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Discharge summary
Report
Admission Date: [**2150-1-10**] Discharge Date: [**2150-1-18**] Date of Birth: [**2097-6-20**] Sex: F Service: MEDICINE Allergies: Bactrim Ds / Cellcept / Zosyn Attending:[**First Name3 (LF) 348**] Chief Complaint: Fever Major Surgical or Invasive Procedure: Hemodialysis History of Present Illness: 52 year old female with ESRD on HD with recent admission for VRE bacteremia, admitted to MICU for sepsis evaluation, transferred to the floor, readmitted to MICU for afib with RVR, then transferred to the floor once hemodynamically stable. She initially presented with fever to 101 after HD on [**1-10**] treated with 650mg of Tylenol at rehab, rechecked at 101.3, and noted have some chills by the nurse. She was subsquently sent to the ED. . The patient reports feeling well overall the days prior to admission. She denies any N/V, cough, shortness of breath, sore throat, rhinnorhea, or abdominal pain. She reports a good appetite. She does complain that the rehab was not dosing her antibiotics appropriately and was only giving her Linezolid once daily until she corrected them a few days ago. . Of note, the patient was recently admitted on [**3-11**] for VRE Bacteremia and was treated with Linezolid for a planned 4 week course; she subsequently had her HD lined removed, underwent a line holiday and then a new line was placed. Also of note, she has been on Dapsone for PCP prophylaxis as well as Gancyclovir for CMV viremia. . On arrival to the ED, her vitals were: T 99.8 BP 93/60 HR 120 RR22 98%RA. Labs were done which showed WBC 4 with 8% bandemia, Lactate 4.8. CXR was negative, U/A not done as pt is anuric. Blood cultures were drawn. EKG showed sinus tachycardia with flattening laterally. She was given 2L IVF and Vanc/Imipenem for empiric coverage of an unclear source given her history. A CVL was offered but the patient refused so an EJ was placed. . In the MICU, the patient was started on daptomycin, imipenem switched to meropenem and vanc continued. Her hypotension resolved with IVF. She remained afebrile with stable vital signs. . ROS: Denies headache, vision changes, rhinorrhea, congestion, sore throat, cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, BRBPR, melena, hematochezia, dysuria, hematuria. Past Medical History: - VRE Bacteremia, treated Linezolid - ESRD due to SLE, s/p cadaveric renal transplant [**8-/2147**] complicated by FSGS and transplant failure [**7-/2149**], now on HD - SLE, followed by Dr.[**Last Name (STitle) **] in Rheumatology - Hypotension (started on midodrine [**11-5**]) - Septic shock [**10/2149**] - CMV viremia [**10/2149**] - Acute uncomplicated diverticulitis [**10/2149**] - hx of C. Diff [**10/2149**] - Paroxysmal atrial fibrillation - NSVT - hx of Hypertension - Hyperthyroidism - s/p bilateral knee surgeries and R ACL repair Social History: Single, currently at [**Hospital 671**] rehab. Denies tobacco, ETOH, and drugs. Family History: Mother and brother both with diabetes and [**Name (NI) 2091**], both deceased. Physical Exam: Vitals - T: 97.7 BP: 125/69 HR: 81 RR: 26 02 sat: 100% RA GENERAL: Ill appearing female, in NAD HEENT: O/P Clear, MMM NECK: No LAD, left tunneled HD line in place, no erythema or tenderness over area CARDIAC: RRR, nl S1S3, no m/r/g LUNG: Clear bilaterally, mild scatered wheezing ABDOMEN: Soft, NT, ND, +BS EXT: No clubbing, edema, warm and well pefused, 2+ DP/PT pulses bilatearlly NEURO: Alert and oriented x3 Pertinent Results: ================== ADMISSION LABS ================== [**2150-1-10**] 07:40PM WBC-4.0 RBC-2.84* Hgb-7.8* Hct-25.1* MCV-88 MCH-27.4 MCHC-31.0 RDW-18.3* Plt Ct-92* Neuts-52 Bands-8* Lymphs-30 Monos-8 Eos-0 Baso-0 Atyps-2* Metas-0 Myelos-0 Hypochr-3+ Anisocy-1+ Poiklo-OCCASIONAL Macrocy-NORMAL Microcy-1+ Polychr-NORMAL Ovalocy-OCCASIONAL Plt Smr-LOW Plt Ct-92* Glucose-170* UreaN-10 Creat-3.0*# Na-137 K-4.3 Cl-97 HCO3-24 AnGap-20 CK(CPK)-13* Calcium-7.6* Phos-1.8*# Mg-1.3* Glucose-164* Lactate-4.8* Na-137 K-4.2 Cl-96* calHCO3-27 UPRIGHT AP VIEW OF THE CHEST: Left-sided dual-lumen central venous catheter tip terminates within the mid SVC. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. The osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary abnormality. ============== EKGs ============== Cardiology Report ECG Study Date of [**2150-1-10**] 7:14:44 PM Sinus tachycardia with baseline artifact. Non-specific anterolateral ST-T wave changes. Compared to the previous tracing of [**2149-12-27**] ventricular premature beats are not seen on the current tracing. Otherwise, no diagnostic interim change. Intervals Axes Rate PR QRS QT/QTc P QRS T 112 138 86 334/425 59 3 144 . Cardiology Report ECG Study Date of [**2150-1-11**] 1:11:50 AM Sinus rhythm. Short P-R interval. ST-T wave abnormalities. Since the previous tracing of [**2150-1-10**] ST-T wave abnormalities are less prominent at a slower rate. Intervals Axes Rate PR QRS QT/QTc P QRS T 88 148 88 386/435 65 -16 70 . Cardiology Report ECG Study Date of [**2150-1-12**] 3:16:38 PM Sinus rhythm. Since the previous tracing baseline artifact is different. There is probably no significant change in previously noted findings. Intervals Axes Rate PR QRS QT/QTc P QRS T 85 140 90 414/457 59 -12 62 . Cardiology Report ECG Study Date of [**2150-1-13**] 5:18:08 AM Probable atrial fibrillation with rapid ventricular response. Since the previous tracing of [**2150-1-12**] atrial fibrillation is new. There is a single wide complex beat, probably ventricular, which is also new. Intervals Axes Rate PR QRS QT/QTc P QRS T 145 0 84 318/466 0 -10 -142 . Cardiology Report ECG Study Date of [**2150-1-13**] 8:19:24 AM Sinus rhythm. Since the previous tracing earlier on [**2150-1-13**], atrial fibrillation is no longer present. There is marked Q-T interval prolongation and there are inferolateral T wave inversions. Clinical correlation is suggested. Intervals Axes Rate PR QRS QT/QTc P QRS T 74 160 88 448/472 63 -3 -114 . Cardiology Report ECG Study Date of [**2150-1-15**] 9:37:40 AM Sinus tachycardia. Diffuse ST-T wave changes. Cannot rule out myocardial ischemia. Compared to the previous tracing of [**2150-1-13**] QTc interval prolongation has improved. Otherwise, previously described multiple abnormalities are present. Intervals Axes Rate PR QRS QT/QTc P QRS T 101 148 86 362/433 6 -12 -173 . Cardiology Report ECG Study Date of [**2150-1-15**] 20:21:24 PM *After 9 beats of NSVT* Sinus rythm with PACs. Extensive ST-T changes may be due to myocardial ischemia. T wave inversion in I, II, aVF, V2-V6. Intervals Axes Rate PR QRS QT/QTc P QRS T 82 118 86 412/450 -17 1 -128 . Cardiology Report ECG Study Date of [**2150-1-16**] 9:30:44 AM *At the time, patient was nauseous* Sinus rythm. Possible LVH. Extensive ST-T changes may be due to hypertrophy and/or ischemia. T wave inversion in I, II, and aVF; biphasic T wave in V2, T wave inversion in V3-V6. Intervals Axes Rate PR QRS QT/QTc P QRS T 121 160 84 334/[**Medical Record Number 99130**] -154 . Cardiology Report ECG Study Date of [**2150-1-16**] 17:07:36 PM *At rest, asymptomatic* Sinus rythm. Extensive ST-T changes may be due to hypertrophy and/or ischemia. T wave inversion in I, II, and aVF; biphasic T wave in V2, T wave inversion in V3-V6. Intervals Axes Rate PR QRS QT/QTc P QRS T 80 152 80 414/449 21 -19 -169 . Cardiology Report ECG Study Date of [**2150-1-17**] 16:22:36 PM *During dialysis, asymptomatic* Possible ectopic atrial rythm. Left ventricular hypertrophy. Extensive ST-T changes may be due to ventricular hypertrophy. T wave inversion in I, II, aVF, V2-V6. In V2 T wave inversions are deep and symmetric. Intervals Axes Rate PR QRS QT/QTc P QRS T 98 126 82 380/446 -35 -6 -161 . Cardiology Report ECG Study Date of [**2150-1-17**] 17:34:12 PM *Post dialysis, back to floor, asymptomatic* Sinus rythm. Left ventricular hypertrophy. Extensive ST-T changes probably due to ventricular hypertrophy. T wave inversion in I, II, aVF, upright in V2, inverted in V3-V6. Intervals Axes Rate PR QRS QT/QTc P QRS T 94 144 88 398/457 24 -17 -169. . Cardiology Report ECG Study Date of [**2150-1-17**] 9:54:46 AM *Nauseous* Sinus tachycardia. Left ventricular hypertrophy. Extensive ST-T changes probably due to hypertrophy and/or ischemia. T wave inversion in I, II, aVF, upright in V2, inverted in V3-V6. Intervals Axes Rate PR QRS QT/QTc P QRS T 106 146 84 424/424 1 -18 -162 . ================== DISCHARGE LABS ================== [**2150-1-18**] 06:00AM BLOOD WBC-2.1* RBC-2.50* Hgb-7.1* Hct-23.2* MCV-93 MCH-28.4 MCHC-30.6* RDW-21.4* Plt Ct-147* [**2150-1-18**] 06:00AM BLOOD Plt Ct-147* [**2150-1-18**] 06:00AM BLOOD PT-21.2* PTT-24.9 INR(PT)-2.0* [**2150-1-18**] 06:00AM BLOOD Glucose-75 UreaN-8 Creat-2.5*# Na-143 K-3.3 Cl-103 HCO3-35* AnGap-8 [**2150-1-18**] 06:00AM BLOOD Calcium-8.0* Phos-2.6* Mg-1.3* ================== CARDIAC ENZYMES ================== [**2150-1-10**] 11:24PM BLOOD CK(CPK)-13* [**2150-1-11**] 05:41AM BLOOD LD(LDH)-443* CK(CPK)-17* TotBili-0.4 DirBili-0.1 IndBili-0.3 [**2150-1-13**] 11:37AM BLOOD CK(CPK)-15* [**2150-1-13**] 05:23PM BLOOD CK(CPK)-10* [**2150-1-16**] 03:30AM BLOOD CK(CPK)-47 [**2150-1-16**] 06:40AM BLOOD CK(CPK)-50 [**2150-1-16**] 03:50PM BLOOD CK(CPK)-56 [**2150-1-10**] 11:24PM BLOOD CK-MB-NotDone cTropnT-0.02* [**2150-1-11**] 05:41AM BLOOD CK-MB-NotDone cTropnT-0.02* [**2150-1-13**] 11:37AM BLOOD CK-MB-NotDone cTropnT-0.08* [**2150-1-13**] 05:23PM BLOOD CK-MB-NotDone cTropnT-0.06* [**2150-1-16**] 03:30AM BLOOD CK-MB-NotDone cTropnT-0.04* [**2150-1-16**] 06:40AM BLOOD CK-MB-NotDone cTropnT-0.05* [**2150-1-16**] 03:50PM BLOOD CK-MB-NotDone cTropnT-0.04* Brief Hospital Course: 52 year old female with ESRD on HD, recent VRE bacteremia, CMV Viremia, SLE presented with fever and hypotension, developed Afib with RVR as well as labile t wave inversion, now hemodynamically stable. # EARLY SEPSIS: Patient presented with fevers, hyotension, tachycardia and a lactate of 4.8. In addition, her WBC was 4.0 but with an 8% bandemia. She has had a number of infections recently in the setting of immunosuppression. The differential was broad including line infection (new HD line placed on [**12-31**]), pneumonia (CXR without obvious infiltrate), CMV Viremia (viral load [**12-29**] negative), UTI, C. Diff (recent infection [**11-5**] but without any symptoms to suggest this). Patients BP/HR improved after administration of 2L IVF, and broad coverage with Meropenem (GN coverage) plus Daptomycin (GP coverage) as well as PO Vanc, given bandemia. BCx, C.Diff cx, and CMV viral load were also obtained and were negative. However, after speaking with ID valganciclovir was restarted. During hospitalization, antibiotics were narrowed to daptomycin. Patient will need to complete 4 week course of Daptomycin for VRE bacteremia in setting of known thrombus that is possibly seeded. She will receive Daptomycin when she receives HD. The renal team has arranged for her to get the medication at HD. The last dose will be on [**2150-1-26**]. . # T Wave Inversions: Patient's T waves were upright at the time of admission. She then developed inverted T waves in V3-V6, I, II, aVF, and intermittently/biphasic in V2 (see attached EKGs copied from [**Hospital1 18**]), with repeated negative cardiac enzymes. Then she developed more deeply inverted T waves in V2 that were deep and symmetrical during HD on [**1-17**] that then turned upright. It was not clear that the T wave inversions were rate related. Cardiology was [**Month/Year (2) 4221**]. The ddx included: ischemia, Takotsubo's, or a cerebral processes, however rapid resolution of the T waves made the later two less likely. She denied chest discomfort though she occasionally had nausea. She did not have any neurological symptoms. Patient has no LVH on prior