombin time 16.6, partial thromboplastin time 150, INR 1.8. Sodium 139, potassium 4.3, chloride 102, bicarbonate 26, blood urea nitrogen 23, creatinine 1.1, glucose 161. CK was 96. Chest x-ray revealed cardiomegaly with no evidence of congestive heart failure. Electrocardiogram revealed a paced rhythm with left bundle branch block. HOSPITAL COURSE: 1. Coronary artery disease - The patient remained pain free on Integrelin, Heparin and Nitroglycerin. The patient ruled in for myocardial infarction with positive troponin of 30 with peaked CK of 198 with positive MB fraction and index. The patient was taken to cardiac catheterization on [**2118-1-17**], and cardiac catheterization showed moderately elevated right and left sided filling pressures with right atrium 9 mmHg, wedge pressure of 25 mmHg and left ventricular end diastolic pressure of 26 mmHg. There was also moderate pulmonary hypertension with a pulmonary artery pressure of 49/26. Cardiac index was low at 1.9. The patient had a 50% distal stenosis of the left main and a 40% stenosis of an acute marginal with patent stents in the right coronary artery. The patient tolerated the cardiac catheterization well and did not have any episodes of chest pain following the catheterization. The patient was placed on Aspirin and Lopressor and continued on his Lipitor. The patient's lipid profile was very good with a LDL of less than 100. 2. Congestive heart failure - The patient had evidence of congestive heart failure on admission with an oxygen requirement. The patient was given two doses of Lasix with good diuresis and improved shortness of breath. The patient's cardiac catheterization showed moderate right and left ventricular diastolic dysfunction. The patient was started on Zestril 5 milligrams and Lasix 20 milligrams on discharge and will follow-up with [**First Name8 (NamePattern2) **] [**Last Name (Titles) **]. DISCHARGE MEDICATIONS: 1. Lisinopril 5 milligrams q.d. 2. Lopressor 25 milligrams b.i.d. 3. Lasix 20 milligrams p.o. q.d. 4. Potassium 8 meq p.o. q.d. 5. Sublingual Nitroglycerin. 6. Aspirin 325 milligrams p.o. q.d. FOLLOW-UP: [**First Name8 (NamePattern2) **] [**Last Name (Titles) **]. DISCHARGE STATUS: To home. CONDITION ON DISCHARGE: Stable. DISCHARGE DIAGNOSES: Acute myocardial infarction. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1544**], M.D. [**MD Number(1) 1545**] Dictated By:[**Last Name (NamePattern1) 16516**] MEDQUIST36 D: [**2118-1-18**] 21:06 T: [**2118-1-19**] 20:30 JOB#: [**Job Number 111264**] ICD9 Codes: 4280, 4019, 3051
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Medical Text: Admission Date: [**2201-7-26**] Discharge Date: [**2201-7-29**] Date of Birth: [**2140-12-29**] Sex: M Service: MEDICINE Allergies: Verapamil / Iodine; Iodine Containing Attending:[**First Name3 (LF) 905**] Chief Complaint: dizzyness Major Surgical or Invasive Procedure: none History of Present Illness: HPI: 60 yo man with hx of IDDM with diabetic neuropathy, chronic renal failure, bilateral foot ulcers, heart failure with implanted defibrillator, atrial flutter on coumadin, and peripheral vascular disease s/p right leg bypass, who presented to ED today with a one week history of dizziness and mild headache. Pt states he noted the onset of room spinning when he stood up but it would resolve when he sat back down; it was associated with tinnitus but no nausea/vomiting or hearing loss. He notes that this am he may have fallen towards the left. He also noted a mild persistent frontal headache, no neck stiffness, fever, chills. On the morning of admission, pt woke up and stood to walk to the bathroom and could barely make it due to severe vertigo, again, no nausea. He came to the ED and it was found that his INR was 16 and he had a small SAH on head CT. Of note, pt states that he tripped over the vacuum cord 3 weeks ago and hit his left hip and elbow, cannot remember if he hit his head, no LOC. Neurology and neurosurgery evaluated the pt in the ED and given his multiple medical problems, he was admitted to the MICU for close monitoring. He received 4units of FFP, and 10mg po vitamin K. . ROS: no fever/chills, no n/v/d, no abd pain, no BRBPR, no dysuria, no chest pain, no sob Past Medical History: Past Medical History: 1. Diabetes type 2 2. diabetic neuropathy with bilateral foot ulcers on heels 3. CRF, baseline cr 3.4 4. CHF, EF ?30% with implanted defibrillator 5. atrial flutter 5. pulmonary fibrosis 6. peripheral vascular disease s/p right leg bypass graft 7. depression 8. gout Social History: Patient lives alone, does own ADL's, no drugs, has VNA. Family History: NC Physical Exam: Per Note of Dr. [**Last Name (STitle) 28360**] T: 98.8, BP: 179/79, R: 61, RR: 12, O2 100% on 2L GEN: NAD SKin: multiple ecchymoses with palpable small hematomas HEENT: PERRL, EOMI, MMM CV: RRR, [**3-1**] diastolic murmur heard best at RUSB Chest: clear ABD: +BS, soft, NTND Ext: no edema, foot drop on right, decreased sensation in bilateral feet; left foot with slow oozing ulcer on heel. Neuro: CN 2-12 intact; old ptosis on left; strength 5/5 upper ext bilaterally; no dorsiflexion on right [**2-25**] nerve injury; [**5-28**] strenght in hip flexion; nl reflexes b/l. Pertinent Results: [**2201-7-26**] 12:10PM PT-49.3* PTT-76.5* INR(PT)-16.1 [**2201-7-26**] 12:10PM WBC-14.5*# HCT-31.4* [**2201-7-26**] 12:10PM PLT COUNT-269 [**2201-7-26**] 08:48PM PT-17.3* PTT-40.0* INR(PT)-2.0 [**2201-7-26**] 12:10PM GLUCOSE-134* UREA N-79* CREAT-3.2* SODIUM-137 POTASSIUM-5.0 CHLORIDE-104 TOTAL CO2-17* ANION GAP-21* FOOT AP,LAT & OBL LEFT [**2201-7-26**] 4:33 PM IMPRESSION: Loss of the visualization of the cortical bone of the base of the 5th metatarsal and of the lateral aspect of the cuboid. This is concerning for osteomyelitis. Correlate with site of ulcer. Bone scan could be performed. The study and the report were reviewed by the staff radiologist. CT HEAD W/O CONTRAST [**2201-7-26**] 3:31 PM IMPRESSION: Small amount of subarachnoid hemorrhage seen superiorly in a right frontal sulcus. The study and the report were reviewed by the staff radiologist. CT HEAD W/O CONTRAST [**2201-7-27**] 10:40 AM COMPARISON: [**2201-7-26**]. IMPRESSION: Stable appearance of small subarachnoid hemorrhage in a right frontal lobe sulcus CHEST (PA & LAT) [**2201-7-26**] 3:22 PM Reason: eval for infiltrate IMPRESSION: No definite evidence of acute pneumonia. Postoperative changes in the right hemithorax with stable fibrothorax. An addendum will be dictated when more recent films become available. ADDENDUM: There is no significant change since the prior CXR of [**2200-9-4**]. The study and the report were reviewed by the staff radiologist. ECG: AV paced at 60; no st-t changes Brief Hospital Course: 60y/o M with h/o a flutter on coumadin, CHF s/p ICD, DM type 2, who presents with one week of dizziness, headache and found to have a small post frontal bleed in setting of supratherapeutic inr 16. 1. Post frontal bleed: Spontaneous bleed in setting of supratherapeutic INR of 16, patient denied any recent trauma prior to arrivel though did attest to having fallen ~3 weeks ago. Per neuro findings were c/w new/recent bleed, they said that if bleed would have happened 3 weeks ago the composition of the blood would have changed and not lit up as it did on CT scans. Inr was reveresed with 4U FFP and 10mg vitamin K. Inr dropped to 2's within 8 hours of admission. Per neuro no focal neurological defects on exam. His repeat CT was unchanged and did not show progression of bleed. His headaches and dizziness resolved. CTA was not performed due to his CRI with creatinines at mid 3's and MRI/MRA not done due to his ICD. Neurosurgery s/o and recommended f/u as outpatient in their clinic in 2 weeks with CT s contrast prior to visit. Neuro also signed off without furhter recommendations. 2. Coagulopathy: unclear as to why patient presented with elevated INR of 16, no change in diet, no change in medications, could have been antibiotics but patient had been off them some time. Possibly poor nutrition as both PT and PTT corrected with vit K doses x 2. After reversal patients coags remained stable and within normal. He was not restarted on his coumadin and we recommended that he be started as an outpatient by pcp. 3. Leukocytosis: unclear etiology, no focal signs of infection, chest x ray was clear, ua was normal, no si/sx's of infection, his left heel ulcer appeared normal with no evidence of puss, erythema, tenderness. Pt was afebrile thoughout stay and abx were not started. Prior to discharge patients white count began to decrease. No further w/u was done. 4. Acute on CRF: [**2-25**] prerenal/hypovolemia. Improved with hydration. Stable. 5. Foot ulcers: X ray was taken of left foot ulcer and showed cortical erosion of the 5th metatarsal but did not correlate with location of ulcer. Podiatry was consulted and said that changes that were seen on the X ray are [**2-25**] his severe deformities and not due to osteomyelitis. They recommended wet to dry dressings and daily dressing changes. 6. DM2: glucoses remained stable, continued on his outpatient medication regimen. 7. HTN: stable, continued on his outpatient med regimen 8. Cardiac: CHF: euvolemic, salt and fluid restricted, continued on heart failure meds. CAD: continued on bb and asa Rhythm: a fib, stopped coumadin and reversed inr. Did not restart coumadin due to CNS bleed, will have pcp restart as outpatient. Restarted amiodarone. 9. Gout: stable, c/w allopurinol. 10. Depression: c/w fluoxetine 11. Hypercholesterolemia: c/w lovastatin and welchol. 12. Full Code Medications on Admission: allopurinol 100mg' amiodarone 200mg' aspirin 325mg' centrum darvocet prn fluoxetine 20mg' HCTZ 25mg' Lisinopril 2.5mg' lotrisone 0.05% [**Hospital1 **] lovastatin 10mg' procrit 20,000 2x per week toprol xl 150mg' vitamin c 500mg' warfarin 5mg' except 7.5mg on Tuesdays Welchol 625mg [**Hospital1 **] Discharge Medications: 1. Allopurinol 100 mg Tablet Sig: One (1) Tablet PO EVERY OTHER DAY (Every Other Day). 2. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Multivitamin Capsule Sig: One (1) Cap PO DAILY (Daily). 5. Paroxetine HCl 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Medication Humulin 22u qam, 12-14u qpm 7. Metoprolol Succinate 50 mg Tablet Sustained Release 24HR Sig: Three (3) Tablet Sustained Release 24HR PO DAILY (Daily). 8. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 10. Lovastatin 10 mg Tablet Sig: One (1) Tablet PO once a day. 11. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. WelChol 625 mg Tablet Sig: One (1) Tablet PO twice a day. 13. Centrum Silver Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Home With Service Facility: [**Hospital1 3894**] Health VNA Discharge Diagnosis: Posterior frontal cerebral bleed Left heel ulcer Acute renal failure Coagulopathy: supratherapeutic INR of 16 Secondary diagnosis: Atrial flutter Heart failure Diabetes Mellitus type 2 Hypertension Gout Depression OSA Discharge Condition: stable Discharge Instructions: Please take all your medications as prescribed and follow up with all your recommended appointments. Please call your doctor if you develop: fevers, chills, chest pain, shortness of breath, confusion, dizziness, vertigo or other concerning symptoms. Your primary care physician will determine when you restart the coumadin. You also need to set up an appointment with the neurosurgeon that was following you in the hospital. Your primary care phsysician should set up a CT of your head prior to seeing the neurosurgeon. Followup Instructions: Please call to schedule an appointment with your primary care phsyciain Dr. [**Last Name (STitle) **] at [**Telephone/Fax (1) 1144**]. Please schedule your appointment within one week. Please call to make an appointment with Dr. [**Last Name (STitle) **] (Neurosurgery) at [**Telephone/Fax (1) 2992**], please make the appointment within 2-4 weeks from your day of discharge. You will need to have a CT scan of your head done prior to seeing him. Your primary care physician will help facilitate that. Provider: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 722**], DPM Where: BA [**Hospital Unit Name **] ([**Hospital Ward Name **] COMPLEX) PODIATRY Phone:[**Telephone/Fax (1) 543**] Date/Time:[**2201-7-31**] 10:50 Provider: [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 722**], DPM Where: BA [**Hospital Unit Name **] ([**Hospital Ward Name **] COMPLEX) PODIATRY Phone:[**Telephone/Fax (1) 543**] Date/Time:[**2201-8-4**] 1:30 Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) 9119**] [**Name12 (NameIs) 28361**] PRACTICES Where: [**Name12 (NameIs) 9119**]-PRIVATE PRACTICES Phone:[**Pager number 28362**] Date/Time:[**2201-7-31**] 12:30 [**Name6 (MD) 251**] [**Name8 (MD) **] MD [**MD Number(1) 910**] ICD9 Codes: 431, 5849, 4280, 2765, 3572, 311, 2749
