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Get Answer: Question History Physical Question Guide

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Question 15 pts History and Physical: The patient is a 67-year-old male who was transferred from Down-the-Street Hospital, where he was admitted 6 days ago with chest pain, shortness of breath, elevated cardiac enzymes, and EKG changes indicating an anterolateral ST elevation myocardial infarction. He subsequently underwent a cardiac catheterization, which revealed significant four-vessel disease. He was transferred for a coronary artery bypass procedure. Past History: Type 2 diabetes (diet controlled), hypercholesterolemia, and status post appendectomy Medications: See transfer list Allergies: None known Physical Exam General: Normal appearing male in no acute distress Cardio: Rate and rhythm regular Lungs: Normal Tests: Chest x-ray normal; EKG nonspecific T-wave changes Impression and Plan: Anterolateral myocardial infarction, coronary artery disease, diabetes mellitus, and hypercholesterolemia; patient will undergo CABG tomorrow Operative Report Preoperative Diagnosis: CAD Postoperative Diagnosis: Same Procedure: CABG x 4; saphenous vein graft of obtuse marginal, diagonal artery and posterior descending artery; left internal mammary artery to the left anterior descending artery. Cardiopulmonary bypass. Description of Procedure: After obtaining adequate anesthesia, the patient was prepped and draped in the usual fashion. A primary median sternotomy incision was made, and the pericardium was opened. The left internal mammary artery was dissected as a pedicle us

 
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