ECHOs to invoke repolarization changes. Recommend performing persantine study to r/o ischemia as an outpatient, not initiated as an inpatient given difficulty to instigate intervention in this setting with recent bacteremia and RUE thrombus. In the mean time, patient is medically managed for coronary artery disease; she is on aspirin and small dose of beta-blocker. Simvastatin was added during this admission. . # Tachycardia: In addition to atrial fibrillation which is currently controlled, she had multiple episodes of regular tachycardia. EKG revealed sinus tach. In terms of the etiologies of sinus tachycardia, she had evidence of volume depletion, especially after HD, which likely led to low systolic blood pressures in the 90s and sinus tachycardia. Sinus tachycardia invariably improved/resolved after gentle IVF (250cc-500cc NS). She also experienced nausea during some episodes of tachycardia, raising the question whether the tachycardia is due to discomfort. However, after treatment with zofran and resolution of nausea, her heart rate remained in the 120s, which argues against that theory. . # Low Blood Pressure: Patient's baseline systolic blood pressure is 100s to 110s, though was noted to occasionally be in the 90s, which responded to small IVF boluses (250-300cc). It was thought to be secondary to volume shifts and possibly be exacerbated by autonomic instability. She should continue on Midodrine 10mg TID. . # ESRD on HD s/p failed transplant: Patient was continued on HD and maintained on Prednisone. . # Venous thrombus: Patient was noted to have a complete thrombosis of the left AV [**Month/Year (2) **], left cephalic vein and left subclavian vein, and partial thrombosis of left brachiocephalic vein with extension to SVC on her previous admission. She was unable to receive a PICC on that side [**12-30**] this thrombus (and not on the right [**12-30**] presence of fistula). She was maintained on warfarin with goal [**12-31**] and should continue anticoagulation until resolution of the thrombus or indefinitely. . # CMV viremia: Patient has been treated with valganciclovir. This was briefly stopped out of concern for myelosuppression but subsequently restarted per ID. Plan is for her to f/u with outpatient ID with Dr. [**First Name (STitle) **] on [**2150-1-21**] regarding need to continue this treatment. . # Atrial fibrillation with RVR: On [**1-13**] patient was transferred to MICU for afib with RVR and hypotension. She was treated with digoxin load and PRN PO metoprolol. She will continue on digoxin 0.125mg 3/week and metoprolol 12.5 [**Hospital1 **] as an outpatient, with holding parameters for SBP<95 or HR<55. . # Nausea: Patient had repeated bouts of nausea accompanied by tachycardia in the 120-140 and hypotension that resolved with ondansetron. This appears to occur after HD and may be related to volume depletion. She also often gets nausea after eating. Patient repeatedly denied SOB or chest discomfort. Repeated cardiac enzymes were negative. . # Anticoagulation: Patient should continue on coumadin with goal INR [**12-31**]. . # Code status: Full Code Medications on Admission: Aspirin 325 mg daily Pantoprazole 40 mg daily Prednisone 5 mg Tablet daily Valganciclovir 450 mg Tablet Sig: One (1) Tablet PO 2X/WEEK (TU,TH). Midodrine 10mg TID Linezolid 600 mg [**Hospital1 **] until [**1-19**] Oxycodone 5 mg q6 prn Injection q dialysis. Humalog 100 unit/mL Cartridge Sig: sliding scale Subcutaneous QACHS. Warfarin 2.5 mg daily Dapsone 100 mg daily Zofran 4 mg Tablet Sig: One (1) Tablet PO twice a day as needed for nausea. Atovaquone 1500 daily Discharge Medications: 1. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Midodrine 5 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day). 4. B Complex-Vitamin C-Folic Acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 5. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 6. Dapsone 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Digoxin 125 mcg Tablet Sig: One (1) Tablet PO Q TUES, THURS, SAT (). 8. Valganciclovir 450 mg Tablet Sig: One (1) Tablet PO WED, SAT (). 9. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). 10. Daptomycin 500 mg Recon Soln Sig: Four [**Age over 90 1230**]y (450) mg Intravenous at dialysis: The last dose on [**2150-1-26**]. 11. Ondansetron 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, Rapid Dissolve PO every eight (8) hours as needed for nausea. 12. Insulin Regular Human 100 unit/mL Cartridge Sig: sliding scale Injection QACHS. 13. Warfarin 2.5 mg Tablet Sig: One (1) Tablet PO once a day: goal INR [**12-31**]. 14. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 15. Epoetin Alfa 2,000 unit/mL Solution Sig: at dialysis Discharge Disposition: Extended Care Facility: [**Hospital6 1643**] Discharge Diagnosis: Primary diagnoses: Fever Atrial fibrillation VRE bacteremia on treatment . Secondary diagnoses: ESRD on HD SLE LUE venous thrombus Discharge Condition: Mental Status:Clear and coherent Level of Consciousness:Alert and interactive Activity Status:Out of Bed with assistance to chair or wheelchair Discharge Instructions: It was a pleasure to be involved in your care, Ms. [**Known lastname 6357**]. You were admitted to [**Hospital1 69**] because of fever and hypotension. You were then found to have a type of arrhythmia called "atrial fibrillation with rapid ventricular response". You were in the medical ICU twice during this admission. For your fever, we did not find any source of infection, and your antibiotics was changed from linezolid to datpomycin because your blood counts went down on linezolid. You will receive daptomycin on the days of your dialysis, and you will finish it on [**2150-1-26**]. You were treated for atrial fibrillation with two medications, digoxin and metoprolol. Please note that your medications have been changed: Please continue daptomycin until [**2150-1-26**] We have added digoxin We have added metoprolol We also added simvastatin Please continue to take coumadin Please continue to take valganciclovir until when you are seen in the infectious disease clinic next week ([**2150-1-21**]) Followup Instructions: Provider: [**First Name11 (Name Pattern1) 1037**] [**Last Name (NamePattern4) 2335**], MD Phone:[**Telephone/Fax (1) 457**] Date/Time:[**2150-1-21**] 11:10 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1330**], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2150-1-30**] 1:00 Provider: [**Name10 (NameIs) 2105**] [**Name11 (NameIs) 2106**], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2150-6-18**] 10:00
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icd9cm
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icd9pcs
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18156
Discharge summary
Report
Admission Date: [**2173-8-3**] Discharge Date: [**2173-8-8**] Date of Birth: [**2114-1-5**] Sex: M Service: MEDICINE Allergies: clindamycin HCl Attending:[**First Name3 (LF) 23497**] Chief Complaint: Weakness and fatigue Major Surgical or Invasive Procedure: None History of Present Illness: 59M w/pmhx CHF (last EF 55-60%), afib, elevated LFTs, chronic LE wounds (recent admission for cellulitis on [**6-14**]), hx of PE and atrial thrombus, presented to clinic today for F/U. Pt had hx of multiple missed appointments and F/U labs were drawn today. Reported losing ~20lbs within the past month. Pt appeared euvolemic and had extensive chronic LE ulcerations (pt was seen in vascular clinic immediately prior to general medicine appointment and was started on Keflex). Referred to ED due to hyponatremia/[**Last Name (un) **] found on labs. On presentation to the emergency Department the patient reports that he has had occasional exertional shortness of breath, reports no symptoms at rest. He denies chest pain at any point. He reports that due to neuropathy he hasn't felt any pain in his leg ulcers but notices that they are significantly more erythematous and draining more fluid. Additionally he reports that he has not taken any of his A. fib medications for several days. In the ED his initial vitals were 98.4 130 90/52 18 100. An EKG showed afib @ 115, NA, lateral minimal stdep likely demand related. no STE. He recieved 1L NS and was restarted on his metorolol and diltiazem. His digoxin was held. Past Medical History: CARDIAC HISTORY: - Afib - noted first during admission [**1-/2171**]; initial TEE CV aborted due to left atrial thrombus; s/p DCCV [**2171-4-11**]. - Systolic CHF/nonischemic dilated cardiomyopathy - thought due to tachymyopathy. Recent EF 40% ([**3-/2171**]) - PFO (noted on TEE) - HTN Other Past History: - Pulmonary embolus (noted on CT [**1-/2171**]) - Anxiety - S/p hernia repair, pt describes complicated course of what sounds like dehiscence and redo x2 with mesh placement, last in 12/[**2168**]. - Seasonal allergies Social History: He is single and lives alone. He worked as a painter at [**Hospital1 **] [**Location (un) 620**], still out of work. He is a lifetime nonsmoker and denies illicit drug use. he does drink approximately [**12-28**] bottle of wine about 3 times weekly and "a few beers" from time to time with friends. Family History: Father: h/o CVA Mother: h/o heart disease, arrythmia and had a pacer. Deceased 82yo. Physical Exam: ADMIT 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: Clear to auscultation bilaterally, no wheezes, rales, ronchi Abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly GU: no foley Ext: warm, 2+ pulses, no clubbing, s/p DP amutation of left great toe, venous stasis dermatitis with possible super infection bilaterally Neuro: CNII-XII intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred. DISCHARGE EXAM: VS: 99.7 112/62 100 18 96% RA Gen: awake, alert, resting comfortably in chair, NAD HEENT: sclera anicteric, MMM CV: RRR Lungs: CTAB, no wheezes/rales/rhonchi Abd: bowel sounds present, soft, NT, ND Ext: bilateral pedal edema, venous stasis changes, legs wrapped in ACE bandages Pertinent Results: IMAGING: CXR [**2173-8-3**] - FINDINGS AND IMPRESSION: The lungs are clear. No pleural effusion, pulmonary edema or pneumothorax is present. Mild cardiomegaly is unchanged. MICRO/PATH: [**2173-8-3**] BLOOD CULTURES X 2 - no growth to date after 5 days. ADMIT LABS: [**2173-8-2**] 04:15PM BLOOD WBC-15.1* RBC-3.29* Hgb-10.5* Hct-30.6* MCV-93 MCH-31.9 MCHC-34.2 RDW-15.6* Plt Ct-289 [**2173-8-2**] 04:15PM BLOOD Neuts-93* Bands-0 Lymphs-5* Monos-1* Eos-1 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2173-8-2**] 04:15PM BLOOD Hypochr-NORMAL Anisocy-NORMAL Poiklo-NORMAL Macrocy-1+ Microcy-NORMAL Polychr-NORMAL [**2173-8-2**] 12:30PM BLOOD PT-15.7* INR(PT)-1.5* [**2173-8-2**] 04:15PM BLOOD UreaN-60* Creat-3.4*# Na-120* K-4.6 Cl-80* HCO3-24 AnGap-21* [**2173-8-2**] 04:15PM BLOOD Glucose-102* [**2173-8-2**] 04:15PM BLOOD ALT-33 AST-36 CK(CPK)-46* AlkPhos-162* TotBili-0.9 [**2173-8-2**] 04:15PM BLOOD Albumin-3.6 Calcium-9.1 Cholest-141 RELEVANT LABS: [**2173-8-3**] 12:25AM BLOOD WBC-12.7* RBC-3.08* Hgb-10.0* Hct-28.8* MCV-94 MCH-32.5* MCHC-34.7 RDW-15.8* Plt Ct-272 [**2173-8-3**] 05:13AM BLOOD WBC-10.7 RBC-2.99* Hgb-10.0* Hct-28.1* MCV-94 MCH-33.3* MCHC-35.5* RDW-15.7* Plt Ct-224 [**2173-8-3**] 12:25AM BLOOD Neuts-82.3* Lymphs-10.2* Monos-6.3 Eos-0.9 Baso-0.3 [**2173-8-3**] 05:13AM BLOOD Plt Ct-224 [**2173-8-3**] 12:25AM BLOOD Glucose-104* UreaN-58* Creat-3.0* Na-118* K-4.6 Cl-85* HCO3-20* AnGap-18 [**2173-8-3**] 05:13AM BLOOD Glucose-91 UreaN-55* Creat-2.5* Na-119* K-4.5 Cl-86* HCO3-24 AnGap-14 [**2173-8-3**] 07:00AM BLOOD Glucose-132* UreaN-58* Creat-2.8* Na-120* K-4.0 Cl-85* HCO3-22 AnGap-17 [**2173-8-3**] 02:00PM BLOOD Glucose-131* UreaN-55* Creat-2.3* Na-124* K-4.1 Cl-89* HCO3-23 AnGap-16 [**2173-8-3**] 07:53PM BLOOD Glucose-136* UreaN-52* Creat-2.0* Na-123* K-5.6* Cl-91* HCO3-22 AnGap-16 [**2173-8-3**] 