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Medical Text: Admission Date: [**2185-7-1**] Discharge Date: [**2185-7-6**] Service: HISTORY OF PRESENT ILLNESS: The patient is an 84 year old male with no significant past medical history, who was witnessed by his wife at 02:30 p.m. on the day of admission, becoming unresponsive. She called The EMS was called and arrived within five minutes. The patient had ventricular fibrillation on the monitor and was cardioverted at 200 joules. He became asystolic and had CPR for one minute. The patient received 1 mg of epinephrine and Atropine and the patient converted to atrial fibrillation. The patient was intubated without difficulty. According to his wife, the patient denied chest pain, shortness of breath. The patient only had some indigestion fifty minutes before his arrest. The patient originally presented to [**Hospital3 4527**] Hospital where he was given 300 mg of intravenous Amiodarone and started on an Amiodarone drip, 5 mg of intravenous Lopressor, aspirin and was started on a heparin drip. The patient was transferred to [**Hospital1 1444**] for cardiac catheterization. PAST MEDICAL HISTORY: None. HOME MEDICATIONS: None. ALLERGIES: No known drug allergies. SOCIAL HISTORY: The patient is married and was visiting daughter. [**Name (NI) **] lives with his wife outside of Montreal, [**Name (NI) 6607**]. He has a 50 year tobacco history. He drinks at least three drinks a day. PHYSICAL EXAMINATION: Pulse 75; blood pressure 156/89; saturation of 99% on assist control 700 by 14, PEEP of 5, FIO2 of 0.5. In general, the patient is intubated and sedated. HEENT: Dried blood surrounding his mouth. Cardiovascular: Distant heart sounds; no murmurs. Lungs were clear anteriorly. Abdomen soft, nontender, nondistended with normal bowel sounds. Guaiac negative. Extremities with no edema. Neurologically, the patient withdraws from pain, moving all four extremities. LABORATORY: From the outside hospital, white blood cell count 6.4, hematocrit 43.4, MCV of 101.5. Platelets 159. Initial CK 75, magnesium 1.9, phosphate 3.5. EKG showed ST depressions in the precordial leads consistent with a posterior myocardial infarction. HOSPITAL COURSE: 1. Coronary artery disease: The patient with posterior myocardial infarction with troponin greater than 50, CK peaking in the high 400s. The patient was started on heparin, aspirin and Lipitor. Cardiac catheterization was not performed secondary to patient's agitation and inability to cooperate. The patient would have required sedation and intubation and undergo cardiac catheterization which the family wanted to avoid. The patient's heparin was briefly stopped for episodes of hemoptysis after extubation. The patient was restarted on Lovenox. 2. For his myocardium, a 2D echocardiogram is being performed today; results of echocardiogram pending. The patient was started on a beta blocker, 12.5 mg of Lopressor twice a day. 3. Electrophysiology: The patient status post ventricular fibrillation arrest, status post cardioversion and atrial fibrillation. The patient on oral Amiodarone to maintain sinus rhythm. The patient was started on a beta blocker. The patient on Lovenox for anti-coagulation. 4. The patient was intubated in the setting of ventricular fibrillation arrest for airway protection. The patient was extubated two days later after his mental status improved. 5. Renal: The patient initially had marginal urine output between 20 and 30 cc an hour despite stable blood pressure. The patient's urine output has since improved. His creatinine has remained stable. 6. Endocrine: The patient initially had high blood sugars in the 300s, presumably secondary to stress reaction as patient has no history of diabetes mellitus. The patient was started on a Regular insulin sliding scale. 7. Neurologic: The patient is only oriented times one. The patient initially received Fentanyl and Ativan while intubated. The patient currently off benzodiazepines and has been receiving Haldol p.r.n. for agitation. The patient's inability to cooperate is limiting his ability to undergo cardiac catheterization. The patient is currently Full Code. Since he is about to undergo cardiac catheterization however, this should be readjusted with the family after cardiac catheterization. It seems that the family wants to avoid intubation and heroic measures. CONDITION AT DISCHARGE: Stable. DISCHARGE STATUS: Transfer patient to a hospital in [**Country 6607**]. DISCHARGE MEDICATIONS: 1. Aspirin 325 mg p.o. q. day. 2. Amiodarone 400 mg p.o. q. day. 3. Lopressor 12.5 mg p.o. twice a day. 4. Lipitor 10 mg p.o. q. day. 5. Protonix 40 mg p.o. q. day. 6. Lovenox 60 mg subcutaneously twice a day. 7. Regular insulin sliding scale. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D. [**MD Number(1) 8227**] Dictated By:[**Name8 (MD) 7112**] MEDQUIST36 D: [**2185-7-6**] 11:33 T: [**2185-7-6**] 11:39 JOB#: [**Job Number 42098**] ICD9 Codes: 4275, 5070, 2765
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Medical Text: Admission Date: [**2168-7-26**] Discharge Date: [**2168-7-31**] Date of Birth: [**2110-2-26**] Sex: M Service: CSURG Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 14964**] Chief Complaint: 58M WITH CHEST PAIN SOB AT REST s/p emergent CABGx4 (LIMA->LAD, SVG->OM1, ->OM2, ->DIAG), EF PMH: HTN, s/p vasectomy [**Last Name (un) 1724**]: none Major Surgical or Invasive Procedure: CORONARY ARTERY BYPASS X4 LIMA->LAD, SVG->OM1, ->OM2, ->DIAG), History of Present Illness: PATINET PRESENTED BY CARDIOLOGY TEAM WITH TRIPPLE VESSEL DISEASE AND ONGOING CHEST PAIN INSPITE OF MEDICAL THERAPY Past Medical History: HYPERTENSION; VASECTOMY Family History: UNREMARKABLE Physical Exam: LUNGS CTA HEART RRR NM G STERNUM SATBLE WOUND NO SX OF INFECTION EXT POS PULSES EDEMA ON LEFT LEG SP SAFENECTOMY CNS ORIENTED X3 Pertinent Results: [**2168-7-26**] 03:31PM TYPE-ART PO2-332* PCO2-48* PH-7.37 TOTAL CO2-29 BASE XS-2 [**2168-7-26**] 03:31PM GLUCOSE-132* K+-5.2 [**2168-7-26**] 02:52PM TYPE-ART PO2-263* PCO2-52* PH-7.34* TOTAL CO2-29 BASE XS-1 [**2168-7-26**] 01:28PM TYPE-ART PO2-343* PCO2-47* PH-7.37 TOTAL CO2-28 BASE XS-1 INTUBATED-INTUBATED VENT-CONTROLLED [**2168-7-26**] 01:28PM GLUCOSE-106* NA+-137 K+-4.3 [**2168-7-26**] 12:34PM GLUCOSE-89 UREA N-13 CREAT-0.7 SODIUM-149* POTASSIUM-3.2* CHLORIDE-113* TOTAL CO2-22 ANION GAP-17 [**2168-7-26**] 12:34PM PT-12.8 PTT-40.2* INR(PT)-1.1 PATIENT EXTUBATED ON [**2168-7-26**] NO POST OP COMPLICATIONS, CHEST TUBES AND WIRES D BEFORE TRANSFER TO THE FLOOR. Brief Hospital Course: SP CABG x4 [**2168-7-26**] EXTUBATED 6 HOURS POST OP NO COMPLICATIONS, CHEST TUBES DC POS OP DAY #2 WIRES DC POST OPD #3. AFEBRILE HEMODINAMICLY STABLE. PT [**Name (NI) 58005**] TO THE FLOOR. TOLERATING CARDIAC DIET PHYSICAL EXAM UNREMARKABLE PT [**Name (NI) 58006**]. STBALE. Medications on Admission: ASA MVI SINVASTATIN 40MG PO QDMETOPROLOL 25 MG PO BID Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 2. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 3. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for [**Name (NI) **] MORE THAN 38. Disp:*30 Tablet(s)* Refills:*0* 4. Clopidogrel Bisulfate 75 mg Tablet Sig: One (1) Tablet PO QD (once a day). Disp:*30 Tablet(s)* Refills:*2* 5. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO QD (once a day). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 6. Multivitamin Capsule Sig: One (1) Cap PO QD (once a day). Disp:*30 Cap(s)* Refills:*2* 7. Polysaccharide Iron Complex 150 mg Capsule Sig: One (1) Capsule PO QD (once a day). Disp:*30 Capsule(s)* Refills:*2* 8. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 9. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. Disp:*30 Tablet(s)* Refills:*0* 10. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO QD (once a day). Disp:*30 Tablet(s)* Refills:*2* 11. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). Disp:*90 Tablet(s)* Refills:*2* 12. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital3 **] VNA Discharge Diagnosis: SP CABGx4 Discharge Condition: GOOD SELF FEEDING SELF AMBUTATING Discharge Instructions: WALK 4 TIMES PER DAY, ELEVATE LOWER EXTREMITIES WHEN ON BED. [**Name8 (MD) **] MD [**First Name (Titles) **] [**Last Name (Titles) **] CHEST PAIN OR WOUND ISSUES. Followup Instructions: FOLLOW UP WITH DR [**Last Name (STitle) **] IN 4 WKS.([**Telephone/Fax (2) 1504**]Provider: [**Last Name (LF) **],[**First Name3 (LF) **] R. [**Telephone/Fax (1) 170**] Follow-up appointment should be in 1 month [**Last Name (LF) **],[**First Name3 (LF) **] R. [**Telephone/Fax (1) 170**] Follow-up appointment should be in 1 month [**Last Name (LF) **],[**First Name3 (LF) **] W. [**Telephone/Fax (1) 3183**] Follow-up appointment in 2 weeks Completed by:[**2168-7-31**] ICD9 Codes: 4019
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Medical Text: Admission Date: [**2136-7-31**] Discharge Date: [**2136-8-3**] Service: MEDICINE Allergies: Amiodarone / Atorvastatin / Vancomycin Hcl Attending:[**First Name3 (LF) 99**] Chief Complaint: Sepsis Atrial Fibrillation CHF Major Surgical or Invasive Procedure: Intubation History of Present Illness: 85 yo m w/ h/o metastatic prostate ca to bone, cad, chf (LVEF 21%), avr, severe mitral stenosis, PAH, PAF who p/w [**2-2**] wk h/o n/v post meals. Patient/wife report approx 2 wk h/o vomiting following meals. Reports delay of approx 10 minutes following meals. Vomiting whole food. Denies abd pain/jaundice/[**Male First Name (un) 1658**] colored stools/dk urine. Denies hematemesis. +constipation-> no bm x 1wk. Wife reports that tonite at dinner pt had multiple episodes of vomiting (usually just one) and was accompanied by shaking chill. Has h/o subj fevers at home. +cough over the last several weeks, productive of yellow sputum. +cough at night. no coughing spells. No sob/DOE/cp/palpitations. Stable minimal exercise tolerance across room. States not limited by resp status. . . According to wife, pt has had steady decline in functional status over the last 3 months, worsened over the last month. . Pt rec'd first dose of Samarium 153 on [**7-5**]- carries known rx of thrombocytopenia. . In ED, 102.4/138/ 117/71/ 18 88% ra, elev lactate to 9.9, started on MUST, rec'd vanc/levo/flagyl Past Medical History: 1) Metastatic adenocarcinoma of the prostate: [**Doctor Last Name **] score 7 (4+3) diagnosed [**6-1**]. He did not receive primary therapy to his prostate gland due to his underlying medical conditions. He was treated with Casodex alone from [**10-1**] until [**3-2**] with minimal response. In [**5-2**], Lupron was initiated with a minimal response. Several months ago, he was treated with Casodex again, which was [**Date Range 8910**] for rising PSA and elevated LFTs. 2) CONGESTIVE HEART FAILURE, LVEF 21% 3) ANEMIA 4) CORONARY ARTERY DISEASE 5) ECZEMA 6) HYPERCHOLESTEROLEMIA 7) ATRIAL FIBRILLATION 8) SCIATICA 9) CHRONIC HEPATITIS C - Acquired through blood transfusion associated with AVR in [**2114**]. 10) RHEUMATIC HEART DISEASE 11) HYPERTENSION 12) ASTHMA, COPD 13) S/P AORTIC VALVE REPLACEMENT [**2114**] 14) PPM, ICD implant 15) VF arrest [**2133**] 16) SEVERE MITRAL STENOSIS 17) 2+ MR Social History: He denies a history of smoking, rare alcohol use, no IVDU. He acquired Hepatitis C from a blood transfusion. He lives at home with his wife and is able to perform his ADLs, although his wife does say he is forgetful with his medications. Family History: NC Physical Exam: bp 97/59, p 68, r 24, 94% 4L NC, cvp 13 w/ prominent a waves, SvO2 62% Ill appearing cachectic male in NAD. PERRL OP clr +JVD Regular S1, prominent S2. No m/r/g b/l basilar crackles +bs. soft. nt. nd. no hepatosplenomegaly. no [**Doctor Last Name **] 1+ LE edema Pertinent Results: 133 94 33 /135 AGap=25 5.2 19 1.1 \ . Ca: 9.6 Mg: 2.0 P: 4.4 ALT: 26 AP: 180 Tbili: 1.8 Alb: AST: 172 LDH: 2860 Dbili: Pnd TProt: [**Doctor First Name **]: 74 Lip: 105 UricA:14.5 . proBNP: [**Numeric Identifier 8915**] Hapto: Pnd . 98 9.4\ 9.5 / 82 / 28.8\ N:58.6 L:36.1 M:3.5 E:0.9 Bas:1.0 . PT: 20.9 PTT: 40.6 INR: 2.9 . cxr: mild pulm vasc redistribution . Brief Hospital Course: 84 yo m w/ chf, avr, ms, w/ h/o vomiting, fever, cough, febrile on admission, tachycardic, w/ elev lactate, and no obvious source of infxn. . 1) sepsis- On arrival to the ICU pt afebrile c no WBC but tachyc, tachypneic c increased lactate. CT of chest showed L pul infiltrate. CT abdomen showed GB wall thickening but no evid of GI source. Pt empirically coverd c ceftriaxone, vancomycin and flagyl. Pt developed rash in UE after one vancomycin administration, so abx given more slowly subsequently. No additional reaction noted. Bedside swallow showed pt at risk for aspiration and so this likely contributed to his development of pna. 2. Fluids- elev cvp but pt likely always runs high given known severe MS. Concerned that patient was relatively hypovolemic given h/o vomiting, elev lactate; therefore, initially given IVF boluses despite elevated CVP. . 2) chf- Pt significantly overweight but as stated previously concern for hypovolemia. Therefore was bolused with fluid. Fluid status balanced between diuresis for possible volume overload in the lungs and need for increased perfusion to the tissues. On [**2136-8-3**] pt hypotensive c decreased RR and fixed and dilated L pupil. Pt's liver and cardiac enzymes as well as his lactate elevated, indicating inadequate perfusion of his end organs. Pt given ASA for cardiac damage [**Hospital1 **] sltrsfu on snyivoshulsyion. Therefore pt was intubated by anesthesia. Follow intubation family elected to make pt DNR and then later that day decided on comfort measures only. Pt was extubated and on [**2136-8-3**] pt expired. Family denied autopsy. . . 3) thrombocytopenia- Heme onc consulted and attributed pt's thrombocytopenia to pt's recent dose of samarium. . 4) elev amylase/lipase- likely [**2-1**] ongoing vomiting, no clinical evidence of pancreatitis. . ) ppx- pneumoboots, gi . Medications on Admission: asa 81 mg qday lisinopril 40 mg qday lopresser 75mg [**Hospital1 **] lasix 40mg qday coumadin sumarin every other wk. Discharge Medications: Pt expired Discharge Disposition: Expired Discharge Diagnosis: Sepsis Pneumonia CHF Discharge Condition: Pt expired Discharge Instructions: Pt expired Followup Instructions: Pt expired ICD9 Codes: 0389, 486, 431, 412, 2859
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Medical Text: Admission Date: [**2170-2-8**] Discharge Date: [**2170-2-16**] Date of Birth: [**2111-10-2**] Sex: F Service: CARDIOTHORACIC Allergies: Penicillins / Tetracycline / Sulfa (Sulfonamide Antibiotics) / Morphine / Codeine Attending:[**First Name3 (LF) 5790**] Chief Complaint: Cervical malacia, with shortness of breath. Major Surgical or Invasive Procedure: [**2170-2-8**]: Cervical tracheal resection and reconstruction and bronchoscopy with bronchoalveolar lavage. History of Present Illness: The patient is a 58-year-old woman who has had a tracheostomy. She also developed severe diffuse tracheobronchomalacia which was treated with the right thoracotomy and posterior splinting of her thoracic airways. After this procedure, she was noted to have persistent and worsening cervical tracheomalacia and some minor narrowing at the site of the previous stoma. She was admitted following tracheal resection and reconstruction. Past Medical History: # tracheobronchial malacia s/p tracheoplasty [**2169-6-13**] # tracheostomy # Cervical malacia # obesity # GERD # avascular necrosis of the L hip s/p L hip replacement in [**2161**] # alcohol abuse # RUE DVT in [**2167-10-14**] # Tracheostomy and PEG placement [**2169-3-13**] # COPD # granulomas in L lung # s/p TAH # s/p appendectomy Social History: Ms. [**Known lastname 42611**] had been a regional manager at insurance company. She lives with her boyfriend of 14 years. Patient has history of significant alcoholism. Former smoker Family History: Noncontributory Physical Exam: VS: T: 98.7 HR: 81-82 SR BP: 102-118/64 Sats: 95% 2L nasal cannula. Room air 86-88% BS: 126-170 Gen: pleasant in NAD Neck: cervical incision with slight erythema, slight swelling without drainage. Lungs: decreased breath sounds bilateral with faint bibasilar crackles. no wheezes CV: RRR S1, S2, no MRG or JVD Abd: soft, NT, ND, PEG site clean no erythema or discharge Ext: warm without edema Neuro: awake, alert oriented Pertinent Results: CXR: [**2170-2-15**]: Calcified left basal granuloma. Status post old left ribs fracture. Bilateral areas of atelectasis that are basically unchanged. No newly appeared focal parenchymal opacities. No larger pleural effusions. No evidence of pulmonary edema. [**2170-2-12**]: Right hemidiaphragm is chronically elevated substantially. Persistent obscuration of the left diaphragmatic contour indicates combination of small pleural effusion and worsening left lower lobe atelectasis, now probably collapsed. Upper lungs are grossly clear. Heart size normal. [**2170-2-10**]: Lung volumes remain very low, and there is greater consolidation at both lung