African American male that is seen today for followup post hospital discharge. He is a 48-year-old gentleman with complicated cardiac history as well as neurological history including congestive heart failure. History of strokes 01/2017, possible sick sinus syndrome. He has an implanted pacemaker that was placed in 06/2017, as well as hypertension. He was taken to the Central Hospital on 09/01 with presentation of chest pain, noted to be around his pacemaker site. He identified being in seizure and suddenly felt chest pain with shortness of breath, and was offered nitro, he developed headaches and dyspnea post nitro treatment, of note is that the EKG that was obtained during that process, did not identify any pacemaker spike despite having a …show more content…
At this point, we do not know exactly what are the settings, we have previous requested pacemaker operative report from Regions. Unfortunately, from what he is telling today, his date of the birth was not correct as such dose report were not same. He noted that he thinks he came back from the hospital, he has not had similar complaint or concern or report of chest pain. It should be noted that hospital records, with a troponin that was negative, 12-lead EKG was similar to the one that was obtained here, essentially identifying sinus bradycardia with first-degree AV block, left ventricular hypertrophy with repolarization abnormality. QT was prolonged, similar EKG obtained at facility also identified pretty much the same abnormality pattern. Troponin was negative. Other workup included chest x-ray in the hospital were all unremarkable. Today he is not reporting any chest pain, no shortness of breath, no nausea or emesis. He has got healed ____ scar to the left chest from pacemaker implantation which is completely healed but slightly
In transport, patient received O2 at 4 liters via nasal cannula, baseline EKG, Normal Saline IV started in left hand, 325 mg aspirin by mouth (po). Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling and hitting her back on a large table. In addition, she states that her heart rate has been ranging from 130/ 90 to 140/92. Patient states her Primary care physician placed her on blood pressure medication 2 months ago due to the increase.
Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling and hitting her back on a large table. In addition, she states that her heart rate has been ranging from 130/ 90 to 140/92. Patient states her Primary care physician placed her on blood pressure medication 2 months ago due to the increase.
The patient tells me his last visit with Peter Dourdoufis, MD was just last week. I do not yet have a note from that visit. He says that he underwent an EKG and a stress test evaluation. To his knowledge, everything was okay, but he actually has an appointment tomorrow with Dr. Dourdoufis to review everything. No medication changes have been made per his report. He tells me that his blood pressures have been in a good range. Here today, his blood pressure is 126/76. He is not having problems with chest pain, shortness of breath, dyspnea on exertion or lower extremity swelling. He is still working
If a pacemaker is implanted to control Greg’s heart rate, he will need or will be forced to make certain life changes to maintain the device. There are many precautions that he will need to take such as keeping electronics a certain distance from directly over the pacemaker and may have other issues in any metal detector situations (Staff, Pacemakers, 2016). In my opinion I think that Greg will be able to play sports again; but, certain sports may be out of the question. Due to the fact of the contact in certain sports, Greg would risk getting hit again putting him as risk for another
You need to explain to him the s/s of blood clotting (since he may have too low an INR d/t treatment and he needs to know this). Explain that his a-fib puts him at risk for blood clots.
On arrival at the ED, the physician auscultates muffled heart tones, no breath sounds on the right, and faint sounds on the left. A.W. is
This case study discusses the management of a 68 year old male who presented with chest palpitations secondary to rapid atrial fibrillation. Atrial fibrillation is a common cardiac arrhythmia with serious complications if not treated correctly. This essay will discuss the initial clinical presentation of the patient and examine the management and outcome of the interventions applied. The significance of atrial fibrillation including its pathophysiology and aetiology will also be discussed.
EKG is an electrocardiogram, a machine used to check on problems with your electrical activity with your heart. An electrocardiogram machine translates the heart’s electrical pattern into lines that specific professionals can read it. The first EKG was made by Willem Einthoven, a Dutch Java island (now called Indonesia) born citizen. Willem was born the 21st day of May 1860. His father, Jacob Einthoven, was born and educated in Groningen (Netherlands). His father was also
Patient is a 45 yo male; 5’7”, 221 lbs who entered the emergency room at 6:30 am on 9/7/14 with severe chest pain (onset at 6:00 am) radiating to his arm, L arm numbness and nausea and vomiting. Past medical history reported by wife includes peptic ulcer, tobacco use (1-2ppd for 27 years), elevated blood pressure (controlled by lopressor). Wife did not know of any family history but reports patient’s father is deceased, died at 42 in his sleep. Mother alive and with high blood pressure.
There are multiple incidents where and when an error occurred in this case study. The first error was following the pacemaker insertion, it was determined that his cholesterol level had elevated, and he was already started on medication prior to the surgery. During the extensive tests and the three weeks of home monitoring prior to his surgery, the test should have shown his cholesterol level had elevated, and then they could have checked with the primary care physician to get a list of medications he was currently taking and had previously been on. Another error was after one month of the patient’s pacemaker insertion and the start of his medication, the patient had an appointment to see his primary care physician. During this time, the patient
The heart is one of the most important organs in an organism’s body, no matter if they are aquatic, amphibian, or a mammal. This super organ works automatically, able to pump massive amounts of oxygen rich blood through the body by means of electrical impulses and the opening and closing of valves within its many layers. It is what keeps us and every other creature on this earth alive; so it is only natural for one to fear when there might be a problem with one’s heart. A cardiac arrhythmia can happen to anyone, no matter the age, race, or gender, and as such, doctors and scientist have spent years trying to better understand the heart and the way it functions so that they can try to prevent these problems and save millions of lives.
Past and Current Medical History: AICD/pacemaker,Atrial fibrillation, Benign hypertension, Chronic obstructive pulmonary disease, Coronary arteriosclerosis, Coronary artery bypass graft (in 2010), Diabetes mellitus, Home oxygen supply (4 liters) Transient cerebral ischemia (in 1989),Kidney stones, Partial nephrectomy.
After further questioning you learn she is strictly following the fl uid and salt restriction ordered during
Artificial Cardiac Pacing (ACP) is an effective treatment for patients suffering from bradycardia. Atrio-ventricular block (AVB) is a common cause of bradycardia indicating the need for the implantation of a permanent pacemaker (PM). Roughly 3000 pacemaker devices are being implanted in Israel annually, more than half of them due to AVB block. A possible complication of this treatment for patients with AVB is the development of heart failure secondary to prolonged pacing via the right ventricle with a normal baseline heart function (Right Ventricular Pacing Induced Cardiomyopathy; RV-PICM).
The Patients assessment tool is the equipment, which are used to treat the patients either outdoors or inside hospital or in any medical centers. An Electrocardiogram (ECG) monitor is a simple diagnostic test to tell about the heartbeat by placing some electrodes on our body. ECG monitor also provide all the heart related problems and the functioning of heart. An ECG monitor is a simple painless noninvasive test that can be performed in virtually any clinic, doctor office or medical facility.