12:25AM BLOOD ALT-33 AST-35 LD(LDH)-333* AlkPhos-163* TotBili-0.8 [**2173-8-3**] 05:13AM BLOOD ALT-29 AST-32 LD(LDH)-283* AlkPhos-146* TotBili-0.9 [**2173-8-3**] 02:00PM BLOOD ALT-25 AST-25 LD(LDH)-265* AlkPhos-137* TotBili-0.7 [**2173-8-3**] 12:25AM BLOOD proBNP-1588* [**2173-8-3**] 02:00PM BLOOD proBNP-1666* [**2173-8-3**] 12:25AM BLOOD ALT-33 AST-35 LD(LDH)-333* AlkPhos-163* TotBili-0.8 [**2173-8-3**] 05:13AM BLOOD ALT-29 AST-32 LD(LDH)-283* AlkPhos-146* TotBili-0.9 [**2173-8-3**] 02:00PM BLOOD ALT-25 AST-25 LD(LDH)-265* AlkPhos-137* TotBili-0.7 [**2173-8-3**] 12:25AM BLOOD proBNP-1588* [**2173-8-3**] 02:00PM BLOOD proBNP-1666* [**2173-8-3**] 07:00AM BLOOD Calcium-8.3* Phos-3.8 Mg-1.5* [**2173-8-3**] 02:00PM BLOOD Albumin-3.2* Calcium-8.0* Phos-3.6 Mg-2.6 [**2173-8-3**] 07:53PM BLOOD Calcium-8.0* Phos-3.6 Mg-2.5 DISCHARGE LABS: [**2173-8-8**] 06:10AM BLOOD WBC-10.0 RBC-2.65* Hgb-8.4* Hct-25.6* MCV-97 MCH-31.9 MCHC-33.0 RDW-15.2 Plt Ct-252 [**2173-8-8**] 06:10AM BLOOD Glucose-99 UreaN-16 Creat-0.9 Na-134 K-4.2 Cl-97 HCO3-27 AnGap-14 [**2173-8-8**] 06:10AM BLOOD Calcium-8.5 Phos-3.6 Mg-1.6 [**2173-8-8**] 06:10AM BLOOD PT-15.0* PTT-28.2 INR(PT)-1.4* Brief Hospital Course: 59 year old male with a past medical history of systolic congestive heart failure (last EF 55-60%), atrial fibrillation on coumadin, transaminitis secondary to cirrhosis, chronic lower extremity stasis dermatitis (recent admission for cellulitis on [**2173-6-14**]), history of pulmonary embolus and atrial thrombus who presented from clinic with with a significant hyponatremia, elevated lactate, and acute kidney injury. #. HYPONATREMIA: Etiology was likely hypovolemic hyponatremia in the setting of over-aggressive diuretic use and decreased dietary intake of sodium. Patient had started dieting, eating less salt and drinking more water. He presented with hypotension and tachycardia. Patient also presented with acute kidney injury, elevated lactate, fractional excretion of sodium less than 1, low urine sodium, and elevated creatinine and BUN all suggesting hypovolemic hyponatremia as the etiology. While in the MICU his sodium was corrected with normal saline and his urine and serum sodium trended. Once his sodium was trending upward he was transferred to the medicine floor. His torsemide was held and then restarted on [**8-7**] on an every other day dosing schedule, and he should follow up with his PCP for repeat lab testing. # HYPOTENSION / TACHYCARDIA - Though initially concerned for SIRS/sepsis because of leukocytosis on admission, and possible source of infection being cellulitis from chronic venous stasis ulcers. CXR, UA, blood cultures were all negative for signs of infection. He did not have fever of systemic signs of infection. Initially he met systemic inflammatory response syndrome criteria with a possible source. He was started on vancomycin and unasyn empirically. On re-evaluation he remained afebrile with no constitutional symptoms concerning for sepsis. His vancomycin and unysin was discontinued and keflex was kept on per his vascular physicians prescription. Hypotension was likely a result of extracellular volume depletion in the setting of overdiuresis and salt restriction as above, with a reactive tachycardia. Metoprolol, digoxin, and diltiazem were held for hypotension but restarted as his pressures tolerated them. He was monitored on telemetry and was not shown to have any atrial fibrillation with RVR. However, he had asymptomatic sinus tachycardia to the 130-160s during physical therapy. This was likely because his home medications were held, and his tachycardia improved upon restarting digoxin, metoprolol, and diltiazem at his home doses. Torsemide was restarted on an every other day dosing schedule. #. ATRIAL FIBRILLATION: Chronic issue. On coumadin, metoprolol, diltizem, and digoxin at home. In the MICU, he became mildly hypotensive (sbp in 90s, not requiring pressors) so his metoprolol and diltiazem were reduced in dose. Upon trasnfer to floor, blood pressure was stable after resuming home meidcations and metoprolol was uptitrates in setting of tachycardia, particularly with exertion with PT. He should follow up with his PCP regarding titration of his rate control. His INR was subtherapeutic, so his warfarin was increased to 6mg. Digoxin was continued and level was not toxic. #. Acute kidney injury: Likely prerenal and related to hypoperfusion in the setting of hypotension. creatinine improved with holding torsemide and administration of IVF. His creatine and BUN were trended and his creatine trended downward with IV fluids. #. STASIS DERMATITIS WITH POSSIBLE SUPER IMPOSED CELLULITIS: While in the MICU he did not spike a fever or appear overtly septic by exam or review of systems. His leukocytosis normalized. The decision was made to leave him on his outpatient dose of keflex however pending follow-up with his vascular physician. #. CIRRHOSIS: This is a diagnosis that is currently undergoing outpatient workup. He did not appear hypervolemic and this was not likely related to the etiology of his hyponatremia. He denies alcohol abuse and is reportedly planning on undergoing a liver biopsy to further characterize his liver disease. His liver function was monitored while in the MICU and remained stable, and no further management of his possible cirrhosis was performed. TRANSITIONAL ISSUES: -Vascular, renal, and hepatic follow-up. -Should f/u with PCP regarding torsemide dosing which was decreased to every other day. He should be evaluated for less aggressive diuresis if has bump in creatinine. -He should follow up with his PCP and cardiology regarding titration of his metoprolol and diltiazem for rate control. -Warfarin increased to 6mg at discharge as his INR was 1.4 Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from [**Month/Year (2) 581**]. 1. Warfarin 2 mg PO DAILY16 2. Torsemide 50 mg PO DAILY 3. OxycoDONE (Immediate Release) 5 mg PO BID:PRN pain 4. Metoprolol Succinate XL 50 mg PO DAILY 5. Latanoprost 0.005% Ophth. Soln. 1 DROP LEFT EYE HS 6. Diltiazem Extended-Release 180 mg PO DAILY 7. Digoxin 0.125 mg PO DAILY 8. Cephalexin 500 mg PO Q6H Discharge Medications: 1. Cephalexin 500 mg PO Q6H 2. Digoxin 0.125 mg PO DAILY 3. Latanoprost 0.005% Ophth. Soln. 1 DROP BOTH EYES HS 4. OxycoDONE (Immediate Release) 5 mg PO BID:PRN pain 5. Oxycodone SR (OxyconTIN) 20 mg PO Q12H 6. Torsemide 20 mg PO EVERY OTHER DAY please hold for SBP <100 RX *Demadex 20 mg 1 tablet(s) by mouth every other day Disp #*15 Tablet Refills:*0 7. Warfarin 6 mg PO DAILY16 8. Metoprolol Succinate XL 100 mg PO DAILY RX *metoprolol succinate 100 mg 1 tablet(s) by mouth daily Disp #*30 Tablet Refills:*0 9. Diltiazem Extended-Release 180 mg PO DAILY 10. Outpatient Lab Work Please check INR [**2173-8-9**] and send results to [**Company 191**] [**Hospital 3052**]. Phone [**Telephone/Fax (1) 2173**]. Discharge Disposition: Home With Service Facility: Allcare VNA Discharge Diagnosis: Primary: Hyponatremia, acute kidney injury Secondary: Atrial fibrillation, chronic systolic congestive heart failure 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 Mr. [**Known lastname 10840**], You were treated at [**Hospital1 18**] for low sodium and decreased kidney function. Your low sodium and decreased kidney function were likely caused by a combination of not eating and drinking as much as you used to, as well as your torsemide diuretic. As we gave you fluid and discontinued your torsemide, your sodium level improved. Please restart your torsemide, but at a lower dose. Take 20 mg every other day until you see your cardiologist and primary care doctor. You should take your next dose on Monday [**2173-8-9**]. Your kidney function also improved with IV fluids, and is now normal. Please have your INR checked on Tuesday [**2173-8-10**]. You may need adjustment in your coumadin dose. For now, you should take 6 mg per day as your INR is low. Please keep the appointments listed below. Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs. Followup Instructions: Department: CARDIAC SERVICES When: FRIDAY [**2173-8-13**] at 11:00 AM With: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2003**], NP [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: VASCULAR SURGERY When: MONDAY [**2173-9-13**] at 10:45 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 20205**], MD [**Telephone/Fax (1) 20206**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Location (un) **] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Department: [**Hospital3 249**] When: WEDNESDAY [**2173-8-18**] at 1:30 PM With: Dr. [**First Name4 (NamePattern1) 2184**] [**Last Name (NamePattern1) 2185**] in the [**Company 191**] POST [**Hospital 894**] CLINIC Phone: [**Telephone/Fax (1) 2010**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 895**] South [**Hospital **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Notes: This appointment is with a hospital-based doctor as part of your transition from the hospital back to your primary care provider. [**Name10 (NameIs) 616**] this visit, you will see your regular primary care doctor in follow up. Completed by:[**2173-8-8**]
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icd9cm
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icd9pcs
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30125
Discharge summary
Report
Admission Date: [**2188-7-16**] Discharge Date: [**2188-8-21**] Date of Birth: [**2114-9-29**] Sex: F Service: SURGERY Allergies: Pravachol / Lisinopril Attending:[**First Name3 (LF) 148**] Chief Complaint: Pancreatic Head Mass Major Surgical or Invasive Procedure: 1. Classical Whipple resection. 2. Open cholecystectomy. 3. Incisional hernia repair (separate procedure). . 4. Percutaneous tracheostomy placement . PICC Dobhoff Feeding tube History of Present Illness: This is a 73 year old female with pancreatic head mass, which is newly identified incidentally. She came alone to the clinic today after having seen Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] from our oncology group just yesterday. Basically, she was getting a workup for dysphasia. She was asymptomatic otherwise. The workup led ultimately to identification of a mass in the head of the pancreas. She has had no weight loss and no steatorrhea. She has no evidence of diabetes. She had an ultrasound-guided biopsy performed by endoscopic ultrasound technique and this has shown cells suspicious for adenocarcinoma. Her only GI procedures of late has been the endoscopic ultrasound performed on the [**2188-7-4**] and this showed biopsy proven adenocarcinoma. She has not been jaundiced and she has not required stenting. Past Medical History: PMH: HTN, hlipid, tics&polyps, breast ca [**2158**] s/p L mast, osteopenia, panc cyst, esophagitis, hypothyroidism, colitis s/p partial colectomy, arthritis, urin incont PSH: L mast, hysterect, herniorrhaphy w mesh infxn and removal, partial colectomy. Social History: Retired Teacher Lives alone Physical Exam: 98.7/98.7 57 96/47 19 93% on trach mask 50% f.s. 117-181 Gen: NAD, comfortable HEENT: PERRL, NCAT Heart: sinus, no murmur Chest: crackles bilat, symmetric bs Abd: soft, NTND, JP in place ext: min. edema, 2+ pulses throughout Pertinent Results: [**2188-7-16**] 07:06PM BLOOD WBC-9.9 RBC-3.67* Hgb-10.6* Hct-30.5* MCV-83 MCH-29.0 MCHC-34.9 RDW-14.5 Plt Ct-234 [**2188-7-27**] 03:24AM BLOOD WBC-12.4* RBC-3.22* Hgb-9.2* Hct-26.5* MCV-82 MCH-28.5 MCHC-34.6 RDW-14.0 Plt Ct-374 [**2188-8-21**] 04:25AM BLOOD WBC-12.7* RBC-3.14* Hgb-8.7* Hct-26.6* MCV-85 MCH-27.5 MCHC-32.6 RDW-15.7* Plt Ct-376 [**2188-8-19**] 06:42AM BLOOD Glucose-125* UreaN-25* Creat-0.8 Na-139 K-3.8 Cl-98 HCO3-31 AnGap-14 [**2188-8-1**] 03:48PM BLOOD ALT-38 AST-34 LD(LDH)-181 CK(CPK)-29 AlkPhos-163* Amylase-19 TotBili-0.4 [**2188-8-1**] 03:48PM