bases, particularly the right since [**2-9**], most likely atelectasis. Small left pleural effusion has increased. Heart is top normal size, unchanged. I see no endotracheal tube. There is no pneumothorax. [**2170-2-14**] WBC-5.9 RBC-3.17* Hgb-8.4* Hct-25.9 Plt Ct-209 [**2170-2-13**] WBC-6.8 RBC-3.29* Hgb-8.5* Hct-26.8 Plt Ct-181 [**2170-2-8**] WBC-9.2 RBC-3.71* Hgb-9.2* Hct-28.9 Plt Ct-231 [**2170-2-7**] WBC-8.2 RBC-4.43 Hgb-11.4* Hct-35.1 Plt Ct-214 [**2170-2-14**] Glucose-117* UreaN-14 Creat-0.7 Na-145 K-4.4 Cl-101 HCO3-38 [**2170-2-11**] Glucose-123* UreaN-14 Creat-0.8 Na-146* K-4.1 Cl-107 HCO3-35 [**2170-2-8**] Glucose-137* UreaN-14 Creat-0.8 Na-148* K-3.5 Cl-111* HCO3-27 [**2170-2-14**] Calcium-8.8 Phos-3.7 Mg-2.3 Micros: [**2170-2-8**] MRSA SCREEN Source: Nasal swab. No MRSA isolated. Brief Hospital Course: Ms. [**Known firstname **] [**Known lastname 42611**] was taken to the operating room by Dr. [**Last Name (STitle) **] on [**2170-2-8**] for a cervical tracheal resection and reconstruction and bronchoscopy with bronchoalveolar lavage for cervical malacia and guard suture placement. She transferred to the ICU intubated monitored overnight. Neuro/Pain: Initial pain management was achieved with IV Dilaudid and propofol while intubated. This was later transitioned to Roxicet via PEG with good control. The patient remained neurologically per her baseline: intact but with some memory loss. She is compulsive with taking off oxygen and getting out of bed. She was kept under fall precautions. Her home Seroquel of 150 mg po daily was divided to 50 mg per NGT TID, with good effect. Pulmonary: She was extubated on POD1. Heliox and BiPAP for hypercarbia during POD's [**1-15**]. With Aggressive pulmonary toilet, mucolytics nebs and incentive spirometry her oxygenation improved. Supplemental oxygen was titrated to 2 L nasal cannula with saturation of 97%. Titrate oxygen to maintain oxygen saturations > 92%. Room air oxygen saturation 86-88%. Serial Chest X-ray's (see above report) Bronchoscopy, flexible [**2170-2-14**] showed intact cervical anastomosis, with abnormal bronchial mucosa in the cervical anastomosis, and abnormal bronchial mucosa in the proximal and mid trachea. Her guard suture was removed. CV: The patient was tachycardic initially which improved with home diltiazem, switched to 60 mg po qid for PEG tube. She remained hemodynamically stable throughout in sinus rhythm 80's, blood pressure 100-120's. GI/Nutrition: Tube feeds were resume via PEG POD1. Strict NPO for known aspiration. She was evaluated by the registered dietician with tube feed recommendations of replete with fiber at 70 ml/hour. Renal/GU: Foley removed [**2170-2-12**]. She voided well thereafter. Electrolytes were monitored and treated as needed. Hypernatremia peak NA 148 discharge 145, normalized with free water and Aldactone. Heme: No blood transfusions. Stable anemia. ID: She remained afebrile, with stable WBC counts. CBC trends were watched throughout her stay. Endocrine: Fingerstick blood sugars < 200. Drains: JP removed [**2170-2-12**]. Prophylaxis: SQ heparin and SCD's were instituted to prevent VTE. Disposition: Physical therapy deemed the patient appropriate for rehabilitation. She continued to make steady progress and was discharged to [**Hospital1 41724**] in [**Location (un) 701**] on [**2170-2-16**]. She will follow-up with Dr. [**Last Name (STitle) **] and Dr. [**Last Name (STitle) **] as an outpatient. Medications on Admission: 1. diltiazem HCl 120 mg Capsule, Sustained Release [**Last Name (STitle) **]: One (1) Capsule, Sustained Release PO BID (2 times a day). 2. Nexium 40 mg Capsule, Delayed Release(E.C.) [**Last Name (STitle) **]: One (1) Capsule, Delayed Release(E.C.) PO once a day. 3. quetiapine 150 mg Tablet Sustained Release 24 hr [**Last Name (STitle) **]: One (1) Tablet Sustained Release 24 hr PO once a day. 4. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization [**Last Name (STitle) **]: One (1) neb Inhalation Q6H (every 6 hours) as needed for shortness of breath or wheezing. 5. multivitamin Capsule [**Last Name (STitle) **]: One (1) Capsule PO once a day. 6. home oxygen 40% humidified oxygen continuous via trach collar. Discharge Medications: 1. docusate sodium 50 mg/5 mL Liquid [**Last Name (STitle) **]: Ten (10) ml PO BID (2 times a day) as needed for constipation. 2. heparin (porcine) 5,000 unit/mL Solution [**Last Name (STitle) **]: One (1) ml Injection TID (3 times a day): SQ for VTE prophylaxis. 3. oxycodone-acetaminophen 5-325 mg/5 mL Solution [**Last Name (STitle) **]: 5-10 MLs PO Q6H (every 6 hours) as needed for pain. 4. acetylcysteine 20 % (200 mg/mL) Solution [**Last Name (STitle) **]: Three (3) ML Miscellaneous every twelve (12) hours as needed for thick secretions: mix with albuterol to prevent bronchospasm. 5. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization [**Last Name (STitle) **]: One (1) neb Inhalation Q6H (every 6 hours) as needed for wheeze. 6. diltiazem HCl 60 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO QID (4 times a day): give crushed via PEG. 7. Seroquel 50 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO three times a day: crushed via peg. 8. Prevacid SoluTab 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] twice a day: crush, give via peg. 9. lactulose 10 gram/15 mL Syrup [**Last Name (STitle) **]: Thirty (30) ML PO BID (2 times a day): hold for loose stools. 10. guaifenesin 600 mg Tablet Sustained Release [**Last Name (STitle) **]: One (1) Tablet Sustained Release PO twice a day. 11. tiotropium bromide 18 mcg Capsule, w/Inhalation Device [**Last Name (STitle) **]: One (1) Inhalation once a day. Discharge Disposition: Extended Care Facility: [**Hospital1 700**] - [**Location (un) 701**] Discharge Diagnosis: Cervical malacia s/p tracheal resection and reconstruction [**2170-2-8**] TBM s/p right tracheoplasty [**2169-7-7**] GERD Esophageal dysmotility with aspiration Tracheostomy and PEG placement [**2169-3-13**] COPD Granulomas in L lung Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Call Dr.[**Name (NI) 2347**] office at [**Telephone/Fax (1) 2348**] if you experience: -Fevers > 101 or chills -Increased shortness of breath, cough or chest pain -Cervical incision develops drainage or increased redness. Pulmonary: aggressive pulmonary toilet with mucolytic nebs Oxygen titrate to maintain oxygen saturations > 93% Humidified oxygen to help keep secreations loose Diet: Strict NPO secondary to aspiration Followup Instructions: Appointments Location: [**Hospital Ward Name 517**] [**Hospital Ward Name 121**] Building [**Hospital1 **] I West [**Hospital 7755**] Clinic Provider: [**Name10 (NameIs) 1532**] [**Last Name (NamePattern4) 8786**], MD Phone:[**Telephone/Fax (1) 3020**] Date/Time:[**2170-3-6**] 11:00 [**Hospital Ward Name 121**] Building [**Hospital1 **] [**First Name (Titles) **] [**Last Name (Titles) 479**] [**Hospital 7755**] Clinic Provider: [**First Name8 (NamePattern2) **] [**Name11 (NameIs) **], MD Phone:[**Telephone/Fax (1) 3020**] Date/Time:[**2170-3-6**] 11:30 Provider: [**Name10 (NameIs) 5073**] INTAKE,ONE [**Name10 (NameIs) 5073**] ROOMS/BAYS Date/Time:[**2170-3-6**] 1:00 Hold Tube feedings midnight the night before her appointment for Flexible Bronchoscopy Completed by:[**2170-2-20**] ICD9 Codes: 2760, 2930, 496, 412
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Medical Text: Admission Date: [**2166-6-5**] Discharge Date: [**2166-6-7**] Date of Birth: [**2087-6-7**] Sex: F Service: MEDICINE Allergies: Rapamune / Ativan Attending:[**First Name3 (LF) 1936**] Chief Complaint: Dyspnea Major Surgical or Invasive Procedure: None History of Present Illness: The patient is a 78 year old female with history of polycystic kidney disease s/p DDRT, HTN, diastolic CHF, who presents with malaise, fever, and hypoxia. Pt reports overall malaise, not feeling well for the past week or so. She has had nausea and decreased PO intake. Yesterday developed SOB with band-like tightness across her upper abdomen. Also had L-sided chest discomfort 2 days ago. These symptoms are similar to previous CHF exacerbation, per pt. Has had dry cough for past few days. Denies diarrhea, but has loose stools on lactulose. Noted temp to 100 at home earlier today and called EMS. . In the ED, initial vs were: T 99.6, P BP 209/107, R O2 sat 87% on 4L NC. She was put on [**First Name3 (LF) 597**] and then BiPap. For her BP, nitro paste was placed and then she was transitioned to a nitro gtt with good BP response. Temp spiked to 102 rectally and so she was started on vanco/zosyn. CXR consistent with volume overload. BNP> 70,000. EKG with STE in V2-3 and STD in V5-6, trop 0.1 (baseline 0.06). Cards did not feel urgent heparin was necessary. Pt also received zofran for nausea, hydrocortison 100mg IV x 1 (given chronic steroids). Admitted to the MICU for further monitoring. . On arrival to the MICU, she reports feeling much improved. Still complains of band-like discomfort across her abdomen. Denies SOB. . Review of sytems: (+) Per HPI (-) Denies chills, night sweats, recent weight loss or gain. Denies headache, sinus tenderness, rhinorrhea or congestion. Denied chest pain or tightness, palpitations. Denied vomiting, diarrhea, constipation or abdominal pain. No recent change in bowel or bladder habits. No dysuria. Denied arthralgias or myalgias. Past Medical History: Past Medical History: 1. Polycystic kidney disease, s/p deceased-donor renal transplant (DDRT) in [**2155**], s/p bilateral native nephrectomy [**2148**], [**2152**] 2. Polycystic liver disease, s/p liver resection - left hepatic trisegmentectomy and right lobe cyst reduction ([**2157**]) 3. Recurrent partial SBO 4. S/p cholecystectomy 5. S/p appendectomy 6. Parathyroid adenoma s/p excision ([**2158**]) 7. Hypertension 8. Breast cancer s/p left radical mastectomy ([**2151**]) 9. History of right elbow and humeral fracture 10. History of incarcerated hernias although per history "reduced" nonsurgically in the past 11. Spinal stenosis 12. Irreducible rectal prolapse s/p abdominal rectopexy ([**2165-3-27**]) 13. Depression 14. Chronic Grade II diastolic CHF Social History: Lives with her husband, who is 92. Has weekly VNA and also home health aide who assists with bathing, cooking, and cleaning. Has 2 adult children nearby. Never smoker. Occasional alcohol. Uses a cane and sometimes a walker. Family History: 11 family members with polycystic kidney disease. Physical Exam: Vitals: Afebrile, BP: 140s-150s/70s P: 60s, R: 19, O2: 95% on RA, 90% ambulating General: Alert, oriented, no acute distress HEENT: Sclera anicteric, MMM, oropharynx clear, bipap mask in place Neck: supple, JVP not elevated, no LAD Lungs: mild crackles at R base, no wheeze CV: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: multiple healed surgical scars across abdomen, BS present, distended, diffuse mild tenderness to palpation, no rebound tenderness or guarding, no organomegaly Ext: Warm, well perfused, 2+ pulses, trace bilateral LE edema, no clubbing, cyanosis. Significant R UE Fistula with thrill Pertinent Results: Discharge Labs: [**2166-6-7**] 05:25AM BLOOD WBC-5.0 RBC-2.95* Hgb-9.1* Hct-28.8* MCV-97 MCH-30.6 MCHC-31.5 RDW-17.5* Plt Ct-146* [**2166-6-7**] 05:25AM BLOOD Plt Ct-146* [**2166-6-7**] 05:25AM BLOOD Glucose-79 UreaN-75* Creat-3.1* Na-143 K-4.5 Cl-106 HCO3-21* AnGap-21* [**2166-6-6**] 10:55AM BLOOD CK-MB-NotDone cTropnT-0.12* [**2166-6-6**] 02:54AM BLOOD CK-MB-NotDone cTropnT-0.14* [**2166-6-5**] 06:30PM BLOOD cTropnT-0.10* [**2166-6-5**] 06:30PM BLOOD CK-MB-NotDone proBNP->[**Numeric Identifier **] [**2166-6-7**] 05:25AM BLOOD Calcium-8.4 Phos-5.6* Mg-2.6 [**2166-6-5**] 06:36PM BLOOD Lactate-1.1 Microbiology: DIRECT INFLUENZA A ANTIGEN TEST (Final [**2166-6-6**]): Negative for Influenza A viral antigen. DIRECT INFLUENZA B ANTIGEN TEST (Final [**2166-6-6**]): NEGATIVE FOR INFLUENZA B VIRAL ANTIGEN. URINE CULTURE (Final [**2166-6-6**]): NO GROWTH. Blood Cx [**6-5**] Pending, Call [**Telephone/Fax (1) 2756**] to obtain results. Imaging: CXR: [**2166-6-5**] IMPRESSION: Findings are most compatible with volume overload and CHF. Repeat radiography after appropriate diuresis is recommended to assess for underlying infection. Please note the patient has had prior right upper lobe pneumonias, which appear relatively similar to the added density noted on the current study. Echo [**2166-6-6**]: The left atrium is moderately dilated. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is low normal (LVEF 50%). There is no ventricular septal defect. The right ventricular free wall is hypertrophied. The right ventricular cavity is dilated with borderline normal free wall function. The ascending aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild (1+) mitral regurgitation is seen. The left ventricular inflow pattern suggests impaired relaxation. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. Compared with the findings of the prior study (images reviewed) of [**2165-6-19**], the left ventricular ejection fraction is reduced. There is increased evidence for delayed relaxation/diastolic dysfunction od the left ventricle. Significant pulmonary hypertension persists. Abd X-ray [**2166-6-8**]: Again seen is marked degenerative change in thoracolumbar spine, with severe scoliotic curvature. Degenerative changes are seen in the hips. The gas pattern remains non-specific, with scattered air in the small and large bowel, with air seen extending into the rectum. There is no evidence for obstruction on today's study. There is no bowel wall thickening, pneumatosis, or supine evidence of free air. Numerous surgical clips are again seen throughout the mid abdomen. IMPRESSION: Non-specific bowel gas pattern, with no dilated loops of small bowel and air seen extending to the rectum. There is no evidence for obstruction. Brief Hospital Course: This is a 78 year-old female with Polycystic Kidney disease status post renal transplant admitted to the MICU for Pulmonary edema. 1) Pulmonary Edema: The patient was admitted to the MICU with flash pulmonary edema from hypertension/CHF. She was admitted and weaned from a nitro drip and her BPs returned to [**Location 213**] 140s. Initial concern for Pneumonia prompted tratment with Vanc/Zosyn/Levaquin that was discontinued after normal CXR and improving respiratory function. TTE showed decreased ejection fraction. She was aggressively diuresed with Lasix IV and her symptoms resolved. After transfer to the medical floor, the patient's oxygen requirement resolved and she was discharged with home physical thearapy. No changes to Heart Failure or renal regimen. 2) Polycystic Renal Disease, s/p Transplant: The patient was admitted with Creatinine elevated between 2.9-3.1. She was continued on her anti-rejection therapy, and discharged on her home lasix dose. 3) Elevated Troponin: The patient did have elevated troponin without specific EK changes. She was briefly started on Aspirin, but stopped given her GI bleed history after not convincingly ruling in for myocardial infarction. 4) Anemia of Chronic disease with possible iron deficiency component: Patient continued on Epogen and started on Iron supplementation with Colace 5) Abdominal Distention: The paitent reported this was increased from baseline, but imaging and bowel function remained intact, and her exam was not suggestive of an acute process. She will follow with her primary care physician. 6) Depression: Continued sertraline. Medications on Admission: CellCept 500mg PO BID Prednisone 6mg PO daily Diltiazem 240mg PO daily Irbesartan 150mg PO daily Furosemide 20mg PO BID Epo 15,000 units q week Calcitriol 0.25 mcg PO daily Vitamin D3 400mg PO daily Sertraline 25mg PO daily Clonazepam 0.5mg PO QHS prn Gabapentin 100mg PO TID Tramadol 50 mg PO daily Lidocaine 5% patch daily to back Zolpidem 5mg PO qHS Senna 8.6mg PO daily prn Lactulose 30 ml PO TID prn Discharge Medications: 1. Mycophenolate Mofetil 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. Prednisone 1 mg Tablet Sig: Six (6) Tablet PO DAILY (Daily). 3. Diltiazem HCl 120 mg Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO DAILY (Daily). 4. Irbesartan 150 mg Tablet Sig: One (1) Tablet PO once a day. 5. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. Epoetin Alfa 10,000 unit/mL Solution Sig: 1.5 mL Injection once a week. 7. Calcitriol 0.25 mcg Capsule Sig: One (1) Capsule PO DAILY (Daily). 8. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Sertraline 50 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 10. Clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)) as needed for anxiety/insomnia. 11. Gabapentin 100 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 12. Tramadol 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) as needed for pain. 13. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 14. Zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for insomnia. 15. Lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO Q8H (every 8 hours) as needed for constipation. 16. Senna 8.6 mg Capsule Sig: One (1) Capsule PO once a day as needed for constipation. 17. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day. Disp:*60 Capsule(s)* Refills:*2* 18. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: Primary Diagnoses: 1. Pulmonary Edema 2. Renal Transplant Secondary Diagnoses Polycystic kidney disease Polycystic liver disease Spinal stenosis Depression Chronic Grade II diastolic CHF Discharge Condition: Stable on room air, afebrile, ambulatory. Discharge Instructions: You have been admitted to the Intensive Care Unit hospital because of shortness of [**Name (NI) 1440**] due to "Pulmonary Edema," a condition in which your lungs collect fluid because of high blood pressure. We have given you lasix to take off excess fluid and correct his problem. We have added two medications for low blood counts (anemia): Ferrous Sulfate 325mg by mouth daily (Iron) Colace 100mg by mouth twice daily (Stool softener) Please call your doctor or 911 if you feel short of [**Name (NI) 1440**], have chest pain or any other concerning symptom. Happy Birthday! Followup Instructions: Please Call [**Telephone/Fax (1) 60**] to make an appointment with Dr. [**Last Name (STitle) **] within 1 week of discharge. ICD9 Codes: 4280, 2859, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7992 }
Medical Text: Admission Date: [**2132-9-4**] Discharge Date: [**2132-9-9**] Service: MED Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1055**] Chief Complaint: 1. SOB x 1 week 2. intermittent black stool for 6 months Major Surgical or Invasive Procedure: Upper Endoscopy Colonoscopy History of Present Illness: This is an 80 yo F who presents to the ED with SOB and LE edema x1 week. On arrival to the ED, she was unable to speak in full sentences and was wheezing. On further questioning, she claims that she had not been taking her usual dose of lasix for one week. Her presciption had ran out. She also notes a 6 month history of intermittent black stool. She has discussed this with her PCP, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **]. Her most recent occult blood in [**2132-8-20**] was negative and according to Dr. [**Last Name (STitle) **], the stool was brown, not black as she describes it. Patient also claims that she has occasional BRBPR on straining with BMs, with a history of hemorrhoids. She is on a daily ASA, and denies other NSAID use. She has no history of alcohol consumption. Denies abd pain/nausea/vomitting/hemetemesis. On ROS, she denies chest pain/fever/ chills/changes in bowel habit/headache/hemeturia/changes in diet. Past Medical History: 1. DM II 2. HTN 3. pulmonary hypertension 4. increased cholesterol 5. chroninc low back pain and sciatica Social History: Denies ETOH, IVDA, or tob use. Physical Exam: BP 150/58 P70 Gen: comfortable, pale elderly Russian speaking female lying in bed in NAD. HEENT: PERRL. Anicteric. MMM. Pale conjunctiva Neck: Supple. No masses or LAD. JVD 8-10 cm. Lungs: diffuse crackles. Cardiac: RRR. S1/S2. II/VI systolic M heard best at apex. Abd: Soft, obese, NT, ND, +NABS. No rebound or guarding. Extrem: 3+ pitting edema b/l, palpable DP pulses Neuro: CN II-VII intact, [**4-30**] musc strength UE/LE Pertinent Results: [**2132-9-4**] 08:14PM HGB-5.7* calcHCT-17 [**2132-9-4**] 04:22PM URINE HOURS-RANDOM [**2132-9-4**] 04:22PM URINE GR HOLD-HOLD [**2132-9-4**] 04:22PM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.009 [**2132-9-4**] 04:22PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2132-9-4**] 04:22PM URINE RBC-<1 WBC-<1 BACTERIA-RARE YEAST-NONE EPI-0-2 [**2132-9-4**] 04:18PM PT-13.3 PTT-29.5 INR(PT)-1.1 [**2132-9-4**] 03:21PM GLUCOSE-169* UREA N-86* CREAT-1.1 SODIUM-142 POTASSIUM-4.9 CHLORIDE-103 TOTAL CO2-24 ANION GAP-20 [**2132-9-4**] 03:21PM CK(CPK)-38 [**2132-9-4**] 03:21PM CK-MB-NotDone cTropnT-<0.01 [**2132-9-4**] 03:21PM VIT B12-182* [**2132-9-4**] 03:21PM WBC-10.2# RBC-1.92*# HGB-5.4*# HCT-17.0*# MCV-88 MCH-27.9 MCHC-31.6 RDW-17.2* [**2132-9-4**] 03:21PM NEUTS-77.8* LYMPHS-18.0 MONOS-3.0 EOS-0.7 BASOS-0.5 [**2132-9-4**] 03:21PM HYPOCHROM-3+ ANISOCYT-1+ MICROCYT-1+ [**2132-9-4**] 03:21PM PLT COUNT-362# Brief Hospital Course: 80 yo F w/ DM2, HTN, PA HTN p/w SOB and LE edema x1 week, now with severe anemia (hct of 17 noted by her PCP) thought to be secondary to UGIB, hemodynamically stable s/p 6 Units of bld w/ increase of hct to 30. serial hcts q 6 hrs remained stable at 30. Pt had EGD in ED ([**2132-9-5**]) which revealed granularity, friability and erythema in the stomach body, fundus and antrum compatible with acute gastritis (biopsy obtained). Erythema in the duodenal bulb compatible with duodenitis. Ulcer in the distal bulb. Otherwise normal EGD to second part of the duodenum. Echo:([**2132-8-23**]) 1. The left atrium is mildly dilated. 2. The left ventricular cavity size is normal. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF>55%). 3. The aortic valve leaflets are mildly thickened. Mild (1+) aortic regurgitation is seen. 4. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. 5. Compared with the findings of the prior study (tape reviewed) of [**2128-8-18**], there has been no significant change. 1. GIB with increased BUN, likely UGIB, however LGIB initially considered as well. Pt had 2 large bore IV's placed. NG lavage was positive as well as stool guiacs. EGD as above. No active bleed noted however ulcer and gastritis likely source of anemia. Ulcer thought to be secondary to NSAID use vs H. pylori. Will treat for H.Pylori if indicated. Pt will follow up with GI. ASA was held secondary to bleed. Losartan was initially held, then restarted at half normal dose. NSAIDs were avoided. Initially given IV PPI [**Hospital1 **] which was then changed to po. Colonoscopy performed was reported to be normal. 2. Cardiac. EKG changes (NSR at 84, Nl axis and intervals, TWI III, TWI V1-V4). Pt was ruled out for MI with three sets of neg cardiac enzymes. She denied CP. ECG changes likely secondary to demand ischemia from severe anemia. She was initially monitored on tele with no events. An echo done on [**2132-8-23**], as above (LVEF>55%). SOB most likely due to discontinuation of lasix for one week in setting of diastolic CHF. Treated with 40 of lasix IV (held off on diuresis intially secondary to concern for GI bld). 3. Resp. CXR done on [**2132-9-5**] without overt evidence of CHF or pneumonia. Findings suggestive of pulmonary artery hypertension. She required O2 supplementation during her stay and was noted to have RA sats in the 80's with ambulation likely secondary to PA HTN. She was sent home on supplemental O2. A Repeat cxr was suggestive of pulm congestion. Lasix given as above. 4. DM2. Initially bld sugars controlled with RISS, oral hyperglycemics were restarted prior to discharge. 5. Anemia secondary to gastritis and PUD, as well as Fe/Vit B12 def. She was transfused a total of 6 Units of PRBC's and her hct was monitored q 6 hrs. She was started on Vit B12 supplementation. She was continued on Niferex. Medications on Admission: 1. Niferex 150 [**Hospital1 **] 2. metformin 850 TID 3. Losartan 50 4. Rosiglitazone 8 QD 5. Lipitor 20 6. ASA 81 7. lasix 40 [**Hospital1 **] 8. Paxil 20 Discharge Medications: 1. Atorvastatin Calcium 20 mg Tablet Sig: One (1) Tablet PO QD (once a day). 2. Paroxetine HCl 20 mg Tablet Sig: One (1) Tablet PO QD (once a day). 3. Metformin HCl 850 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 4. Rosiglitazone Maleate 8 mg Tablet Sig: One (1) Tablet PO QD (once a day). 5. Polysaccharide Iron Complex 150 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 7. Cyanocobalamin 500 mcg Tablet Sig: Two (2) Tablet PO QD (once a day). Disp:*60 Tablet(s)* Refills:*2* 8. Losartan Potassium 50 mg Tablet Sig: One (1) Tablet PO once a day. 9. Furosemide 40 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 10. Supplemental Oxygen Please use supplemental Oxygen with exerction. Discharge Disposition: Home With Service Facility: [**Hospital6 1952**], [**Location (un) 86**] Discharge Diagnosis: Upper GI Bleed secondary to Gastritits Secondary Diagnoses: DM HTN Vitmain B12 deficiency Discharge Condition: Good. Discharge Instructions: Please call your primary care physician or return to the hospital if you experience further bleeding, shortness of breath, or any other problems arise. Please use supplemental oxygen with exerction. DO NOT TAKE ASPIRIN. Followup Instructions: 1. Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1953**], [**Name12 (NameIs) 280**] Where: [**Hospital6 29**] [**Hospital3 249**] Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2132-9-17**] 10:40 2. Provider: [**Name10 (NameIs) **] Where: [**Hospital6 29**] MEDICAL SPECIALTIES Phone:[**Telephone/Fax (1) 1954**] Date/Time:[**2132-9-30**] 2:20 3. Provider: [**Name Initial (NameIs) **] PAIN MANAGEMENT CENTER Where: PAIN MANAGEMENT CENTER Date/Time:[**2132-9-17**] 3:00 4. Provider: [**First Name11 (Name Pattern1) 1955**] [**Last Name (NamePattern4) 1956**], M.D. Where: [**Hospital6 29**] [**Hospital3 1935**] CENTER Phone:[**Telephone/Fax (1) 253**] Date/Time:[**2132-10-31**] 1:00 ICD9 Codes: 4280, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7993 }
Medical Text: Admission Date: [**2119-9-29**] Discharge Date: [**2119-10-6**] Date of Birth: [**2060-9-23**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2297**] Chief Complaint: Hypoxia Major Surgical or Invasive Procedure: subclavian central venous catheter placement endotracheal intubation and extubation peripherally inserted central venous catheter History of Present Illness: 59 yo M with advanced MS, hx of MRSA/VRE, neurogenic bladder, g-tube/colostomy, psych disorders, hypothyroidism presents from NH with hypoxia. Patient noted to be shortness of breath, tachypnea, tachycardia, diaphoretic starting [**2119-9-27**]. Patient dx with LLL PNA at [**Hospital 100**] rehab on [**9-27**] started on Augmentin and Nebs. NH VS Tmax 100.2 HR 120-130s, BP 110/60's, RR 40 O2 sat 80's on 4 L NC. ABG was 7.56/26/83. Patient transfered to [**Hospital1 18**] for ongoing management. . In the ED VS: 98.0 125 100/60 20's-40 99% NRB. CXR showing possible aspiration, CTA protocol r/out PE c/w multilobar PNA. Started Vanco, levo, Flagyl for aspiration PNA. Total 3 L fluid bolus for BP 80->90s via right subclavian line placed in ED. . Upon arrival to the ICU, VSS, BP 110's, still very tachypneic RR ~40 however does not appear in distress, O2 sat 99% NRB, desats to upper 70's when pulls off mask. Past Medical History: - Multiple sclerosis. - Neurogenic bladder. - Swallowing disorder. - Schizoaffective disorder/Depression. - Hypothyroidism. - s/p colectomy with mucous fistula in [**2106**] secondary to C.diff colitis, course complicated by abscess, has G-tube - h/o aspiration pneumonia - h/o MRSA/VRE in urine [**2107**] - GERD - anxiety Social History: The patient is a [**Hospital 100**] Rehab resident. No ETOH, no tobacco, no IV drug use. has legal guardian Physical Exam: Upon arrival to the ICU: VS: 97.3 BP 112/73 HR 121 97% NRB-->78% RA Gen: middle aged male, contracted on left side, non verbal, NAD, not using accessory muscles of respiration. Neck: supple, JVD above clavicle at 45 degrees Heent: slightly pale, MMM, PERRL, anicteric, sunken eyes Skin: pale, no rashes, moist, few LE excoriations Chest: rhonchi diffusely, good air entry, no rales CVS: nl S1 S2, tachy, regular, no m/r/g appreciated Abd: soft, colostomy draining soft brown stool, NT/ND, BS+ Ext: atrophy, no edema, +excoriations, warm, 2+ dp pulses b/l, right arm/hand contracted Neuro: PERRL, 2mm pupils, does not follow commands, moans, able to use left hand . Pertinent Results: Admission Labs: [**2119-9-29**] 12:40AM WBC-10.7 RBC-3.11*# HGB-9.0*# HCT-27.1*# MCV-87 MCH-28.9 MCHC-33.2 RDW-16.7* [**2119-9-29**] 12:40AM PLT COUNT-156 [**2119-9-29**] 12:40AM NEUTS-84.4* LYMPHS-8.4* MONOS-5.1 EOS-1.7 BASOS-0.3 [**2119-9-29**] 12:40AM GLUCOSE-109* UREA N-31* CREAT-1.2 SODIUM-135 POTASSIUM-3.7 CHLORIDE-99 TOTAL CO2-25 ANION GAP-15 [**2119-9-29**] 12:55AM LACTATE-2.1* [**2119-9-29**] 01:50AM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2119-9-29**] CXR: There is a consolidation at the left lower lobe with air bronchograms. There is diffuse opacification of both lung fields. There is mild re-distribution of pulmonary vasculature, but no septal lines and no frank evidence for pulmonary edema. The heart and great vessels of the mediastinum are stable. Severe thoracolumbar scoliosis is again noted. IMPRESSION: Left lower lobe pneumonia with more diffuse pneumonia or mild pulmonary edema. . [**2119-9-29**] CTA chest: Brief Hospital Course: A/P: 59 yo patient with advanced MS presents with multilobar PNA. . 