BLOOD Lipase-25 [**2188-8-13**] 05:29AM BLOOD CK-MB-NotDone cTropnT-0.05* [**2188-8-19**] 06:42AM BLOOD Calcium-9.8 Phos-3.5 Mg-2.1 . Micro: Date 6 Specimen Tests Ordered By All [**2188-7-20**] [**2188-7-21**] [**2188-7-23**] [**2188-7-28**] [**2188-7-31**] [**2188-8-3**] [**2188-8-6**] [**2188-8-8**] [**2188-8-11**] [**2188-8-12**] [**2188-8-19**] [**2188-8-20**] All BLOOD CULTURE BRONCHOALVEOLAR LAVAGE CATHETER TIP-IV MRSA SCREEN PERITONEAL FLUID SPUTUM STOOL SWAB URINE All INPATIENT [**2188-8-20**] STOOL CLOSTRIDIUM DIFFICILE TOXIN A & B TEST-FINAL INPATIENT [**2188-8-19**] PERITONEAL FLUID GRAM STAIN-FINAL; FLUID CULTURE-PRELIMINARY {PSEUDOMONAS AERUGINOSA}; ANAEROBIC CULTURE-PRELIMINARY; FUNGAL CULTURE-PRELIMINARY INPATIENT [**2188-8-12**] STOOL CLOSTRIDIUM DIFFICILE TOXIN A & B TEST-FINAL INPATIENT [**2188-8-11**] BRONCHOALVEOLAR LAVAGE GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL {GRAM NEGATIVE ROD(S)}; FUNGAL CULTURE-PRELIMINARY INPATIENT [**2188-8-11**] MRSA SCREEN MRSA SCREEN-FINAL INPATIENT [**2188-8-11**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2188-8-11**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2188-8-8**] BRONCHOALVEOLAR LAVAGE GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL {PSEUDOMONAS AERUGINOSA}; FUNGAL CULTURE-PRELIMINARY INPATIENT [**2188-8-8**] URINE URINE CULTURE-FINAL INPATIENT [**2188-8-6**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2188-8-6**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2188-8-6**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL {PSEUDOMONAS AERUGINOSA} INPATIENT [**2188-8-3**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2188-8-3**] URINE URINE CULTURE-FINAL {PSEUDOMONAS AERUGINOSA} INPATIENT [**2188-8-3**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2188-7-31**] CATHETER TIP-IV WOUND CULTURE-FINAL INPATIENT [**2188-7-31**] CATHETER TIP-IV WOUND CULTURE-FINAL INPATIENT [**2188-7-28**] SWAB R/O VANCOMYCIN RESISTANT ENTEROCOCCUS-FINAL {ENTEROCOCCUS SP.} INPATIENT [**2188-7-23**] PERITONEAL FLUID GRAM STAIN-FINAL; FLUID CULTURE-FINAL {ESCHERICHIA COLI, STAPH AUREUS COAG +}; ANAEROBIC CULTURE-FINAL INPATIENT [**2188-7-21**] URINE URINE CULTURE-FINAL INPATIENT [**2188-7-21**] MRSA SCREEN MRSA SCREEN-FINAL {POSITIVE FOR METHICILLIN RESISTANT STAPH AUREUS} INPATIENT [**2188-7-21**] SWAB R/O VANCOMYCIN RESISTANT ENTEROCOCCUS-FINAL INPATIENT [**2188-7-21**] MRSA SCREEN MRSA SCREEN-FINAL {POSITIVE FOR METHICILLIN RESISTANT STAPH AUREUS} INPATIENT [**2188-7-20**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL {STAPH AUREUS COAG +} INPATIENT [**2188-7-20**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT . ASCITES ANALYSIS WBC RBC Polys Lymphs Monos [**2188-8-19**] 03:14AM [**Numeric Identifier 71804**]* 13* 92* 8* 0 Import Result ASCITES CHEMISTRY Glucose Amylase [**2188-8-19**] 12:16PM [**Numeric Identifier 71805**] Import Result [**2188-8-19**] 03:14AM 207 Import Result [**2188-7-21**] 11:00AM [**Numeric Identifier **] Import Result OTHER BODY FLUID CHEMISTRY Amylase [**2188-8-1**] 10:46AM 1652 Import Result . SPECIMEN SUBMITTED: fs pancreatic neck margin, gall bladder, Jejunum, whipple specimen. Procedure date Tissue received Report Date Diagnosed by [**2188-7-16**] [**2188-7-16**] [**2188-7-21**] DR. [**Last Name (STitle) **]. [**Doctor Last Name **]/ttl DIAGNOSIS: I. Gallbladder (A-B): 1. Chronic cholecystitis, mild. 2. Cholelithiasis, cholesterol-type. II. Jejunum (C-D): Within normal limits. III. Pancreatic neck margin (E): 1. Tiny focus of pancreatic intraepithelial neoplasm, low grade (PanIN I). 2. No invasive carcinoma. IV. Whipple (F-AR): 1. Adenocarcinoma of the pancreas, see synoptic report. 2. Multiple foci of pancreatic intraepithelial neoplasm, low grade (PanIN I-II), including the uncinate area. 3. Segments of stomach, duodenum, and bile duct; No tumor. Pancreas (Exocrine): Resection Synopsis MACROSCOPIC Specimen Type: Pancreaticoduodenectomy, partial pancreatectomy. Tumor Site: Pancreatic head. Tumor Size Greatest dimension: 2.0 cm. Additional dimensions: 2.0 cm. Other organs/Tissues Received: Gallbladder, Jejunum. MICROSCOPIC Histologic Type: Ductal adenocarcinoma. Histologic Grade: G2: Moderately differentiated. EXTENT OF INVASION Primary Tumor: pT3: Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery. Regional Lymph Nodes: pN1a: Metastasis in single regional lymph node (see comment). Lymph Nodes Number examined: 31. Number involved: 2. Distant metastasis: pMX: Cannot be assessed. Margins: Margins uninvolved by invasive carcinoma: Distance from closest margin: 1.7 cm. Specified margin: Pancreatic neck. Venous/Lymphatic vessel invasion: Absent. Perineural invasion: Present. Additional Pathologic Findings: Pancreatic intraepithelial neoplasia -- highest grade: PanIN: 2. Comments: The tumor extends focally into the peripancreatic adipose tissue. One of the lymph nodes involved with tumor is due to contiguous spread. Clinical: Pancreatic cancer. . Radiology Report CTA CHEST W&W/O C&RECONS, NON-CORONARY Study Date of [**2188-7-18**] 1:38 PM IMPRESSION: 1. Negative examination for pulmonary embolism. 2. Bibasilar consolidations, probably corresponding to atelectasis, but infection/aspiration cannot be excluded. Suggest followup. Minimal pleural effusion. 3. Endotracheal tube end impinges lateral anterior wall of the trachea. Suggest reposition. 4. Coronary calcifications. 5. Enlarged heart size, especially left ventricle. 6. Unchanged appearance of the liver hypodense lesion, likely cyst. . Radiology Report CHEST (PORTABLE AP) Study Date of [**2188-7-20**] 4:46 AM Final Report REASON FOR EXAM: Intubated patient, post-Whipple. Comparison is made with prior study performed the day earlier. There have been no interval changes. ET tube is in standard position. Right IJ catheter tip is in the SVC. Small bilateral pleural effusions, greater in the left side with associated atelectasis and atelectasis in the right upper lobe are unchanged as does cardiomegaly and prominent pulmonary arteries. There is no CHF or new lung abnormalities. NG tube tip is out of view below the diaphragm. . [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT IMPRESSION: Suboptimal image quality. LVH with preserved regional and global function. The RV is not well seen but may be dilated with depressed systolic function. Mild pulmonary artery systolic hypertension. Compared with the prior study (images reviewed) of [**2187-7-6**], the right ventricle appears to be dilated with depressed function on the current study. Mild pulmonary artery systolic hypertension is now seen. The other findings are similar. . Radiology Report CT ABDOMEN W/CONTRAST Study Date of [**2188-7-22**] 11:50 AM IMPRESSION: 1. Patient is status post classic Whipple procedure. There is a hypodense area adjacent to the pancreaticojejunostomy that cannot be evaluated well without oral contrast. The hypodense area appears to be a jejunal loop; however, hematoma or postoperative collection cannot be excluded. 2. Multiple hypodense liver lesions in both lobes of the liver, one in segment II appears to be new. Attention will be paid to these areas on future studies. 3. Small bilateral pleural effusions with increased dependent atelectasis versus infiltrate in the right lower lobe. Minimal atelectasis in the left base. 4. Status post abdominal hernia repair. 5. Large bladder calculus. 6. Diverticulosis without evidence of diverticulitis. . Radiology Report CHEST (PORTABLE AP) Study Date of [**2188-7-27**] 4:27 AM Provisional Findings Impression: DJRX SUN [**2188-7-27**] 11:49 AM Bilateral perihilar densities suspicious for pneumonia. IMPRESSION: Focal areas of increased density bilaterally suspicious for pneumonia. A little interval change . Radiology Report CT HEAD W/O CONTRAST Study Date of [**2188-7-28**] 12:16 PM IMPRESSION: 1. No acute intracranial pathology identified. 2. Sinus disease as described above, likely related to chronic inflammatory process and/or patient's intubated status; however, correlation should be made for any findings to suggest acute sinusitis/mastoiditis. 3. S/P left occipital craniotomy- please provide reason for this procedure. . Radiology Report CHEST (PORTABLE AP) Study Date of [**2188-7-30**] 2:59 AM FINDINGS: The tracheostomy tube remains in place, but appears to contact the right lateral tracheal wall. Nasogastric tube is still in place. The right internal jugular line ends in the SVC. Allowing for difference in positions, there is no significant change in the degree of cardiomegaly, bilateral pleural effusions, or pulmonary vascular congestion. . Radiology Report CTA CHEST W&W/O C&RECONS, NON-CORONARY Study Date of [**2188-8-1**] 10:21 PM IMPRESSION: 1. No pulmonary embolus or acute aortic abnormality. 2. Bilateral pleural effusions, right greater than left, with fluid tracking into the fissures, which could be loculated. Associated compressive atelectasis demonstrates enhancement, and is not likely to represent pneumonic consolidation. 3. Support lines in place. 4. Extensive vascular calcification. 5. Cardiomegaly. . Radiology Report CHEST (PORTABLE AP) Study Date of [**2188-8-6**] 4:36 AM IMPRESSION: AP chest compared to [**7-31**]: Mild pulmonary edema has worsened since [**8-5**]. Large heart and generally large and tortuous thoracic aorta are chronic. No pneumothorax or pleural effusion. Right subclavian line barely central should be re-evaluated by film it is not rotated. Esophageal tube or probe ends in the upper stomach, as before. . Radiology Report CHEST (PORTABLE AP) Study Date of [**2188-8-14**] 4:47 AM Of note, the patient is markedly rotated. Tracheostomy tube and right PICC are in standard positions. NG tube tip is out of view below the diaphragm. Bibasilar consolidations consistent with aspiration or pneumonia are stable. Opacity in the right upper lobe is more conspicuous in this examination could be due to aspiration. . Radiology Report VIDEO OROPHARYNGEAL SWALLOW Study Date of [**2188-8-19**] 9:47 AM IMPRESSION: Mild oropharyngeal dysphagia characterized by mildly reduced bolus control with thin liquids, and mildly reduced laryngeal elevation and laryngeal valve closure, resulting in episodes of penetration during swallow of thin liquids. . Radiology Report CT ABDOMEN W/CONTRAST Study Date of [**2188-8-20**] 10:13 AM IMPRESSION: 1. Resolving postoperative stranding status post Whipple procedure. Soft tissue attenuation conglomeration in the pancreaticojejunostomy bed is not as well evaluated on the current study but is not significantly changed and likely represents loops of jejunum. 2. Three hypodense liver lesions no fully characterized. Attention should be paid to these areas on followup studies. 3. Peribronchovascular ground glass opacities may represent infection, inflammation and less likely edema. 4. Enlarged pulmonary artery suggesting underlying pulmonary arterial hypertension. 5. Dense coronary artery calcificiations. Brief Hospital Course: This is a 73 year old female with a pancreatic head mass who went to the OR on [**2188-7-16**] for: 1. Classical Whipple resection. 2. Open cholecystectomy. 