1.) Multilobar Pneumonia/Respiratory Failure: The patient had a fever, cough, and chest xray finding s consistent with pneumonia. He developed progressive respiratory distress and was electively intubated and placed on mechanical ventilation. He underwent a bronchoscopy which on lavage releaved staph aureas (methicillin resistant) and a moderate amount of hemorrhage. He was treated initially with broad spectrum antibiotics which were later tailored once antibiotic sensitivities were available. He will complete a 14 day course of vancomycin (7 days of which after discharge). Of note, he did develop a self-limited mild eosinophilia while on zosyn. He did not develop a rash or clinically worsen. This should not be thought of as an absolute contra-indication for future zosyn therapy should this antibiotic be clinically indicated. He was gradually weaned from the venilator as he was diuresed with furosemide and acetazolamide. He was successfully extubated and upon discharge he had stable oxygenation with supplemental oxygen by face mask. A PICC line was placed for antibiotics. His vancomycin on the day of discharge was held for a high trough level. His goal vancomycin trough should be [**10-6**]. He will be discharged on 1 gram of vancomycin every day which can be adjusted per vancomycin trough. He received nebulized bronchodilators. . 2.) Hypotension: The patient did develop hypotension to sbp ~90 during his admission. This was thought likely to be from sepsis. He was fluid resusitated and received brief period of vasopressors. He had an appropriate response on [**Last Name (un) 104**]-stim testing and did not require steroid replacement. Upon discharge he was normotensive with maintenance of adequate urine output and stable creatinine. . 3.) Anemia. Hct 27 (baseline low 40's). Guiac positive ostomy output per ED. The hematocrit drop was thought secondary to the pulmonary hemorrhage with subsequent blood being swallowed into the stomach. His hematocrit stabilized. He did not require blood transfusions. . 4.) Hypothyroid: no acute issues during this hospitalization and he continued on his home dose of synthroid. . 5.) GERD. PPI, elevate head of bed. . 6.) Psych. H/o schizoaffective disorder, anxiety. The patient is non-verbal and minimally responsive at baseline and it was difficult to assess mood or thought disorders. A psychiatry consult was obtained to make recommendations on use of the patient's despiramine during this acute illness. A despramine level was checked and found to not be toxically elevated. He was continued on this medication. He received versed and fentanyl while intubated then low dose ativan as needed for anxiety and agitation post-extubation. . 7.) Multiple Sclerosis: The patient has advance multiple sclerosis. He has a neurogenic bladder and chronically foley dependent. Urine output was monitored with foley catheter in place . 8.) PPx. PPI, Heparin SC, hold bowel reg/has colostomy . 9.) FEN. He recieved tube feeds via his gastrostomy tube. His electrolytes were repleted as necessary. . 10.) Thrombocytosis: The patient had an elevated platelet count which was thought to be a reactive process secondary to his resolving pneumonia exacerbated by the diuresis that was required to resolve the pulmonary edema. This lab value should be follow-up to insure resolution. . 11.) Full Code. Confirmed in NH records and with sister who is legal guardian. . 12.) Dispo: The patient was monitored in the intensive care unit while in the hospital. He was transferred back the the MAC unit where he was a resident. . 13.) Access: He had a subclavian central venous catheter placed for volume resusitation. He was discharge with PICC line for the IV antibiotics. . 14.) Comm: Sister [**Name (NI) **] [**Name (NI) 1726**] [**Telephone/Fax (1) 104993**], [**Telephone/Fax (1) 104994**]; Brother [**Name (NI) 4036**] [**Name (NI) 104995**] [**Telephone/Fax (1) 104996**] PCP [**Name Initial (PRE) **] [**Telephone/Fax (1) 608**] Medications on Admission: - Augmentin 500 mg q12 started [**9-28**] - Ativan 0.5 prn - Synthroid 50 mcg daily - Pepcid 20 mg daily - MVI daily - Desipramine 75 mg daily - G-tube Jevity 1.2 cal Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Primary: Pneumonia Sepsis . Secondary: Multiple sclerosis schizoaffective disorder neurogenic bladder hypothyroidism Anemia c. dif colitis s/p colectomy with mucous fistula Discharge Condition: stable. afebrile. stable vital signs. tolerating tube feeds at goal. Discharge Instructions: You have been evaluated and treated for pneumonia. You will continue to receive antibiotics for the next 7 days according to the prescriptions. Followup Instructions: Per extended care facility routine ICD9 Codes: 5070, 0389, 4280, 2449
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Medical Text: Admission Date: [**2148-3-27**] Discharge Date: [**2148-3-28**] Service: MEDICINE HISTORY OF PRESENT ILLNESS: The patient is an 80 year old woman with a history of hypertension and peripheral vascular disease who presented to her primary care physician in [**2147-11-25**] with a complaint of cough and chest tightness. The symptoms persisted and the patient had a chest x-ray done on [**2148-3-6**], which showed a large right sided [**Location (un) 21851**] in the paratracheal region. On review of systems, the patient reports slow progression of exertional dyspnea, fatigue, anorexia and hemoptysis times several weeks. The patient presented to the Emergency Room on [**2148-2-26**], with significant worsening of dyspnea, wheezing and cough. CT scan was done which showed a large right upper lobe mass extending into the mediastinum, 7.2 centimeters by 7.7 centimeters, associated with right upper lobe collapse. There was extensive right hilar and sub-carinal lymphadenopathy with an 8 millimeter nodular density in the right posterior middle lobe and small right pleural effusion. The patient was discharged and had an outpatient bronchoscopy performed which showed tumor invasion in the distal tracheal, right main-stem bronchus was patent at that time. Unable to do biopsy secondary to patient coughing, discomfort and difficulty visualizing the bronchus. Repeat bronchoscopy was done on [**2148-3-15**], which showed complete obstruction of the main stem bronchus. Biopsies taken indicated poorly differentiated carcinoma infiltrating bronchial sub-mucosa. The patient was admitted on [**2148-3-16**], to [**Hospital3 20445**] for worsening shortness of breath. The patient was started on Solu-Medrol which was subsequently changed to Prednisone. The patient underwent a staging work-up with abdominal CT scan which showed no metastases. The patient was sent for mapping to initiate XRT to large lung mass. While lying flat, the patient became more dyspneic with increasing coughing and obvious cyanosis. The patient underwent an emergency CT scan which showed progression of disease and compression of the trachea and main [**Last Name (un) 2435**] bronchus. The patient was sent to [**Hospital1 190**] for emergent XRT and then sent back to [**Hospital3 1196**] for chemotherapy. The patient received one cycle of Carboplatin and Taxol on [**2148-3-24**], and has had a total of five cycles of XRT (last cycle on [**2148-3-22**]). The patient reportedly developed increasing cough with periods of bronchospasm and cyanosis despite increasing doses of steroids, nebulizer treatments and heated face mask. The patient was referred to [**Hospital1 69**] for stenting of her trachea and right main stem bronchus. PAST MEDICAL HISTORY: 1. Hypertension. 2. Severe peripheral vascular disease on Coumadin status post bilateral femoral-popliteal bypass in [**2127**]. 3. Status post left below the knee amputation in [**2128**] secondary to obstructing clot and left foot ischemia. 4. In [**2140**], the patient underwent a redo right axillary shunt to lower extremity bypass which was complicated by postoperative pulmonary embolus treated with Coumadin and IVC filter placement. 5. Non-small cell lung cancer as above. The patient's Oncologist is Dr. [**Last Name (STitle) 6099**] and Dr. [**First Name8 (NamePattern2) 3551**] [**Last Name (NamePattern1) 8631**]. Her Pulmonologist is Dr. [**Last Name (STitle) 40217**]. MEDICATIONS AT HOME: 1. Coumadin 2 mg p.o. q. h.s. 2. Maxzide. MEDICATIONS ON TRANSFER: 1. Diltiazem 60 mg p.o. q. day. 2. Albuterol and Atrovent nebulizers q. four hours. 3. Decadron 4 mg intravenous q. four hours. 4. Levaquin 250 mg p.o. q. day. 5. Robitussin and Tessalon Pearls p.r.n. SOCIAL HISTORY: The patient is widowed for seven years. She has three children. She lives independently and ambulates with a cane. She has 40 pack year history of smoking; quit in [**2127**]. PHYSICAL EXAMINATION: Temperature 98.6 F.; blood pressure 134/60; pulse 110; saturation of 93% on five liters. In general, the patient was alert and oriented times three. Cardiovascular: The patient was tachycardic with no appreciable murmurs, rubs or gallops. Lungs: Bronchial breath sounds, left greater than right. Abdomen: Obese, nontender, not distended, normal bowel sounds. Extremities: Left below the knee amputation. No cyanosis, clubbing or edema. LABORATORY: On admission, white blood cell count 25.0, hematocrit 32.3, platelets 185. Sodium 129, potassium 5.1, BUN 39, creatinine 0.9, albumin 2.8, calcium 8.5, magnesium 2.1. HOSPITAL COURSE: The patient is an 80 year old woman with poorly differentiated non-small cell lung cancer admitted with compression of the trachea and right main stem bronchus by a large right upper lobe tumor. On hospital day one, the patient underwent a rigid bronchoscopy with findings of the right upper lobe occluded by tumor; in addition, distal trachea had a near total obstruction by tumor. The patient underwent placement of a stent to the distal trachea and right main stem bronchus. Repeat bronchoscopy was performed on hospital day number two, which showed stents to be patent and in good position. Distal airways were patent as well and mild to moderate secretions were noted bilaterally. Post-procedure, the patient maintained O2 saturations of 93 to 98% on a 50% face mask (this was her O2 requirement on admission). The patient was subsequently transitioned to shovel mask with three liters nasal cannula, again maintaining her saturations above 93%. The patient did note subjectively improvement in shortness of breath post-procedure. The patient was continued on humidified oxygen, standing Albuterol and Atrovent nebulizers q. four hours. In addition, the patient was given Lidocaine nebulizers to help with continued cough. In addition, the patient was continued on Decadron to help decrease inflammation in the bronchus and was continued on prophylactic antibiotics with Levaquin and Flagyl post-procedure. MEDICATIONS AT THE TIME OF DISCHARGE: 1. Diltiazem 60 mg p.o. q. day. 2. Heparin 5000 units subcutaneously twice a day. 3. Decadron 4 mg intravenously q. four hours. 4. Protonix 40 mg p.o. q. day. 5. Levaquin 500 mg p.o. q. day. 6. Flagyl 500 mg p.o. q. eight hours. 7. Albuterol and Atrovent nebulizers q. eight hours. 8. Lidocaine nebulizers 2.5 cc. of 1% Lidocaine q. one hour p.r.n. CONDITION ON DISCHARGE: Stable. DISCHARGE STATUS: The patient will be discharged back to [**Hospital3 1196**] for continuing care. DISCHARGE DIAGNOSES: 1. Non-small cell lung cancer with compression of trachea and main stem bronchus status post stent placement. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3090**], M.D. [**MD Number(1) 3091**] Dictated By:[**Last Name (NamePattern1) 1297**] MEDQUIST36 D: [**2148-3-28**] 13:02 T: [**2148-3-28**] 13:26 JOB#: [**Job Number 40218**] ICD9 Codes: 4439, 4019
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Medical Text: Admission Date: [**2201-1-23**] Discharge Date: [**2201-2-2**] Date of Birth: [**2154-5-17**] Sex: F Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1505**] Chief Complaint: Increasing shortness of breath Major Surgical or Invasive Procedure: [**2201-1-26**] Atrial Septal Defect Repair with Bovine Pericardial Patch, and Atrial Thrombectomy History of Present Illness: Mrs. [**Known lastname 20948**] is a 46 yo female with increasing SOB over past 3 weeks, associated with a 20 punds weight gain. She also noted acrocyanosis one week prior to admission. Echo at outside hospital reported large atrial septal defect wtih primarily left to right shunt. There was moderate right ventricular dilatation, moderate right ventricular hypokinesis with moderate pulmonary hypertension. Echo also notable for a four centimeter clot in the right atrium. Prior to surgical intervention, she underwent cardiac catheterization which revealed normal coronary arteries. She was transferred to the [**Hospital1 18**] for cardiac surgical intervention. Past Medical History: Atrial Septal Defect with Right Atrial Thrombus Pulmonary Hypertension Obesity History of Atrial Fibrillation ?Obstructive Sleep Apnea Social History: Denies tobacco and ETOH. Works as cafeteria worker. Family History: Denies premature coronary disease/sudden death. Physical Exam: PREOP EXAM: Vitals: 98.7, 101/60, 92, 18, 95% 3L NAD lying in bed Neuro A&O nonfocal exam Lungs with decreased breath sounds at both bases, fine crackles Heart Irregular Abdomen benign, obese Extrem warm, 2+ BLE edema, Rash on bilateral ankles Pertinent Results: [**2201-1-23**] Transthoracic ECHO: The left atrium is mildly dilated.A left-to-right shunt across the interatrial septum is seen at rest across a large secundum atrial septal defect. There is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (LVEF>55%). Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. The right ventricular cavity is moderately dilated with moderate global free wall hypokinesis. The number of aortic valve leaflets cannot be determined. There is no aortic valve stenosis. No aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. The tricuspid valve leaflets are mildly thickened. Moderate [2+] tricuspid regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. [**2201-1-26**] Intraop TEE: PREBYPASS: A definite large (3.1cmx2cm) thrombus in the right atrial appendage. There is a bidirectional shunt across the interatrial septum at rest. A large secundum atrial septal defect is present. The left ventricular cavity size is normal. There is mild global left ventricular hypokinesis (LVEF = 45-50 %). The right ventricular cavity is markedly dilated with moderate global free wall hypokinesis. The ascending, transverse and descending thoracic aorta are normal in diameter and free of atherosclerotic plaque. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. No aortic regurgitation is seen. The mitral valve leaflets are structurally normal. Mild (1+) mitral regurgitation is seen. POSTBYPASS: Pt was removed from cardiopulmonary bypass on epinephrine and phenylephrine infusions and was AV paced. 1. The large ASD has been subsequently repaired; there is no evidence of flow across the intraatrial septum. 2. The RV remains markedly dilated with moderate global hypokinesis. 