3. Incisional hernia repair (separate procedure). During the case there was some concern about her oxygenation particularly in the early portion of the operation where she required 100% oxygen saturation in order to maintain a appropriate saturation rate level. There is no evidence of any pneumothorax, and she had a bronchoscopy in the case which was nonrevealing. On POD 2, she desaturated on floor and was transferred to the ICU and reintubated for acute respiratory distress/failure. She remained in the ICU for 3 weeks. The following summarizes significant events: [**7-18**]: CTA neg for PE , increased PEEP, EKG, cardiac enzymes were negative. [**7-19**]: continue vent [**7-21**]: vanc and zosyn lasix d/ced and then restarted TTE EF 60% RV dilated, fever, inc insulin in TPN [**7-22**]: ct abd - small fluid collection (not drainable), wean fio2 [**7-23**]: decr lopressor, JP cx, wean vent, tighten SSI, cont TPN, incr insulin to 50, vulvar lesion clean (recent partial vulvectomy [**2188-7-8**]) [**7-24**]: Decrease PEEP, Insulin 65 with TPN [**7-25**]: wound care consult, added NPH 40/40 [**7-26**]: consult gyn for vulvar lesion [**7-27**]:wean propofol [**7-28**]: head ct negative, continue tpn, [**7-29**]: trach, [**7-30**]-nasoenteric feeding tube placed by radiology [**7-31**]: picc placed, CVL removed; increased secretions from trach (02 sat stable) [**8-1**]:d/c vanco/cirpo;acute hypotensive episode x 1 with spontaneous return, CTA PE - negative, BL atelectasis with R>L effusions, secretions reduced from previous but present; Echo - nl ef, no gross abnormalities; Cards consulted - no changes; increased Fi02 to 60% for improved oxygenation; acetazolamide started [**8-2**]: 2 units PRBC, desat after 1 unit, improved after lasix [**8-3**]: destat episode, mucous plugging. Lasix gtt increased for fluid volume overload and pulmonary hypertension [**8-4**]: up in chair, good sat, lasix 2/hr [**8-5**]: up in chair, secretions still tend to be substantial, lasix gtt increased to make the patient negative [**8-6**]: replaced dobhoff, clonidine patch and PO, versed prn, increased lasix gtt [**8-7**]: Recurrent episodes of desaturation, likely secondary to mucous plugging. Increased Fi02, Aggressive suctioning. Pt also with episode of vomiting when given large volume KCL down dobhoff. Feeds held, then restarted. Pt with vagal episode with vomiting. [**8-9**]: Dobhoff removed and patient fighting placement, IVF started while tube feeds off, copious secretions, lasix gtt increased, diamox frequency increased, albumin level f/u in AM [**8-10**]: Dobhoff placed. Lasix gtt decreased [**8-11**]: cont diuresis, stopped diamox, started metalozone, fluc started [**8-13**]: Tube feeds restarted p MN, NGt was placed for decompression/evacuation, no asystolic events [**8-14**]: Pt had FS 57, NPH decreased to 25, 25. Pt self d/c aline [**8-15**]: passed S/S eval, [**Hospital 71806**] rehab screening, diamox [**8-20**] CT: resolving stranding, soft tissue atten in pancreaticojej bed not well-evaluated, but no signif. change, likely represents loops of jejunum. 3 hypodense LVR lesions not fully characterized. Peribronchovascular ground glass opacities may represent infection, inflammation and less likely edema. . CARDIOVASCULAR: Due to Bradycardia and pauses, her nodal blocking agents were held. These were restarted without incident once back on the floor. PULMONARY: trach and passe muir valve in place. GI / ABD: abdomen soft, and nontender. JP drain on the right side has sequentially been backed out. There is now an ostomy appliance in place. The last JP Amylase was [**Numeric Identifier 71805**]. NUTRITION: TF at goal 50cc/hr. Tolerating some PO's. See recs below. RENAL: lasix gtt, diamox stopped. Fluid status now stable. HEMATOLOGY:stable ENDOCRINE: RISS ID:inhaled tobramycin, and fluc have been completed. Zosyn to continue for 2 weeks due to PSEUDOMONAS AERUGINOSA from the JP drain. LINES/TUBES/DRAINS: Trach, picc line rt antecub, WOUNDS:none . Pathology: Primary Tumor: pT3: Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery. 2/31 nodes positive. Margins uninvolved by invasive carcinoma: No PVI, +perineural invasion. . Micro: [**8-20**] C dif: Negative x2 [**8-19**] Peritoneal: Pseudomonas - Resistant to Cipro [**8-12**] C dif: negative [**8-11**] BAL: GNRs [**8-8**] Spcx: pseudomonas - R cipro [**8-8**] Ucx: neg [**8-6**] Spcx: pseudomonas - R cipro [**8-3**] Ucx: pseudomonas - R cipro [**7-23**] JPcx: E.coli - R gent; MRSA . Consults: [**8-15**] Cards: AF, WBC downtrending. d/c nodal blocking agents; atropine at bedside, pacer pads; if continues to have pauses > 5 secs, would consider placing temp pacing wire. Once transferred to the floor, she was no longer having pauses and meds were restarted. . Video Swallow: 1. PO intake of thin liquids and regular solids. 2. Pills may be given whole with puree. 3. Aspiration Precautions: A. Use straws while drinking thin liquids. B. If drinking by cup, use a chin tuck. C. Use intermittent cough to help clear any penetration. D. No mixed consistencies (i.e. cereal, hearty soups). 4. PMV must be in place for all POs. 5. Continue supervision to assist with feeding and monitor swallow safety. Medications on Admission: Alendronate 35 Qwk, atenolol 25', fenofibrate 200', fexofenadine 180', levothyroxine 150mcg', nifedipine 90', valsartan 320', ASA 81', percs, tylenol, B12, Ca +D, naproxen, VitE Discharge Medications: 1. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection Q12H (every 12 hours). 2. Docusate Sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 3. Tobramycin 300 mg/5 mL Solution for Nebulization Sig: One (1) Inhalation [**Hospital1 **] (2 times a day). 4. Metolazone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Levothyroxine 150 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Famotidine 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 7. Albuterol 90 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q4H (every 4 hours) as needed. 8. Metoclopramide 10 mg Tablet Sig: Two (2) Tablet PO QID (4 times a day). 9. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q6H (every 6 hours) as needed. 10. Atenolol 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours) as needed. 12. Nifedipine 60 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO DAILY (Daily). 13. Hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 14. Valsartan 160 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 15. Insulin NPH Human Recomb 100 unit/mL Suspension Sig: Twenty Five (25) Subcutaneous twice a day. 16. Insulin Regular Human 100 unit/mL Solution Sig: Sliding Scale Injection four times a day. 17. Piperacillin-Tazobactam-Dextrs 4.5 gram/100 mL Piggyback Sig: One (1) Intravenous Q8H (every 8 hours) for 2 weeks: 2 weeks. 18. Heparin, Porcine (PF) 10 unit/mL Syringe Sig: Two (2) ML Intravenous PRN (as needed) as needed for line flush. Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: Adenocarcinoma of the pancreas Post-op Acute Respiratory Failure / Hypoxia Post-op Blood Loss Anemia Post-op Fluid Volume Overload / Pulmonary Hypertension Post-op Bradycardia / Cardiac Pauses Post-op Mild oropharyngeal dysphagia Post-op Pneumonia Post-op Atelectasis Discharge Condition: Good 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 skin, or the whites of your eyes become yellow. * 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. * 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. . * Take all new meds as ordered. * Do not drive or operate heavy machinery while taking any narcotic pain medication. You may have constipation when taking narcotic pain medications (oxycodone, percocet, vicodin, hydrocodone, dilaudid, etc.); you should continue drinking fluids, you may take stool softeners, and should eat foods that are high in fiber. * Continue to increase activity daily * Monitor your incision for signs of infection (redness, drainage). * Continue with drain care Followup Instructions: Please follow-up with Dr. [**Last Name (STitle) **] on [**2188-9-12**] at 8:30am. Completed by:[**2188-8-21**]
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icd9cm
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42184
Discharge summary
Report
Admission Date: [**2179-8-16**] Discharge Date: [**2179-8-20**] Service: MEDICINE Allergies: morphine Attending:[**First Name3 (LF) 2356**] Chief Complaint: dizziness and vomitting Major Surgical or Invasive Procedure: none History of Present Illness: OUTPATIENT CARDIOLOGIST: [**Last Name (LF) 1270**], [**Name8 (MD) **] MD . PCP: . CHIEF COMPLAINT: Dizziness and vomiting . . HISTORY OF PRESENTING ILLNESS: Pt is a [**Age over 90 **] y/o female with history of ?bradycardia, LE swelling, CKD, HTN, HL, hypothyroidism, RA who was transferred to [**Hospital1 18**] for pacemaker placement s/p symptomatic bradycardia. Per OSH (Good Sumaritan) records, she was in usual state of health until this evenning when she developed acute onset dizziness while washing her dishes when she fell and EMS was caled. No LOS or headache. On route developed chest pain radiating to her back and got aaspirin 325 and nitro once. In the ambulance she was noted to be diaphoretic, pale, nausea with vomiting and dizzzines. The initial EKG showed junctional bradycardia in 40s. A subsequent 12 lead EKG demonstrated aflutter with 5:1 conduction with rates between 49 and 52. In the ED Code STEMI was activated given STE in I and aVL and patient determined to be medically managed and NOT taken to cath lab. She was sent for CT chest to r/o aortic dissection and after put on heparin drip, asa, nitro drip, morphine, and continued on her home dose of lasix, hydrochlorothiazide, and home benazepril was changed to lisinopril (unknown dose). Her exam at OSH was notable for BP systolic 160s both upper extremities, bradycardia, crackles in left base, 2+ pitting edema in LE bilaterally, and skin tear on left elbow with brusing and echhymoses. Labs WBC 11.3, hct 38.5, plt 225,000, INR 0.9 PTT 30. Na 137 K3.7, Cl94, bicarb 29, AG 14. BUN/Cr 71/2.2. glu 250 and Ca 9.6. Cl 73, peak MB 14, peak TropI 1.55. EKG with Aflutter 5:1 conduction block. 1mm STE in I, 2mmSTE in aVL with reciprocal ST depressions in II, II, avF, V5 and V6. Also "new LBBB". CXR with enlarged cardiac silhouette. CT Chest showed cardiac enlargement with small pericardial effusion, large hiatal hernia, small right pleural effusion. ECHO showed EF 60-65%, normal systolic function, right atrium mildly dilated, trace AR, no AS, Pulmonary HTN present with RVSP 67 On arrival to CCU the patient appeared well and was conversant, alert and oriented x3. She did describe some chest pain on her lower right sternum which only was present during moving. The pain was felt to be internal and non-radiating. She denied nausea, dizziness, shortness of breath, but did endorse a cough which is new. REVIEW OF SYSTEMS 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 dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. Past Medical History: PAST MEDICAL HISTORY: 1. CARDIAC RISK FACTORS: -Diabetes, +Dyslipidemia, +Hypertension 2. CARDIAC HISTORY: ?CHF Bradycardia- had been evaluated by cardiologist who recommended no intervention as patient was asymptomatic. Unclear if history 3. OTHER PAST MEDICAL HISTORY: CKD ANEMIA GERD Rheumatoid arthritis MEDICATIONS: hydrochlorothiazide - in OMR, not on OSH records 25 mg tablet 0.5 (One half) Tablet(s) by mouth once a day [**2179-4-9**] isosorbide mononitrate [Imdur] 60 mg tablet extended release 24 hr 1 Tablet(s) by mouth once a day levothyroxine [Synthroid] 25 mcg tablet 1 Tablet(s) by mouth once a day [**2179-2-12**] nitroglycerin [Nitrostat] 0.3 mg tablet, sublingual 1 Tablet(s) sublingually 5 minutes [**2178-12-11**] pantoprazole [Protonix] 40 mg tablet,delayed release (DR/EC) simvastatin [Zocor] 20 mg tablet 1 Tablet(s) by mouth once a day Benzapril 40 mg daily Lasix 20 mg daily Prednisone 5 mg daily ALLERGIES: Morphine years ago, does not remember her reaction Social History: SOCIAL HISTORY Lives in [**Hospital3 **] home, lately increased dependence on ambulatory aid. 1 son [**Name (NI) **] [**Name (NI) **] involved in her care -Former smoker, [**3-28**] ppd 45 years, quit in [**2144**] -No etoh or illicits Family History: FAMILY HISTORY: Mother and father died in 80s, father from CAD, sister cancer, mother unknown Physical Exam: PHYSICAL EXAMINATION: VS: T=97.6 BP=143/61 HR= 45 3rd degree AV block RR=20 O2 sat=99% GENERAL: NAD. Oriented x3. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of 9 cm. CARDIAC: PMI located in 5th intercostal space, midclavicular line. Slow rate, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: Crackles auscultated in left lower lobe ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: [**1-25**]+ edema bilateral lower extremities, R>L. Ecchymosis on L elbow SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ . Pertinent Results: 11:16p 140 98 56 144 AGap=15 3.9 31 1.6 Comments: Glucose: If Fasting, 70-100 Normal, >125 Provisional Diabetes estGFR: 30/36 (click for details) CK: 165 MB: 10 MBI: 6.1 Trop-T: 0.52 Comments: CK(CPK): New Reference Interval As Of [**2177-1-27**];Upper Limit (97.5th %Ile) Varies With Ancestry And Gender (Male/Female);Whites 322/201 Blacks 801/414 Asians 641/313 cTropnT: Reported To And Read Back By cTropnT: J.Brady @ 0054 [**2179-8-17**] cTropnT: Ctropnt > 0.10 Ng/Ml Suggests Acute Mi Ca: 9.1 Mg: 2.1 P: 3.0 94 12.6 12.3 201 34.5 PT: 10.8 PTT: 42.4 INR: 1.0 EKG: -In house: Rate 40, 3rd degree AV block, Axis 80, No ST changes seen on this EKG. -OSH- STE in Leads aVL and I with reciprocal changes in v5 and v6. Ventricular escape takes over in 09:56:36 PM EKG. . 2D-ECHOCARDIOGRAM: EF 60-65%, normal systolic function, right atrium mildly dilated, trace AR, no AS, Pulmonary HTN present with RVSP 67 [**2179-8-16**] 11:16PM GLUCOSE-144* UREA N-56* CREAT-1.6* SODIUM-140 POTASSIUM-3.9 CHLORIDE-98 TOTAL CO2-31 ANION GAP-15 [**2179-8-16**] 11:16PM estGFR-Using this [**2179-8-16**] 11:16PM CK(CPK)-165 [**2179-8-16**] 11:16PM CALCIUM-9.1 PHOSPHATE-3.0 MAGNESIUM-2.1 [**2179-8-16**] 11:16PM WBC-12.6* RBC-3.69* HGB-12.3 HCT-34.5* MCV-94 MCH-33.3* MCHC-35.6* RDW-13.4 [**2179-8-16**] 11:16PM PLT COUNT-201 [**2179-8-16**] 11:16PM PT-10.8 PTT-42.4* INR(PT)-1.0 Brief Hospital Course: ASSESSMENT AND PLAN This is a [**Age over 90 **] y/o female with PMHx of HTN, HL, questionable history of bradycardia and CHF, also with CKD who presented to [**Hospital3 **] hospital with near syncope found to be in 3rd degree heart block/Aflutter with evidence of lateral STEMI . She was transferred here for consideration of pacemaker placement. ACUTE ISSUES # Afib with Junctional escape/complete heart block: Per son and attending, this had happened in the past and pt had not been symptomatic. ECG changes indicated likely completed STEMI that could be contributing to bradycardia vs acute on chronic process. Patient felt dizzy when walking with physical therapy. At this point in time it was decided to not place a pacemaker. # Completed STEMI: Trop peak was 1.5 at the outside hospital. She was treated with heparin for 2 days as ACS treatment. She was also given aspirin and plavix. Her beta blocker wa held because of slow heart rate. She was not brought to cath lab because it was believed this was a completed MI. On [**8-18**] her CKMB was down to 4 and trop down to .32. # Right arm hematoma: Patientn came home with a right arm hematoma. She did not recall how she got this though it is possible it was related to when she fell before coming in. During hospital stay the hematoma got larger and we consulted vascular and hand surgery for their input. They could obtain an ulnar pulse on doppler and recommended the patient be monitored and there was no need to do any surgery at this time. We did further imaging which showed a brachial artery dissection with no fractures in any of the bones in her arm. We gave her tramadol and tylenol for pain while she was uncomfortable. #Vertigo: On [**8-20**] patient started feeling vertigo. She described a dizziness like the room is spinning sensation. She said it was worse when turning her head. We felt this was either Meuniere's vs benign position veritgo vs a small stroke involving the brainstem. We started her on meclizine on day of discharge and ordered a soft collar to prevent neck movements. # HTN: Her SBPs were in the 160s-170s. We stopped her home hctz and started amlodipine. She was also on captopril which was changed to her home benazepril at discharge. Her goal SBP Is 140. CHRONIC ISSUES. # Hypothryoidism: TSH nl. We continued home levothyroxine # HLD: stable We continued home simvastatin # GERD/Hiatal hernia -Pantoprazole 40 mg daily #HL -Simvastatin 20 mg daily TRANSITIONAL ISSUES #veritgo: patietn should follow up with PCP #[**Name10 (NameIs) **] hematoma showed be followed up with vascular surgery if does not resolve. #hypertension: we started amlodipine during hosptial stay and discontinued her home thiazide. Her SBPs were in the 140's. #Bradycardia with heart block: should be followed up with outpatient cardiologist in terms of if patient will need a pacemaker in the future. Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from Patient. 1. Furosemide 20 mg PO ONCE Duration: 1 Doses 2. Hydrochlorothiazide 25 mg PO DAILY 3. Isosorbide Mononitrate (Extended Release) 60 mg PO DAILY 4. PredniSONE 5 mg PO DAILY 5. Simvastatin 20 mg PO DAILY 6. Pantoprazole 40 mg PO Q24H 7. Levothyroxine Sodium 25 mcg PO DAILY 8. Nitroglycerin SL 0.3 mg SL PRN angina 9. benazepril *NF* 40 mg Oral daily Discharge Medications: 1. Levothyroxine Sodium 25 mcg PO DAILY 2. Nitroglycerin SL 0.3 mg SL PRN angina 3. Pantoprazole 40 mg PO Q24H 4. PredniSONE 5 mg PO DAILY 5. Simvastatin 20 mg PO DAILY 6. Acetaminophen 650 mg PO TID 7. Amlodipine 5 mg PO DAILY Hold for SBP < 100 8. Aspirin 325 mg PO DAILY 9. Clopidogrel 75 mg PO DAILY 10. Docusate Sodium 100 mg PO BID:PRN constipation hold for loose stools 11. Heparin 5000 UNIT SC TID D/C once pt is mobile 12. Meclizine 12.5 mg PO TID 13. Senna 1 TAB PO BID:PRN constipation 14. TraMADOL (Ultram) 50 mg PO Q6H:PRN pain 15. benazepril *NF* 40 mg ORAL DAILY Hold SBP < 100 Discharge Disposition: Extended Care Facility: Commons Residence At Orchard - [**Location (un) 2624**] (a.k.a. [**Location (un) 5481**]) Discharge Diagnosis: Completed STEMI Acute on chronic diastolic congestive Heart failure Acute on chronic kidney function Atrial Fibrillation with complete heart block Vertigo Hypertension Right arm hematoma 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 had a fall before you arrived here and your heart rate was found to be very slow. You had a heart attack before you came and you have been started on medicines to help your heart recover. Your heart rate has been slow for a long time so a pacemaker was not placed. You had some fluid overload and was given diuretics to remove the fluid. A large bruise developed over your upper and lower right arm and you were seen by a vascular surgeon, a rheumatologist and a plastic surgeon. They have all agreed that it is resolving on it's own. Please be sure to keep it elevated. You have new dizziness that may have been caused by a very small stroke. You are now on aspirin and plavix for your heart that may also help to prevent further strokes. Your vertigo should go away as you recover. Followup Instructions: Department: BIDHC [**Location (un) **] When: FRIDAY [**2179-9-24**] at 11:00 AM With: [**First Name4 (NamePattern1) 1730**] [**Last Name (NamePattern1) **], MD [**0-0-**] Building: [**Street Address(2) 1126**] ([**Location (un) **], MA) [**Location (un) 861**] Campus: OFF CAMPUS Best Parking: On Street Parking [**First Name4 (NamePattern1) 1730**] [**Last Name (NamePattern1) **] MD [**MD Number(1) 2362**]
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icd9cm
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icd9pcs
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40520
Discharge summary
Report
Admission Date: [**2171-6-4**] Discharge Date: [**2171-6-18**] Date of Birth: [**2091-8-28**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 896**] Chief Complaint: Abdomnal pain Major Surgical or Invasive Procedure: ERCP with placement of a plastic stent ([**2171-6-4**]) PICC line placement ([**2171-6-6**]) Percutaenous cholecystostomy drain ([**2171-6-7**]) Drainage of liver abscess by interventional radiology ([**2171-6-13**]) History of Present Illness: Mr. [**Known lastname **] is a 79yoM with a history of HTN, HLD, and previous bladder neoplasm who developed acute RUQ pain two days ago. It occurred suddenly, has been constant, dull, and nonradiating in nature. He has been anorexic but denies nausea or vomiting. He notes subjective fevers. He had confusion per his wife. His urine has been cola-colored, but denies changes in his stool. Has not noticed yellowing of skin. No previous history of biliary or hepatic disease. Denies previous gall stones. He saw his PCP, [**Name10 (NameIs) 1023**] referred him to the [**First Name4 (NamePattern1) 5871**] [**Last Name (NamePattern1) **]. There he was febrile to 103.8F with systolic blood pressures in the upper 80s which responded well to fluid resuscitations. He had a RUQ US showing acute cholecystitis with a CBD diameter of 5mm. A CT showed pneumobilia with scattered hepatic densities concerning for abscesses. He was transferred to [**Hospital1 18**], initial VS were T99.4 BP83/42 HR80 RR18 Sat97RA. His lactate was elevated to 4.4, he received 2L NC. His initial labs showed transaminitis of AST/ALT 198/167, Tbili 4.9 Dbili 4.0, AP 34, Lipase 86. Surgery was consulted for suspicion of cholangitis. He received zosyn, and was admitted to [**Hospital Unit Name 153**] briefly before undergoing ERCP, which revealed only sludge in the gallbladder without note of stone. A stent was placed, and he received tetracycline/clindamycin for suspected claustridium given his pneumobilia. He was transferred back to the [**Hospital Unit Name 153**] in stable condition. On arrival back to the [**Hospital Unit Name 153**], his initial VS were T95.6 P82 BP118/39 RR14 Sat94%RA. He has mild RUQ pain but he is comfortable and has no acute complain. On ROS, denies chest pain, shortness of breath, N/V/D, no palps, myalgias, arthralgieas, dysuria, hematuria. Past Medical History: PMH: - HTN - hyperlipidemia - ? bladder neoplasm PSH: - TURP - ? resection of tumor from the bladder Social History: Lives with wife, retired, smoked a pack a day for about 40 years, quit several years ago Family History: No family history of biliary or hepatic disease, gallstones, pancreatitis Physical Exam: on admission: gen: NAD, pleasant, jaundiced sclera, flushed in the face, uncomfortable in pain VS: 99.4 80 83/42 16 97% Nasal Cannula CV: RRR pulm: CTA b/l abdomen: mildly softly distended, + BS, tender in the RUQ tolight palpation, also tender in RLQ to deeper palpation extremities: no LE edema, no cyanosis Pertinent Results: ERCP ([**2171-6-4**]) The common bile duct, common hepatic duct, right and left hepatic ducts, biliary radicles and cystic duct were filled with contrast and well visualized. The course and caliber of the structures are normal with no evidence of extrinsic compression. There was a filling defect in the middle third of the common bile duct. This could represent stone fragment or debris. The intrahepatics appeared normal, but the cholangiogram was limited due to a small amount of contrast injection due to the patient's sepsis from cholangitis. Successful placement of a plastic biliary stent for decompression. Otherwise normal ercp to third part of the duodenum CT ABDOMEN ([**2171-6-4**]) 1. Air within a mildly distended gallbladder with associated pericholecystic stranding is compatible with acute cholecystitis, with likely involvement of a gas-forming organism. 2. Pneumobilia and ill-defined hypodensities in the left lobe of the liver are concerning for infection with developing hepatic abscesses, likely secondary to ascending cholangitis. 3. Calcifications in the region of the distal common bile duct could be within the lumen of the duct, although could also be within the pancreatic head. Further evaluation could be performed with MRCP, if clinically indicated. 4. Right adrenal nodule, not fully characterized. 5. Well-defined hypodense liver lesions are likely simple cysts, as described above. DISCHARGE LABS ([**2171-6-17**]) WBC-7.0 RBC-3.55* Hgb-11.1* Hct-33.4* MCV-94 MCH-31.2 MCHC-33.2 RDW-13.4 Plt Ct-362 Glucose-107* UreaN-8 Creat-1.0 Na-141 K-3.7 Cl-104 HCO3-26 AnGap-15 BLOOD ALT-63* AST-51* LD(LDH)-248 AlkPhos-52 TotBili-0.6 BLOOD CULTURE ([**2171-6-4**]): pansensitive BLOOD CULTURE ([**2171-6-10**]) GRAM POSITIVE ROD(S). CONSISTENT WITH CLOSTRIDIUM OR BACILLUS SPECIES. BILE CULTURE ([**2171-6-7**]) KLEBSIELLA PNEUMONIAE | KLEBSIELLA OXYTOCA | | AMPICILLIN/SULBACTAM-- <=2 S 8 S CEFAZOLIN------------- <=4 S 16 I CEFEPIME-------------- <=1 S <=1 S CEFTAZIDIME----------- <=1 S <=1 S CEFTRIAXONE----------- <=1 S <=1 S CIPROFLOXACIN---------<=0.25 S <=0.25 S GENTAMICIN------------ <=1 S <=1 S MEROPENEM-------------<=0.25 S <=0.25 S PIPERACILLIN/TAZO----- S S TOBRAMYCIN------------ <=1 S <=1 S TRIMETHOPRIM/SULFA---- <=1 S <=1 S ANAEROBIC CULTURE (Final [**2171-6-11**]): CLOSTRIDIUM PERFRINGENS. SPARSE GROWTH. Brief Hospital Course: 1. SIRS/sepsis with: - cholangitis - septicemia (GNR and anaerobic bacteremia) - liver abscess Initially presented to an OSH with signs and symptoms suggestive of cholangitis (RUQ pain, fever and hypotension; labs and ultrasound indicative of biliary obstruction). He was taken for ERCP on [**6-4**] which revealed gallbaldder sludge and a filling defect in the middle third of CBD without stone presence or extrinsic compression; a stent was placed. Surgery recommended PTC drain to decompress the gallbladder which was done on [**6-7**]. Blood cultures returned with klebsiella and clostridium species. After initially treating broadly, antibiotics were narrowed. Unfortunately, the patient worsened with RUQ ultrasound and MRCP showed worsening perihepatic abscesses; repeat blood culture returned positive for bacillus. After drainage of the largest liver abscess by interventional radiology and use of vancomycin (for empiric enterococcus), pip-tazo, and fluconazole (for empiric fungal coverage) he once again improved. At the time of discharge, plan included; - antibiotics (vancomycin and ertepenem) until cholecystectomy - cholecystectomy in [**4-3**] weeks - once cholecystectomy performed, both the gallbladder drain and plastic stent can be removed 2. CHF, acute diastolic, resolved. After volume repletion was grossly overloaded requiring diuresis. 3. Acute renal failure. Improved with supportive care. Medications on Admission: - HCTZ 25 mg PO qd - cetirizine 10 mg PO qd - citalopram 20 mg PO qd Discharge Medications: 1. citalopram 40 mg Tablet Sig: One (1) Tablet PO once a day. 2. hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO once a day. 3. cetirizine 10 mg Tablet Sig: One (1) Tablet PO once a day. 4. ertapenem 1 gram Recon Soln Sig: One (1) gram Injection once a day for 4 weeks. Disp:*qs mg* Refills:*0* 5. vancomycin 500 mg Recon Soln Sig: 1250 (1250) mg Intravenous Q 12H (Every 12 Hours) for 4 weeks. Disp:*[**Numeric Identifier **] mg* Refills:*0* 6. Outpatient Lab Work [**2171-6-24**] - result to Dr. [**Last Name (STitle) 9461**] (fax [**Telephone/Fax (1) 17715**]) Vancomycin trough LFTs CBC with diff Chem 7 7. Outpatient Lab Work [**2171-7-2**] - result to Dr. [**Last Name (STitle) 9461**] (fax [**Telephone/Fax (1) 17715**]) Vancomycin trough LFTs CBC with diff Chem 7 8. Outpatient Lab Work [**2171-7-8**] - result to Dr. [**Last Name (STitle) 9461**] (fax [**Telephone/Fax (1) 17715**]) Vancomycin trough LFTs CBC with diff Chem 7 9. Outpatient Lab Work [**2171-7-15**] - result to Dr. [**Last Name (STitle) 9461**] (fax [**Telephone/Fax (1) 17715**]) Vancomycin trough LFTs CBC with diff Chem 7 10. oxycodone 5 mg Tablet Sig: One (1) Tablet PO every eight (8) hours as needed for pain. Disp:*20 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: VNA of Greater [**Location (un) 5871**]/[**Location (un) 6159**] Discharge Diagnosis: acute cholecystitis, choledocholithiasis Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted with fevers, confusion and cholangitis. An ERCP on [**6-4**] revealed gallbaldder sludge and a filling defect in the middle third of CBD without stone. To help reduce the pressure in the gallbladder, a stent was placed followed by a drain. You also required drainage of a liver abscess by interventional radiology. As a result of these multiple infections, you will require: 1. Treatment with antibiotics (ertapenem and vancomycin) with coordination and duration directed by the infectious diseases team 2. Removal of your gallbladder (cholecystectomy). Dr. [**Last Name (STitle) 853**] will coordinate timing of this with you. Once the gallbladder has been removed, the current gallbladder drain and stent can be removed. Followup Instructions: Department: GENERAL SURGERY/[**Hospital Unit Name 2193**] When: TUESDAY [**2171-6-25**] at 4:15 PM With: ACUTE CARE CLINIC [**Telephone/Fax (1) 2359**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Location (un) **] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Department: INFECTIOUS DISEASE When: THURSDAY [**2171-6-27**] at 3:10 PM With: [**Doctor First Name 1412**] [**Name Initial (MD) **] [**Name8 (MD) 1413**], M.D. [**Telephone/Fax (1) 457**] Building: LM [**Hospital Unit Name **] [**Hospital 1422**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Department: ENDO SUITES When: TUESDAY [**2171-7-2**] at 12:00 PM Department: DIGESTIVE DISEASE CENTER When: TUESDAY [**2171-7-2**] at 12:00 PM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2839**], MD [**Telephone/Fax (1) 463**] Building: [**First Name8 (NamePattern2) **] [**Hospital Ward Name 1950**] Building ([**Hospital Ward Name 1826**]/[**Hospital Ward Name 1827**] Complex) [**Location (un) 1951**] Campus: EAST Best Parking: Main Garage
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icd9cm
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icd9pcs
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Discharge summary
Report
Admission Date: [**2136-8-3**] Discharge Date: [**2136-8-9**] Date of Birth: [**2064-2-14**] Sex: M Service: CARDIOTHORACIC Allergies: Niacin Preparations Attending:[**First Name3 (LF) 5790**] Chief Complaint: Left lower lobe mass Major Surgical or Invasive Procedure: [**2136-8-3**] Left thoracotomy and left lower lobectomy with en bloc chest wall resection and reconstruction with a 2-mm [**Doctor Last Name 4726**]-Tex mesh, mediastinal lymph node dissection, intercostal muscle flap buttress. History of Present Illness: Mr. [**Known lastname 20692**] is a 72 year old male with a 10 cm LLL NSCLC confirmed by EBUS with negative work up for nodal and distant metastatic disease. Preoperative evaluation for resection of mass revealed borderline PFT's. He [**Known lastname 1834**] VQ scan on [**2136-7-19**] with evidence of sufficient residual lung volume to tolerate LLL resection. Patient [**Month/Day/Year 1834**] preop cardiac evaluation today with MIBI and was found to have new onset atrial fibrillation with RVR 120's. Cardiologists recommended no additional work up since patient was without angina or other symptoms of ischemia. Echo revealed normal systolic function with mild MR. Past Medical History: - Cardiac stenting 12 years ago without recent stress test - 2 lumbar disk surgeries - Cholecystectomy [**45**] years ago - Neuropathy - Right thyroid nodule Social History: Cigarettes: quit 15 yrs ago, 20 pk yr hx ETOH: 1 glass wine/night Family History: Sister had cervical CA in 80s, otherwise no family cancer hx. Both mother and father died in 70's from DM complications: amputations and DM. Physical Exam: Vital signs: T- HR- BP- RR- O2 Sat- General: Well appearing, breathing comfortably HEENT: Moist mucous membranes, no nasal flaring CV: Irregular, Nl S1, S2 Resp: Right lung with breath sounds throughout, left lung -no breath sounds at midchest downward, occasional wheezes Abdomen: Soft, nontender, nondistended Ext: Mild pedal edema (at baseline), no cyanosis, or sking breakdown Neuro: No gross abnormalities Psych: A&Ox3, appropriate Pertinent Results: [**2136-8-8**] CBC: WBC-11.4 Hgb-10.7 Hct-32.8 Plt Ct-347 Chemistry: Na-137 K-4.1 Cl-102 HCO3-26 UreaN-16 Creat-0.7 Glucose-105 CXR [**2136-8-9**]: Status post left lower lobectomy with according pleural and chest wall changes, as well as overall volume loss of the left hemithorax. There is no visualization of an apical pneumothorax. Brief Hospital Course: Mr. [**Known lastname 20692**] [**Last Name (Titles) 1834**] a left lower lobectomy with en bloc 4 rib resection, chest wall reconstruction with a 2-mm [**Doctor Last Name 4726**]-Tex mesh, mediastinal lymph node dissection, and intercostal muscle flap buttress on [**2136-8-3**] without complications. He was extubated without difficulty in the OR and was admitted to the ICU for management of atrial fibrillation with sick sinus syndrome. The rest of Mr. [**Known lastname 20693**] hospital course is described below by system: 1. Respiratory: Postoperatively, Mr. [**Known lastname 20692**] was kept on 4L of oxygen by nasal cannula with O2 sats >95% and was breathing comfortably with pain control by bupivicaine epidural and dilaudid PCA. Chest tube had minimal serosanginous ouput with no leak detected. On POD#2, patient had an episode of desaturation to high 80s on 100% O2. CXR showed complete collapse of left lung. Bronchoscopy was performed with removal of copious clear mucus plugs from left mainstem and LUL bronchi. Patient was placed on BIPAP overnight for improved ventilation. AM CXR on POD#3 showed re-expansion of lung and patient was started on nebulizer treatments, with improvement in dyspnea, cough production, and oxygen saturation. Chest tube was removed on POD#4 without evidence of pneumothorax on post-pull CXR. Oxygen was gradually weaned to 2L and patient was transferred to the floor on POD#5. With chest PT and continued nebs, oxygen was weaned completely by POD#5 during rest and exertion. Patient was discharged home on POD#6 with O2 sats >98% on room air and arrangements for VNA and nebulizer treatments at home. 2. Cardiac: Mr. [**Known lastname 20693**] newly diagnosed afib was present throughout his postoperative period. He was started on IV lopressor and transitioned to po lopressor with dose titrated to keep rate less than 120. He did not experience any ischemic symptoms throughout this period. He was started on coumadin on POD#6, as per his cardiologist, with plans to follow up with his PCP for coumadin dosing. 3. Endocrine: Mr. [**Known lastname 20693**] blood glucose was 150-200 in the PACU after surgery. He was kept on a sliding scale during his hospital stay. He will follow up with his PCP regarding diabetes work up. 4. Heme/Onc: Pathology reports are pending on Mr. [**Known lastname 20693**] resected lung mass. EBL from surgery was 1 liter and patient's hct post-op trended down to 25.2 from preop of 30. He was transfused 2U PRBCs with appropriate increase in HCT and Hct on day of discharge was 32.8. 5. ID: No issues. 6. Renal: No issues, Cr less than 1 throughout stay, 0.7 on discharge. 7. GI/FEN: No issues, tolerated regular diet with normal bowel functions. Medications on Admission: Hydrocodone 5 mg + acetaminophen 500 mg prn Discharge Medications: 1. Nebulizers Kit Sig: One (1) Miscellaneous every [**3-13**] hours.Disp:*1 * Refills:*0* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 3. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours) as needed for pain. Disp:*20 Tablet(s)* Refills:*1* 5. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q6H (every 6 hours). Disp:*1 * Refills:*2* 6. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours).Disp:*1 * Refills:*2* 7. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Left lower lobe lung cancer Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Call Dr. [**Last Name (STitle) **] at [**Telephone/Fax (1) 2348**] if you develop fevers greater than 101.5, chills, nightsweats, shortness of breath, unmanageable pulmonary secretions, uncontrolled pain or if left chest incision develops redness, drainage or opens. Walk 10-15 minutes 3-5 times a day. Start slow and increase. Do not drive while on narcotics for pain. Take stool softeners while on narcotics to prevent constipation. Use nebulizer treatments every 6 hours (albuterol and ipratropium) until you can cough easily without them. Do daily breathing exercises (deep breath in, hold for 3 sec, breath out) to keep your lungs expanded. Followup Instructions: Followup appointments: Provider: [**Name10 (NameIs) 1532**] [**Name11 (NameIs) 1533**], MD Phone:[**0-0-**] Date/Time:[**2136-8-21**] 1:00 [**Hospital Ward Name 23**] 9 [**Hospital Ward Name **]. Get a chest xray 30 minutes before this appointment on the [**Location (un) **] radiology department of the [**Hospital Ward Name **]. Provider: [**Name10 (NameIs) **] [**Name8 (MD) 831**], MD Phone:[**0-0-**] Date/Time:[**2136-8-21**] 11:45 [**Hospital Ward Name 23**] 9 [**Hospital Ward Name **] Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3404**], MD Date/Time:[**2136-8-23**] 8:30 Completed by:[**2136-8-14**]