3. LV remains with mild left ventricular hypokinesis without evidence of regional wall abnormalities. 4. Aortic contours are intact post decannulation. [**2201-1-29**] CXR: The cardiomegaly is unchanged. The post-sternotomy wires are intact. Bibasilar consolidations consistent with atelectasis are grossly unchanged, still significant. There is no appreciable pleural effusion, and there is no pneumothorax. Brief Hospital Course: She was started on a heparin drips. She was started on cipro for a UTI. She was taken to the operating room on [**1-26**] where she underwent an atrial thrombectomy and ASD repair. She was transferred to the ICU in critical but stable condition on epi and propofol. She was given 48 hours of vancomycin as she was in the hospital preoperatively. She was extubated later that same day. She was started on fluconazole for the rash on her ankles. She was started on coumadin. She was transferred to the floor on POD #1. Over the next several days the patient was gently diuresed, she was started on Bblockers and was anticoagulated. She has been in AFib with a rapid ventricular rate, up to the 140's with activity. By POD #7, after her Lopressor had been increased, her heart rate was better controlled. She was also started on Keflex for an IV site phlebitis. She is now stable, and ready to be discharged home. Her Coumadin will be followed by the [**Hospital 40198**] [**Hospital **] Clinic ([**Telephone/Fax (1) 77855**]), [**Doctor Last Name **] has been notified, and records faxed to her there. Medications on Admission: Home: Aspirin, MVI Transfer: Lisinopril 2.5 qd, Aspirin 81 qd, Lasix IV 40 bid, Nexium 40 qd, IV Heparin, Metoprolol 50 tid, Silver Sulfa Cream, Colace, KCL 40 qd, Digoxin 0.125 qd, Vitamin C, Zinc Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 2. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 3. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 4. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 5. Warfarin 5 mg Tablet Sig: One (1) Tablet PO ONCE (Once): take 1 tablet (5 mg) daily for 2 days, then as directed by [**Hospital 40198**] Health Care Center ([**Telephone/Fax (1) 77856**]. Disp:*30 Tablet(s)* Refills:*0* 6. Furosemide 40 mg Tablet Sig: One (1) Tablet PO once a day for 10 days. Disp:*10 Tablet(s)* Refills:*0* 7. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: Two (2) Tab Sust.Rel. Particle/Crystal PO once a day for 10 days. Disp:*20 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 8. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO once a day: Please take two 200mg tablets once daily for 7days. Then one 200mg once daily until stopped by cardiologist. Disp:*60 Tablet(s)* Refills:*2* 9. Metoprolol Tartrate 25 mg Tablet Sig: Three (3) Tablet PO TID (3 times a day). Disp:*270 Tablet(s)* Refills:*2* 10. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours) for 5 days. Disp:*20 Capsule(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital1 40198**] VNA Discharge Diagnosis: Atrial Septal Defect with Right Atrial Thrombus - s/p Repair Acute Right Heart Failure Preoperative Urinary Tract Infection Lower Extremity Rash Obesity History of Atrial Fibrillation ?Obstructive Sleep Apnea Discharge Condition: Good Discharge Instructions: 1)Please shower daily. No baths. Pat dry incisions, do not rub. 2)Avoid creams and lotions to surgical incisions. 3)Call for redness or drainage from surgical wounds 4)No lifting more than 10 lbs for at least 10 weeks from surgical date. 5)No driving for at least one month. 6)Monitor PT/INR every Mon, Wed, and Friday until INR stablizes. [**Hospital1 40198**] Health Clinic will manage Coumadin dosing as outpatient. VNA should call or fax results to clinic. Goal INR is between 2.0 - 3.0. Followup Instructions: [**Hospital 40198**] Health Care Center for INR check/Coumadin dosing on Weds [**2-4**] at 10:00 am Dr. [**Last Name (STitle) **] in [**2-21**] weeks, call for appt Dr. [**Last Name (STitle) 77857**] 2-3 weeks, call for appt Dr. [**First Name (STitle) 437**], call for appt Completed by:[**2201-2-2**] ICD9 Codes: 4280, 5990
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Medical Text: Admission Date: [**2149-1-29**] Discharge Date: [**2149-2-5**] Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 165**] Chief Complaint: chest pain Major Surgical or Invasive Procedure: OP CABGx4(SVG-LAD,SVG-Diag,SVG-OM,SVG-PDA)[**1-31**] History of Present Illness: 89 year old man with h/o HTN, admitted to OSH [**1-27**] with severe [**10-21**] substernal chest pain, non-radiating. This occured after the patient had gotten in an argument as well as had been shoveling some snow prior to the onset of chest pain. Patient usually does not have any anginal symptoms. He had some associated SOB, no N/V, lightheadedness of diaphoresis. The pain had improved to [**4-20**] with sublingual nitro he received by EMT en route to the hospital. At the OSH an EKG revealed very mild ST elevation V1-V3 and peaked T's. Initial troponin 0.064 with subsequent troponin .350. CK 76. He receved Lopressor and nitro in the ED. He was subsequently transferred to [**Hospital1 **] where he underwent cardiac cath which revealed 3 vessel disease with a tight proximal LAD lesion with thrombus, moderate stenosis of the ostial RCA, OM2 with tight lesion. Post-cath course complicated by a right groin hematoma 6"long x 1" wide. Hct 40.7 upon transfer (47 on admission). Patient was transfered here for evalution for CABG. He came in on a heparin and integrillin gtt. Past Medical History: hypertension kidney stones polymyalgia [**Hospital1 23389**] [**Hospital1 **] 7 years ago s/p hernia repair Social History: Patient currently works as a constable for the town of [**Location (un) 1110**]. He lives at home with his wife whom he cares for. He formerly smoked (15 pack year history) but quit 50 years ago, denies ETOH or drug use. . Family History: Family history notable for CAD in his brother and sister. [**Name (NI) 6961**] died from cancer. Physical Exam: VS - 98.7 128/66 66 18 Gen: Elderly male in NAD HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Neck: Supple with JVP of 8 cm. CV: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. SEM heard over entire precordium. Chest: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. Abd: Soft, NTND. No HSM or tenderness. Ext: No c/c/e. Skin:Ecchymosis on right forearm and 2cm ecchymotic area of left lower lip. Pertinent Results: [**2149-2-5**] 09:20AM BLOOD WBC-12.0* RBC-3.38* Hgb-10.6* Hct-31.9* MCV-94 MCH-31.5 MCHC-33.3 RDW-14.3 Plt Ct-135* [**2149-2-5**] 09:20AM BLOOD Plt Ct-135* [**2149-2-3**] 08:05AM BLOOD PT-15.1* PTT-30.4 INR(PT)-1.3* [**2149-2-5**] 09:20AM BLOOD Glucose-116* UreaN-26* Creat-1.2 Na-135 K-4.2 Cl-101 HCO3-24 AnGap-14 CHEST (PORTABLE AP) [**2149-2-3**] 8:57 AM CHEST (PORTABLE AP) Reason: evaluate for ptx s/p ct removal [**Hospital 93**] MEDICAL CONDITION: 89 year old man with s/p cabg REASON FOR THIS EXAMINATION: evaluate for ptx s/p ct removal REASON FOR EXAMINATION: Chest tube removal in a patient after CABG. Evaluation for pneumothorax. Portable AP chest radiograph compared to [**2149-1-31**]. The patient was extubated in the meantime interval with removal of the Swan- Ganz catheter, NG tube, chest tube, and mediastinal drains. The cardiomediastinal silhouette is stable. Post-sternotomy wires are unremarkable. Lungs are clear. Minimal bilateral pleural effusion is present. There is no pneumothorax. [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname 76630**], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 76631**] (Complete) Done [**2149-1-31**] at 8:48:55 AM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) **] Division of Cardiothoracic [**Doctor First Name **] [**First Name (Titles) **] [**Last Name (Titles) **] [**Hospital Unit Name 4081**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2059-8-10**] Age (years): 89 M Hgt (in): BP (mm Hg): / Wgt (lb): HR (bpm): BSA (m2): Indication: Abnormal ECG. Aortic valve disease. Chest pain. Coronary artery disease. Hypertension. ICD-9 Codes: 786.51, 440.0, 424.1 Test Information Date/Time: [**2149-1-31**] at 08:48 Interpret MD: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 5209**], MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 5209**], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Suboptimal Tape #: 2007AW2-: Machine: Echocardiographic Measurements Results Measurements Normal Range Left Ventricle - Septal Wall Thickness: *1.4 cm 0.6 - 1.1 cm Left Ventricle - Ejection Fraction: 35% to 40% >= 55% Findings LEFT ATRIUM: Mild LA enlargement. No spontaneous echo contrast in the body of the [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **] LAA. No mass/thrombus in the [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **] LAA. Good (>20 cm/s) LAA ejection velocity. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. A catheter or pacing wire is seen in the RA and extending into the RV. No ASD by 2D or color Doppler. LEFT VENTRICLE: Mild symmetric LVH. Normal LV cavity size. Mild-moderate regional LV systolic dysfunction. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. Normal RV wall thickness. Normal RV chamber size. AORTA: Normal aortic diameter at the sinus level. Simple atheroma in aortic root. Normal ascending aorta diameter. Simple atheroma in ascending aorta. Normal aortic arch diameter. Simple atheroma in aortic arch. Normal descending aorta diameter. Simple atheroma in descending aorta. AORTIC VALVE: Three aortic valve leaflets. Moderately thickened aortic valve leaflets. Mild AS (AoVA 1.2-1.9cm2). Trace AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Moderate mitral annular calcification. Calcified tips of papillary muscles. Mild (1+) MR. TRICUSPID VALVE: Mild [1+] TR. PULMONIC VALVE/PULMONARY ARTERY: Pulmonic valve not well seen. PERICARDIUM: Trivial/physiologic pericardial effusion. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. The patient received antibiotic prophylaxis. The TEE probe was passed with assistance from the anesthesioology staff using a laryngoscope. No TEE related complications. patient. Conclusions 1. The left atrium is mildly dilated. No spontaneous echo contrast is seen in the body of the left atrium or left atrial appendage. No mass/thrombus is seen in the left atrium or left atrial appendage. No atrial septal defect is seen by 2D or color Doppler. 2. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. There is mild to moderate regional left ventricular systolic dysfunction with anteroseptal inferior hypokinesis. Apical akinesis. 3. . Right ventricular chamber size and free wall motion are normal. Right ventricular chamber size is normal. 4. There are simple atheroma in the aortic root. There are simple atheroma in the ascending aorta. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. 5. There are three aortic valve leaflets. The aortic valve leaflets are moderately thickened. There is limited mobility of the RCC. There is mild aortic valve stenosis (area 1.2-1.9cm2). Trace aortic regurgitation is seen. 6. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. 7. There is a trivial/physiologic pericardial effusion. On infusions of Levo, epi, phenylephrine during coronary occlusions. Post CABG lvef =35-40%. Inferoseptal, anterior and anteroapical hypokinesis. MR remains 1+. Brief Hospital Course: He was seen by cardiac surgery. His platelet count was low, and HIT ab was negative. He was taken to the operating room on [**1-31**] where he underwent an off pump CABG x 4. He was transferred to the ICU in critical but stable condition on epi, phenylephrine and propofol. He received 48 hours of prophylactic vancomycin as he was in the hospital preoperatively. He was extubated on POD #1. He was transferred to the floor late on POD #1. He was started on plavix for his off pump CABG. Chest tubes and wires were pulled without incident. He did well postoperatively and was ready for discharge to rehab on POD #5. Medications on Admission: CURRENT MEDICATIONS on Transfer: Asa 325mg prednisone 9mg daily lopressor 25mg twice a day protonix 40 mg daily colace heparin gtt Integrellin gtt . Medication at home: HCTZ 25mg daily Diltiazem ER 120mg daily Prednisone 9mg daily Potassium 200mEq daily Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 4. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 5. PredniSONE 1 mg Tablet Sig: Nine (9) Tablet PO DAILY (Daily): 9 mg daily. 6. Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day). 7. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 8. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 1 weeks: then reassess need for diuresis. Disp:*qs Tablet(s)* Refills:*0* 9. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO BID (2 times a day) for 1 weeks: while on lasix . 10. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO Q 8H (Every 8 Hours). Tablet(s) Discharge Disposition: Extended Care Facility: [**Hospital 745**] Health Care Center Discharge Diagnosis: CAD now s/p CABG NSTEMI HTN, kidney stones, polymyalgia [**Last Name (LF) 23389**], [**First Name3 (LF) **] 7 years ago, s/p hernia repair Discharge Condition: Good. Discharge Instructions: Call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week. Shower, no baths, no lotions, creams or powders to incisions. No lifting more than 10 pounds or driving until follow up with surgeon. Followup Instructions: Dr. [**Last Name (STitle) 32255**] 2 weeks Dr. [**Last Name (STitle) 70216**] 2 weeks Dr. [**First Name (STitle) **] 4 weeks [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2149-2-5**] ICD9 Codes: 9971, 2762, 4019, 2875
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Medical Text: Admission Date: [**2158-8-23**] Discharge Date: [**2158-8-27**] Date of Birth: [**2089-3-31**] Sex: F Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 165**] Chief Complaint: asymptomatic with heart murmur Major Surgical or Invasive Procedure: [**First Name3 (LF) **].Inv. MVR (29mm [**Company 1543**] Mosaic porcine) History of Present Illness: 69 yo female with long history of heart murmur. recent echo showed worsening MR with increased PA pressures. Pt. is currently asymptomatic and remains very active. Referred for valve surgery. Past Medical History: mitral valve prolapse/regurg. HTN PSH: c- sections x3 bil. vein strippings Social History: grandmother, lives alone never used tobacco, occasional ETOH Family History: father died at 55 of complics. of DM Physical Exam: WDWN in NAD skin/HEENT unremarkable neck supple with full ROM, no carotid bruits appreciated CTAB Irregular HR with 4/6 systolic murmur best heard at LLSB soft, NT, ND, + BS extrems warm, well-perfused, no edema bil. vein stripping scars neuro grossly intact 2+ bil. fem/DP/PT/radials Pertinent Results: [**2158-8-26**] 04:55AM BLOOD WBC-7.0 RBC-2.60* Hgb-8.3* Hct-24.3* MCV-94 MCH-32.0 MCHC-34.1 RDW-13.6 Plt Ct-129* [**2158-8-24**] 12:45PM BLOOD Hypochr-1+ Anisocy-NORMAL Poiklo-NORMAL Macrocy-NORMAL Microcy-NORMAL Polychr-NORMAL [**2158-8-26**] 04:55AM BLOOD Plt Ct-129* [**2158-8-26**] 04:55AM BLOOD Glucose-92 UreaN-16 Creat-0.7 Na-137 K-4.0 Cl-104 HCO3-26 AnGap-11 [**2158-8-23**] 01:00PM BLOOD ALT-9 AST-14 AlkPhos-39 TotBili-0.4 [**2158-8-23**] 01:00PM BLOOD %HbA1c-5.8 [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname 95**] [**Hospital1 18**] [**Numeric Identifier 71608**] (Complete) Done [**2158-8-24**] at 2:46:52 PM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) **] [**Street Address(2) 15115**] [**Location (un) 15116**], [**Numeric Identifier 15117**] Status: Inpatient DOB: [**2089-3-31**] Age (years): 69 F Hgt (in): BP (mm Hg): 110/60 Wgt (lb): HR (bpm): 72 BSA (m2): Indication: mitral valve prolapse ICD-9 Codes: 424.0, 440.0 Test Information Date/Time: [**2158-8-24**] at 14:46 Interpret MD: [**Name6 (MD) 3892**] [**Name8 (MD) 3893**], MD Test Type: TEE (Complete) Son[**Name (NI) 930**]: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 3893**], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Adequate Tape #: 2007AW01-: Machine: Echocardiographic Measurements Results Measurements Normal Range Left Atrium - Long Axis Dimension: *4.2 cm <= 4.0 cm Left Ventricle - Septal Wall Thickness: 1.1 cm 0.6 - 1.1 cm Left Ventricle - Inferolateral Thickness: 1.1 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: 4.5 cm <= 5.6 cm Left Ventricle - Ejection Fraction: 55% >= 55% Aorta - Ascending: 3.1 cm <= 3.4 cm Aortic Valve - Peak Velocity: 1.0 m/sec <= 2.0 m/sec Findings LEFT ATRIUM: Normal LA size. No spontaneous echo contrast or thrombus in the LA/LAA or the RA/RAA. RIGHT ATRIUM/INTERATRIAL SEPTUM: Normal RA size. LEFT VENTRICLE: Normal LV wall thickness, cavity size and regional/global systolic function (LVEF >55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Simple atheroma in descending aorta. AORTIC VALVE: Mildly thickened aortic valve leaflets (3). No AS. No AR. MITRAL VALVE: Moderate/severe MVP. Moderate to severe (3+) MR. TRICUSPID VALVE: Mild to moderate [[**11-29**]+] TR. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets with physiologic PR. PERICARDIUM: No pericardial effusion. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. The patient appears to be in sinus rhythm. Results were personally reviewed with the MD caring for the patient. Conclusions PRE-BYPASS: The left atrium is normal in size. No spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%) Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. There is moderate/severe mitral valve prolapse of posterior leaflet with myxomatous disease of the posterior leaflet. Moderate to severe (3+) mitral regurgitation is seen. There is no pericardial effusion. Post_Bypass: Biventricular normal systolic function. LVEF 55%. There is a bioprosthesis in the mitral location with normal function and stability. Mean transmitral gradient is 5mm of Hg. Thoracic aortic contour is intact. I certify that I was present for this procedure in compliance with HCFA regulations. Electronically signed by [**Name6 (MD) 3892**] [**Name8 (MD) 3893**], MD, Interpreting physician RADIOLOGY Final Report CHEST (PORTABLE AP) [**2158-8-26**] 8:21 AM CHEST (PORTABLE AP) Reason: r/o PTX, interval change [**Hospital 93**] MEDICAL CONDITION: 69 year old woman with s/p Minimally Invasive MVR(porcine) s/p chest tube to water seal REASON FOR THIS EXAMINATION: r/o PTX, interval change HISTORY: Mitral valve replacement. Single portable radiograph of the chest demonstrates similar cardiomediastinal contour when compared with [**2158-8-25**]. The right internal jugular Swan-Ganz catheter and introducer sheath have been removed. A prosthetic cardiac valve is again seen and is unchanged. There is mild bibasilar atelectasis and a small left-sided pleural effusion. No pneumothorax. Trachea is midline. No consolidation is evident. No pneumoperitoneum. IMPRESSION: Interval removal of support lines. Persistent bibasilar atelectasis and small left-sided pleural effusion. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 6892**] Approved: SAT [**2158-9-2**] 12:19 AM ?????? [**2153**] Brief Hospital Course: Admitted [**8-23**] for cath which revealed nl. cors. and EF 75% with 4+ MR.[**First Name (Titles) **] [**Last Name (Titles) **]. invasive MVR with Dr. [**First Name (STitle) **] on [**8-24**] and was transferred to the CVICU in stable condition on titrated propofol and phenylephrine drips.Extubated later that afternoon and transferred to the floor on POD #1 to begin increasing her activity level. She was gently diuresed toward her preoperative weight. Ibuprofen started for anti-inflammatory effect and low-dose beta blockade also started. Chest tube removed without incident and cleared for discharge to home on POD #3 with VNA services. Pt. is to make all follow up appts. as per discharge instructions. Medications on Admission: lisinopril 40 mg daily HCTZ 25 mg daily ASA 81 mg daily Discharge Medications: 1. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 2. Furosemide 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 5 days. Disp:*10 Tablet(s)* Refills:*0* 3. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO Q12H (every 12 hours) for 5 days. Disp:*20 Capsule, Sustained Release(s)* Refills:*0* 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*2* 5. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 7. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) for 2 weeks: then TID prn pain. Disp:*90 Tablet(s)* Refills:*0* 8. Zantac 150 mg Tablet Sig: One (1) Tablet PO twice a day: WHILE ON IBUPROFEN. Disp:*60 Tablet(s)* Refills:*2* Discharge Disposition: Home With Service Facility: [**Hospital1 **] VNA, [**Hospital1 1559**] Discharge Diagnosis: MR s/p [**Hospital1 **]. inv. MVR HTN Discharge Condition: good Discharge Instructions: may shower, no swimming or bathing for 1 month no creams,lotiions or powders to any incisions Followup Instructions: with Dr. [**Last Name (STitle) 26909**] in [**12-31**] weeks Dr. [**Last Name (STitle) **] in [**12-31**] weeks with Dr. [**First Name (STitle) **] in 4 weeks Please call for appts. [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2158-9-12**] ICD9 Codes: 4240, 4019
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Medical Text: Admission Date: [**2113-7-23**] Discharge Date: [**2113-8-23**] Date of Birth: [**2040-6-19**] Sex: M Service: MEDICINE Allergies: Iodine; Iodine Containing Attending:[**First Name3 (LF) 348**] Chief Complaint: chest pain Major Surgical or Invasive Procedure: Thoracentesis. Thallium myocardial viability study. Intubation. Central line placement. Echocardiogram. History of Present Illness: Mr. [**Known lastname 44755**] is a 73 year old man transfered from an outside hospital with chest pain and ecg changes. Patient has past medical history of ESRD on HD for 5 years, PAF, CVA, anemia, CAD s/p MI, Aortic stenosis. Patient was admitted to [**Hospital3 4107**] last month with an MI. His hospital course was complicated by bradycardic arrest, MRSA pneumonia, C diff colitis. He was discharged to NESH 3.5 weeks ago. Since this admission he has had worsening mental status with dementia. On the day of admission he complained of chest pain [**9-20**] radiating to his right shoulder. This was relieved only after 3 NTG. BP was stable; HR was 105-113 during this episode. He was transfered to [**Hospital3 417**] Hospital where ECG showed intermittant rate related RBBB and LVH with strain. Patient was pain free on arrival and remained pain free. He was given one aspirin. TnI was 0.2 and the patient was transfered here for management of ACS. On arrival here the patient had 10/10 chest pain. ECG showed sinus tachycardia with LVH and strain. Pain resolved with one sublingual nitroglycerin. TnT here 0.6, and CK is 51. Currently the patient denies chest pain, shortness of breath, abdominal pain, nausea, vomiting. He reports frequent diarrhea. He has h/o orthopnea, PND but denies pedal edema. He has SOB with ambulation. Past Medical History: 1. ESRD on HD for 5 years 2. diverticulosis 3. GI bleed 4. PAF 5. CVA 2 years ago, with residual left sided weakness 6. CAD s/p MI (echo [**5-19**] with inferior hypokinesis) 7. Anemia 8. Cardiac arrest 9. GERD 10. OSA on CPAP 16 cm with 1 L oxygen 11. Moderate Aortic stenosis (echo in [**Month (only) 547**] at OSH) Social History: Lives at home with his wife. Stopped smoking in [**2105**]. Family History: non contributory Physical Exam: T 98.0 HR 110 BP 138/59 RR 24 O2 sat 99% on 4L Gen: elderly gentleman, appearing older than stated age, lying in bed, in NAD. HEENT: PERRL, EOMI, sclera anicteric, MM dry. Neck: No JVD, no LAD. Lungs: coarse BS bilaterally, anteriorly and posteriorly. Expriatory wheezes. CV: Regular with no MRG appreciated. Abd: soft, distended, tender in the RUQ with guarding, no rebound. active bowel sounds. Ext: no clubbing, cyanosis or edema. Weak pulses bilaterally. Neuro: sleepy but arousable. Follows commands. oriented to self, place, but states date is [**2012**]. Strength 5/5 on the right and 4+/5 on the left lower extremity (can resist minor force) and [**6-15**] on the right upper extremity and [**5-16**] on the left upper extremity (cannot resist any force). Reflexes are 2+ in the left patella and bicepts and 1+ on the right. Toes downgoing on right and equivocal on left. Pertinent Results: OSH: 18.7\ /593 [**Age over 90 **]|95|25 /108 CK 30 MB 2.5 TnI 0.2 BNP > 5000 /40.3\ 5.3|30|5.9\ INR 2.5 DDimer 1409 LABS HERE: [**Age over 90 **] |93|32 / 99 AGap=23 4.9 |26|6.4\ 8:30p CK: 38 MB: Notdone Trop-*T*: 0.63 7:45p CK: 51 MB: Notdone Trop-*T*: 0.62 Ca: 10.0 Mg: 2.2 P: 3.7 ALT: 16 AP: 93 Tbili: 0.6 Alb: AST: 22 LDH: 172 Dbili: TProt: [**Doctor First Name **]: 54 Lip: 46 TSH:Pnd MCV 92 17.7\12.1/569 /37.8\ N:87.5 Band:0 L:8.7 M:2.5 E:0.8 Bas:0.5 Hypochr: 1+ Anisocy: 1+ Polychr: 1+ Plt-Est: High PT: 20.9 PTT: 28.5 INR: 2.9 ECG: 8:20 Sinus tachycardia at 107 bpm, LAD, RBBB, Q in III, AVF. TWI in V1-V4, III, AVF. No STE or depression. 14:09 Sinus at 95 bpm. First degree AV block. LAD. Q in III, AVF. Flat TW in I, AVL, V5-6. LVH with strain pattern. 14:20 Sinus at 96 bpm. First degree AV block. LAD. Q in III, AVF. TW flat in I, avl, V5-6. LVH with strain pattern. 18:47 Sinus at 106 bpm. RBBB. LAD. TW normalization in I, AVL, V5-6. Q in III, AVF. TWI in V1-V4. No STE or depression. 19:39 Sinus at 104 bpm. LAD. TW flat in I, AVL, V5-6. Q in III, AVF. LVH with strain pattern. labs around time of GI bleed. [**2113-8-17**] 01:25PM BLOOD PT-14.2* PTT-36.6* INR(PT)-1.3 [**2113-8-17**] 08:07PM BLOOD PT-15.4* PTT-80.0* INR(PT)-1.6 [**2113-8-18**] 04:32AM BLOOD PT-14.5* PTT-63.0* INR(PT)-1.4 labs on discharge [**2113-8-23**] 06:12AM BLOOD PT-21.0* PTT-33.7 INR(PT)-2.9 [**2113-8-23**] 06:12AM BLOOD WBC-10.0 RBC-3.44* Hgb-10.2* Hct-32.5* MCV-94 MCH-29.7 MCHC-31.5 RDW-20.7* Plt Ct-335 [**2113-8-23**] 06:12AM BLOOD Glucose-79 UreaN-23* Creat-4.5*# Na-145 K-3.6 Cl-105 HCO3-28 AnGap-16 [**2113-8-23**] 06:12AM BLOOD Calcium-9.5 Phos-3.8 Mg-1.7 Brief Hospital Course: This 73 year old gentleman with a history of ESRD on HD, ischemic cardiomyopathy, EF 35%, PAF, h/o CVA, h/o CAD s/p MI who was initially transferred here from [**Hospital3 4107**] on [**2113-7-23**] with chest pain, intermittent RBBB/LVH, TropI 0.6, CK 51. [**Hospital3 **] course notable for bradycardic arrest, MRSA pna, C diff colitis and was d/c to rehab. with MRSA pneumonia, C diff colitis. . On admission here, pt thought not to have acute ischemia; finished course of PO vanco for c diff and IV vanco for MRSA pna. His mental status was noted to be poor, thought to be [**3-15**] delerium. Dialysis was continued. Wished for CTA to r/o PE, but pt has iodine allergy. Had abnl cxr so v/q not pursued either. Passed swallow study on [**7-25**] and [**7-31**]. . [**7-25**], pt had resp distress but cxr showed layering pleural effusions L>R, BNP [**Numeric Identifier 44756**]. . [**7-26**], patient had another episode of tachypnea, hypoxia at HD and was transferred to the [**Hospital Unit Name 153**] for further mngt. In [**Hospital Unit Name 153**], he was rapidly weaned to nasal cannula, CPAP at night (has OSA). SOB thought to be multifactorial from volume overload, pleural effusions, AF w/ RVR. Leukocytosis to 13-14 persisted but ID work up negative besides his previous known infections, as above. Effusion not tapped since patient's resp status improved (he also apparently refused per record). . [**7-29**] Recurrence of tachypnea, tachycardia, hypotension on [**7-29**] that was thought [**3-15**] aspiration vs flash pulm edema vs mucous plugging, again improved w/o intervention. Aggressive chest PT was initiated. Cards consulted who wished to optimize his CHF mngt w/ Ace-i, cont amio/bb and stop digoxin. EF now 25% with new akinesis. Cardiac cath considered for concern of recurring ischemia (INR elevated [**3-15**] coumadin, so held off for some time). Vanco was started on [**8-1**] for GPC's in sputum and increased secretions. . [**8-1**] With clinical improvement was transferred to general medicine [**Hospital1 **]. Cath tentatively planned for [**8-7**], pt started on heparin today for stroke ppx since INR now. [**2113-8-5**] Had HD session w/o incident and had acute onset of resp distress w/ sats 83% approx 30 min after arrival on floor. MICU team near by and helped evaluate patient. VS at that time were T 96.3 BP 108/60's HR 90's RR 30's sats 83% NRB (was 98% 2L previous to this). Pt confused but semi-alert, not mentating, not comuunicative. ABG 7.42/40/49 on NRB. Code blue called for impending resp arrest. pt w/ pulse; ekg NSR 90's old TWI's in V1-V5. Intubated and brought to MICU. . MICU stay Underwent throacentesis with 1700 cc of serous fluid removed which was transudative. He was thought to have flash pulmonary edema. He was initially on a levophed gtt for hypotension, but with fluid boluses he was weaned off the gtt. [**8-7**] -weaned off all pressors, -seen by cardiology and they decided to defer catherization until the patient was stable from a respiratory standpoint. -Patient's stool was positive for C diff. He was started on Flagyl for a ten day course. He was also -started on levofloxacin/flagyl for empiric treatment of aspiration pneumonia. [**8-8**]. -extubated, transferred to general medicine wards . General medicine [**Hospital1 **] stay. [**Date range (1) 44757**] This period was characterized by recurrent episodes of chest pain, respiratory distress, hypotension, and tachycardia. No EKG changes accompanied these. Aggressive suctioning with O2 therapy successfully resolved all of these episodes, and it was felt these episodes were secondary to mucus plugging. Chest PT, nebulizer therapy, and mucolytic therapy were instituted with success. . [**8-16**] Episode of 200 cc coffee ground emesis after HD. Emesis guiaiac positive, stool guaiac negative. PTT was supratherapeutic GI consulted, felt endoscopy would not be of benefit unless catheterization performed. . [**8-17**] Thallium viability performed revealed no reversible defects, as no tissue could be recovered by reperfusion, Cardiology decided catheterization would not benefit the patient and signed off. Per there recommendations, beta blocker and ACEi therapy were titrated up. GI signed off. [**8-18**] Thoracentesis performed 2L removed transudative negative for gram stain and culture, largely for respiratory comfort. Respiratory function notably improved after this, with somewhat less oxygen requirement, and more vigorous cough reflex. Lungs clear to auscultation. Pt had only one minor episode of respiratory distress after this time. [**8-21**] Wife met with attending, Dr. [**Last Name (STitle) **], and elected to change pt status to DNR/DNI. In summary this is a 73 year old Caucasian gentleman with a prior history of coronary artery disease s/p myocardial infarction, paroxysmal atrial fibrillation on amiodarone and anticoagulation, ischemic cardiomyopathy EF 25%, end stage renal disease on hemodialysis. He was admitted for non-ST elevation MI, since admission his course has been complicated by recurrent respiratory distress with chest pain and hypotension and necessitating one intubation, pneumonia, upper GI bleed from supratherapeutic INR, and C. dificile on discharge this patients issues are as follows. Resp distress: Improved s/p thoracentesis and with nebulizer, chest PT and mucinex therapy. Mucus plugging was likely cause of his recurrent resp distress. No recent sign of pneumonia. Prior episode of pneumonia during stay successfully treated with levofloxacin. No EKG changes have occured during these episodes. Ischemic heart disease: EF of 25%, now with new akinesis. Unfortunately, invasive procedures will no longer benefit the pt owing to the lack of viable tissue left. We have attempted to optimize medical management using beta blocker and ace inhibitor for protection of remainder of myocardium. PAF: Appears stable, on amiodarone and now transitioned to Coumadin for anticoagulative therapy last INR: 2.9. End Stage Renal Disease: On hemodialysis Tuesday, Thursday, and Saturday. On epogen for anemia. Appreciate work of renal team in managing fluids. Sepsis: Pt was septic requiring pressors x 3, resolved in MICU. h/o MRSA pneumonia. GI bleed: No further episodes of GI bleed since [**8-16**]; this was probably secondary to his supratherapeutic INR C. Dificile: On discharge, he will be on day 10 of 14 DVT prophylaxis: Coumadin Anemia: Likely from chronic disease, ESRD, on epogen. Hypothyroid: On replacement. Code: DNR/DNI per wife as of [**2113-8-21**] Medications on Admission: Amiodarone 200 mg po daily Lipitor 10 mg po daily Aspirin 81 mg daily Celexa 20 mg daily Levoxyl 25 micrograms daily Prevacid 30 mg daily Provigil 100 mg daily Nephrocaps 1 cap daily Coumadin 2.5 mg daily Lorazepam 0.5 mg q 8 hr prn Vancomycin 250 mg po three times a day colace 100 mg po daily xopenex q 6 hr atrovent q 6 hr epogen 12,000 unit sq M,W, F lactinex 2 tab po bid megace 800 mg daily Discharge Medications: 1. Epoetin Alfa 10,000 unit/mL Solution Sig: One (1) Solution Injection ASDIR (AS DIRECTED). 2. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Atorvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Citalopram Hydrobromide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Levothyroxine Sodium 25 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 7. Docusate Sodium 150 mg/15 mL Liquid Sig: Ten (10) mL PO BID (2 times a day). 8. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 9. Aluminum-Magnesium Hydroxide 225-200 mg/5 mL Suspension Sig: 15-30 MLs PO QID (4 times a day) as needed. 10. Guaifenesin 100 mg/5 mL Syrup Sig: 5-10 MLs PO Q6H (every 6 hours) as needed. 11. Calcium Acetate 667 mg Tablet Sig: One (1) Tablet PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 12. Nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID (4 times a day) as needed for Oral Thrush. 13. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 4 days: Course to complete 2 weeks of therapy on [**2113-8-27**]. 14. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 15. Ipratropium Bromide 0.02 % Solution Sig: One (1) inh Inhalation Q6H (every 6 hours). 16. Captopril 12.5 mg Tablet Sig: One (1) Tablet PO TID (3 times a day): Please do NOT give on hemodialysis days. 17. Albuterol Sulfate 0.083 % Solution Sig: One (1) neb Inhalation Q6H (every 6 hours) as needed. 18. Guaifenesin 600 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO bid (). 19. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day): Please do NOT give on hemodialysis days. 20. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed for pain. 21. Warfarin Sodium 1 mg Tablet Sig: 1.5 Tablets PO at bedtime. 22. Compazine 5 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed for nausea. Discharge Disposition: Extended Care Facility: [**Hospital3 **] Hospital - [**Location (un) 701**] Discharge Diagnosis: Non-ST elevated MI Sepsis with hypotension. End stage renal disease now on hemodialysis. Congestive heart failure (ischemic cardiomyopathy. Coronary artery disease. Clostridium difficile infection. Recurrent respiratory distress with mucus plugging. Gastrointestinal bleed. Paroxysmal atrial fibrillation. Anticoagulative therapy Discharge Condition: Stable. Stable.Still requiring oxygen 2-3 L by NC or face mask.Chest pain free. Discharge Instructions: Please return to hospital if respiratory distress, chest pain recurs. Please return if coffee ground or bloody vomiting recur. Followup Instructions: Rehabilitation facility. Please see PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) 4469**] in [**8-20**] days. ICD9 Codes: 5070, 4280, 0389, 5119, 2449, 2859
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Medical Text: Admission Date: [**2141-6-15**] Discharge Date: [**2141-6-18**] Date of Birth: [**2073-8-31**] Sex: M Service: [**Hospital Unit Name 196**] CHIEF COMPLAINT: Fevers, chills. HISTORY OF PRESENT ILLNESS: Mr. [**Known lastname **] is a 67 year old male with a history of bladder cancer, status post bladder resection with ileal conduit in [**2112**] who has a history of nephrolithiasis and multiple urinary tract infections who now presents with fevers, chills, nausea, vomiting and a recent urine culture positive for gram negative rods. The patient was recently admitted to [**Hospital6 256**] in [**2141-4-23**] for an elective lithotripsy of a left renal stone which was complicated by Corynebacterium urosepsis for which he was treated with ten days of Vancomycin. During that admission he also had multiple bilateral lower lobe pulmonary emboli and negative lower extremity noninvasive studies. The patient was in his usual state of health until four to five days prior to admission when he experienced fatigue and fevers to 102 degrees. He presented to his primary care clinic and was started on Levofloxacin by his primary care physician on [**6-13**]. On [**6-14**], he developed severe left flank pain and was sent to the Emergency Department with a fever of 102.7 degrees. Computerized axial tomography scan showed severe left hydronephrosis with gas requiring urgent decompression. The patient was given one unit of fresh frozen plasma in order to correct his Coumadin-induced coagulopathy before his interventional radiology procedure, however, he developed a pruritic rash while receiving his fresh frozen plasma, so he only received one out of three proposed units. At Interventional Radiology he had a temporary inferior vena cava filter placed through his right jugular and a left percutaneous nephrostomy tube was placed as well under local anesthesia. Immediately after the procedure, the patient desaturated to 66% oxygen saturation which then increased to the 90s of 100% FIO2 with a nonrebreather mask. The patient was then transferred to the Medical Intensive Care Unit for further management. PAST MEDICAL HISTORY: Bladder cancer with bladder resection in [**2112**] with an ileal conduit. This was transitional cell carcinoma, diabetes Type 2, hypertension, coronary artery disease, status post myocardial infarction ten years ago, status post stent to the left circumflex in [**2140-1-22**], at which time catheterization showed an ejection fraction of 65%, hypercholesterolemia, left nephrolithiasis with recurrent urinary tract infection, bilateral pulmonary emboli in [**2141-4-23**], requiring, anticoagulation, status post diskectomy. ALLERGIES: Codeine causing a rash. MEDICATIONS ON ADMISSION: Vancomycin 1 gm intravenously q. 12, ten day course completed [**2141-5-12**]. Coumadin 2 mg h.s. alternating with 3 mg h.s., 3 mg on Tuesday and Thursday, Metoprolol XL 200 daily, iron 150 daily, Senna one tablet daily, Lisinopril 20/Hydrochlorothiazide 12.5 daily, Aspirin 325 daily, Nifedipine CR 60 daily, Atorvastatin 10 mg daily, Tricor 160 mg daily, Humulin N 75/25 36 units q. AM, 52 units q.h.s. SOCIAL HISTORY: He lives with his wife and does not drink. He used to smoke, he has a 35 pack year history but he quit 12 to 13 years ago. FAMILY HISTORY: Non-contributory. PHYSICAL EXAMINATION: Temperature 103.7 degrees, heartrate 113, blood pressure 119/42, respiratory rate 31, oxygen saturation 94% on nonrebreather with 100% FIO2. General: Visibly tachypneic. Head, eyes, ears, nose and throat: Dry mucosal membranes, extraocular muscles intact. Pupils equal, round and reactive to light. Supple neck. Cardiovascular examination: Regular, tachycardiac, S1 and S2 present, no murmurs, no jugulovenous distension noted. Pulmonary examination, lungs clear to auscultation bilaterally. Abdomen, soft, nontender, nondistended, positive bowel sounds. The patient has a right lower quadrant urostomy and a left percutaneous nephrostomy tube. Extremities, warm, trace edema on the right lower extremity, trace to 1+ edema on the left lower extremity. Dorsalis pedis pulses were palpable bilaterally. Neurological examination, alert and oriented times three, answers questions appropriately. Strength 5/5 bilaterally in upper and lower extremities. LABORATORY DATA: White blood cell count 9.4, hematocrit 33.6, platelets 271. Sodium 133, potassium 3.8, chloride 97, bicarbonate 20, BUN 47, creatinine 2.8, glucose 192, INR 2.5. Urine analysis showed specific gravity of 1.017, large blood, positive nitrates, moderate leukocytes, 11 to 20 red blood cells, 50 white blood cells, many bacteria. Urine culture from [**6-13**], was growing gram negative rods. Arterial blood gases showed 7.43, 27 pCO2 and pO2 of 81 and lactate of 5.9. Chest x-ray after his interventional radiology procedure showed new bibasilar lung opacities in the retrocardiac region with atelectasis. These are new findings compared to his chest x-ray from earlier in the Emergency Department. Computerized axial tomography scan of his abdomen showed severe left hydronephrosis with gas in the collecting system around the left ureteral stone. Electrocardiogram showed normal sinus rhythm with rate of 125, Q wave in II, III and AVF. HOSPITAL COURSE: 1. Urosepsis - The patient had a left percutaneous nephrostomy tube placed for drainage by Interventional Radiology. He was started on Levofloxacin, Ampicillin and Flagyl for his urosepsis, however, after 24 hours, it was changed to Zosyn. He was initially borderline hypotensive with systolic pressures in the 90s, however, after 24 hours of antibiotics his pressure increased and his fever broke. The patient was followed by Urology who was initially planning on treating him with intravenous antibiotics and continuing the percutaneous nephrostomy tube for a period of four to six weeks followed by definitive treatment with an open procedure to extract the stone. 2. Hypoxia - The patient had several episodes of hypoxia throughout his stay, some points requiring CPAP ventilation. He was found to have crackles on examination during some of these episodes of shortness of breath and he was given Lasix as he was felt to be in failure. His chest x-rays were consistent with small amount of pulmonary edema. He responded to the Lasix, however, it was also thought that his pulmonary emboli may be contributing to his hypoxic episodes. Despite having his inferior vena cava filter placed for pulmonary embolism prophylaxis, he was restarted on heparin on [**6-18**] and a V/Q scan was ordered to assess for pulmonary emboli. In addition, the patient was scheduled for an echocardiogram to assess for systolic or diastolic failure as he has responded to Lasix therapy during some of the episodes of shortness of breath. 3. History of pulmonary embolism - The patient had an inferior vena cava filter placed and was initially not given his daily Coumadin. However, three days after admission the patient stabilized and was restarted on his heparin therapy. The plan will include removing the temporary inferior vena cava filter after the patient is restarted on Coumadin and is therapeutic with an INR of 2.0 to 3.0. 4. Anemia - The patient had a small amount of blood loss during his interventional radiology procedure, and he was initially transfused for a hematocrit of 25 considering his history of previous myocardial infarction and coronary artery disease. He received approximately one unit of blood at which time he became short of breath. This was felt to be due to fluid overload and transfusion was stopped. The patient was given Lasix and he responded with improved oxygen saturation and decreased symptomatic shortness of breath. After being transfused one unit of blood, his hematocrit stabilized between 28 and 29%. It was felt that this level was adequate for the patient as it was over 28 and in light of his initial reaction to receiving his first transfused unit. 5. Diabetes mellitus - The patient was placed on insulin sliding scale and fingerstick glucoses were checked and the patient's blood sugar was tightly controlled and kept in the low 100 range. 6. Fluids, electrolytes and nutrition - The patient's electrolytes were closely monitored and repleted as necessary. The patient's diet was also advanced. He was hemodynamically stable. 7. Prophylaxis - The patient was placed on a proton pump inhibitor for gastrointestinal prophylaxis. He had an inferior vena cava filter placed and was restarted on heparin therapy. 8. Hypertension - After he became hemodynamically stable, the patient eventually developed some mild hypertension. He should be restarted on his outpatient antihypertensives before discharge. CODE STATUS: Full code. The remaining portion of the discharge summary will be dictated by the covering house staff. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 4561**] Dictated By:[**Last Name (NamePattern1) 9609**] MEDQUIST36 D: [**2141-6-18**] 17:27 T: [**2141-6-18**] 18:04 JOB#: [**Job Number 27938**] ICD9 Codes: 4280, 2851, 5990, 5849