[ "V45.82", "355.8", "V15.82", "427.31", "427.81", "162.5" ]
icd9cm
[ [ [ 1259, 1274 ] ], [ [ 1381, 1390 ] ], [ [ 1432, 1459 ] ], [ [ 2894, 2912 ] ], [ [ 2919, 2937 ] ], [ [ 6133, 6159 ] ] ]
[ "99.04" ]
icd9pcs
[ [ [ 4989, 4993 ] ] ]
6054, 6112
2498, 5230
305, 535
6184, 6184
2137, 2475
7007, 7651
1522, 1665
5324, 6031
6133, 6163
5256, 5301
6335, 6984
1680, 2118
245, 267
563, 1235
6199, 6311
1257, 1416
1432, 1506
96,443
103,219
15250
Discharge summary
Report
Admission Date: [**2109-12-20**] Discharge Date: [**2110-1-5**] Date of Birth: [**2045-2-20**] Sex: F Service: CARDIOTHORACIC Allergies: Quinine Attending:[**First Name3 (LF) 922**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: [**2109-12-20**] Right posterolateral thoracotomy, replacement of the proximal descending thoracic aortic aneurysm using a 26mm Vascutek Dacron interposition tube graft [**2109-12-20**] Diagnostic bronchoscopy pre-aortic reconstruction and bronchoscopy with toilet aspiration of secretions post aortic reconstruction [**2109-12-23**] Right Bronchial Y-stent placement [**2109-12-23**] Flexible bronchoscopy and Therapeutic aspiration of secretions [**2109-12-27**] Flexible bronchoscopy through endotracheal tube, Therapeutic aspiration of secretions, Bronchoalveolar lavage of the right middle lobe History of Present Illness: 64 y/o female with complex past medical history (see below) who has had intermittent bouts of dyspnea on exertion and hoarseness (along with wheezing and dysphagia) over the past several years. Underwent coronary artery bypass graft x 1 with respiratory function continuing to decline. Further work-up revealed right sided arch with aberrant takeoff of left subclavian and dilated aorta. Also noted to have right mainstem bronchus compression. Has already underwent 2 surgical procedures with vascular surgery (Dr. [**Last Name (STitle) **] and now presents for surgical replacement of her descending aorta. Past Medical History: Descending thoracic aortic aneurysm with aberrant left subclavian artery and Kumeral's diverticulum with aortic sling compressing the right main stem bronchus, s/p Left Carotid to Subclavian bypass [**7-7**], s/p Amplatzer plugging of Aberrant left subclavian [**9-6**], Coronary artery bypass graft x 1 (LIMA to LAD), Connective tissue disorder with features of Lupus, Sjogren's and raynaud syndrome, Stroke, Interstitial lung disease, Hypothyroidism, Gastroesophageal Reflux disease, Right kidney cyst, s/p cholecystectomy, s/p carcinoid tumor removal during colonoscopy, s/p right lung resection?wedge Social History: She is a retired administrative assistant. She quit smoking 15 years ago and has wine daily with dinner. She is currently living with her husband. Family History: She has a noncontributory family history. Physical Exam: At Discharge:Expired Pertinent Results: [**12-20**] Echo: PREBYPASS: 1. The left atrium is mildly dilated. 2. Left ventricular wall thicknesses and cavity size are normal. Overall left ventricular systolic function is normal (LVEF>55%). 3. Right ventricular chamber size and free wall motion are normal. 4. The descending thoracic aorta is moderately dilated. The patient has a known right sided arch. 5. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. No aortic regurgitation is seen. 6. The mitral valve appears structurally normal with trivial mitral regurgitation. 7. There is no pericardial effusion. 8. Dr. [**Last Name (STitle) 914**] was notified in person of the results during the surgical procedure. POSTBYPASS: Patient is on an phenylephrine infusion and is in sinus rhythm 1. Biventricular function is preserved. 2. Descending thoracic graft not clearly appreciated. 3. Other findings are unchanged. [**Known lastname 44356**],[**Known firstname 3049**] [**Age over 90 44357**] F 64 [**2045-2-20**] Radiology Report CT CHEST W/O CONTRAST Study Date of [**2109-12-31**] 8:43 AM [**Last Name (LF) **],[**First Name7 (NamePattern1) 177**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 5204**] CSRU [**2109-12-31**] SCHED CT CHEST W/O CONTRAST; CT ABDOMEN W/O CONTRAST Clip # [**Clip Number (Radiology) 44358**] Reason: elevated lft's, not tolerating tube feeds, elevated INR not [**Hospital 93**] MEDICAL CONDITION: 64 year old woman s/p right sided descending aorta repair REASON FOR THIS EXAMINATION: elevated lft's, not tolerating tube feeds, elevated INR not on coumadin. Please do chest and abdominal CT WITH PO contrast CONTRAINDICATIONS FOR IV CONTRAST: None. Provisional Findings Impression: AJy TUE [**2109-12-31**] 6:33 PM PFI: 1. The feeding tube appears to be coiled within the stomach and is not post-pyloric. Remainder of the supporting and monitoring lines and tubes appear in adequate position. 2. Bilateral lower lobe focal consolidation with air bronchograms consistent with pneumonia. Aspiration should be considered given location. Further interstitial and ground-glass opacities likely reflect a combination of atelectasis and fluid overload. 3. Ascites and diffuse anasarca suggest fluid overload. 4. Borderline fatty infiltration of the liver, but no biliary dilatation or mass lesions to explain patient's liver function test abnormalities. 5. Status post repair of descending thoracic aortic aneurysm, without evidence for immediate complication. Final Report HISTORY: 64-year-old female, status post repair of descending thoracic aortic aneurysm. Referred for evaluation of persistent fever, elevated LFTs and INR, and poor tolerance of tube feedings. COMPARISON: CT of the chest dated [**2109-5-10**]. TECHNIQUE: MDCT axial imaging of the chest and abdomen was performed following the administration of oral but not IV contrast. Sagittal and coronal reformatted images were reviewed. CT CHEST: An endotracheal tube terminates approximately 2.5 cm from the carina. Tracheal Y-stent is seen with branches extending into the right and left main stem bronchi. Two right-sided central venous lines, one subclavian and one internal jugular, terminate in the distal SVC. There is an NG tube terminating in the stomach. A Dobbhoff-type feeding tube is also seen extending into the stomach and is coiled extensively, not extending post- pylorically. A right-sided chest tube courses along the posterior margin of the lung and terminates adjacent to the superior mediastinum. Right-sided aortic arch is again noted. Patient is status post repair of descending thoracic aortic aneurysm, with graft anastomoses seen at the level of the arch and inferiorly. The graft appears to extend approximately 10 cm in the craniocaudal direction, and has a diameter of 2.9 cm at the level of the carina. There is no significant mediastinal hematoma. The heart and pulmonary vessels appear unremarkable. Coronary vascular calcifications are appreciated. There are diffuse reticular and ground-glass opacities in both lungs, left greater than right, and more pronounced at the lung bases, where there are also areas of focal consolidation and air bronchograms appreciated. The crowding of vessels and bronchi suggests a component of atelectasis, and generalized anasarca indicates that a degree of fluid overload is also likely involved. However, an underlying pneumonia cannot be excluded; dependent location would suggest aspiration as possible etiology. There is no significant pleural effusion on the right. Pleural effusion on the left is small. There is no mediastinal lymphadenopathy appreciated. There is no axillary or supraclavicular lymphadenopathy. CT ABDOMEN: Oral contrast is seen in the stomach only. Evaluation of intra- abdominal organs is limited in lack of IV contrast. There is moderate amount of ascites present. The liver is of somewhat low attenuation, suggesting fatty infiltration. Liver is otherwise unremarkable without focal lesions or intra-/extra-hepatic biliary dilatation. Patient is status post cholecystectomy. The pancreas, spleen, and adrenal glands appear normal. The left kidney is unremarkable. There is a large 5 x 6 cm cystic structure arising from the superior pole of the right kidney and has the density of simple fluid and is likely a simple cyst. This is unchanged compared to [**Month (only) 547**] of [**2109**]. There is no soft tissue stranding or significant lymphadenopathy present. There is no free air. Vascular calcifications are seen without aneurysmal dilatation. IMPRESSION: 1. The feeding tube is coiled in the stomach. The remainder of the supportive and monitoring devices appear in adequate position. 2. Status post repair of descending thoracic aortic aneurysm, with no evidence for immediate post-surgical complication. 3. Diffuse interstitial and ground glass opacities in the lungs, left greater than right, with focal consolidations at the bilateral bases. While atelectasis and fluid overload are present, underlying pneumonia cannot be excluded. The location suggests aspiration as possible etiology. 4. Mild ascites and soft tissue anasarca suggests fluid overload. 5. Stable large right renal cyst. 6. Borderline fatty infiltration of the liver, without evidence for focal liver lesions, biliary dilatation, or masses. Patient is status post cholecystectomy. The study and the report were reviewed by the staff radiologist. DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] DR. [**First Name (STitle) 8085**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 8086**] Approved: WED [**2110-1-1**] 10:03 AM Imaging Lab [**Known lastname 44356**],[**Known firstname 3049**] [**Age over 90 44357**] F 64 [**2045-2-20**] Radiology Report LIVER OR GALLBLADDER US (SINGLE ORGAN) PORT Study Date of [**2109-12-29**] 4:57 PM [**Last Name (LF) **],[**First Name7 (NamePattern1) 177**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 5204**] CSRU [**2109-12-29**] SCHED LIVER OR GALLBLADDER US (SINGL; DUPLEX DOPP ABD/PEL Clip # [**Clip Number (Radiology) 44359**] Reason: evaluate flow, increased LFT ? obstruction [**Hospital 93**] MEDICAL CONDITION: 64 year old woman with s/p descending aorta replacement REASON FOR THIS EXAMINATION: evaluate flow, increased LFT ? obstruction Wet Read: KYg SUN [**2109-12-29**] 7:13 PM limited exam. no e/o bil dil. patent hepatic vasculature. Final Report CLINICAL HISTORY: 64-year-old female with lupus, status post descending aorta surgery, with increased LFTs. Evaluate for obstruction. COMPARISON: None. ABDOMINAL ULTRASOUND: Limited exam as indwelling chest tubes limits acoustic windows. The liver is somewhat heterogeneous in appearance. No focal hepatic lesion is identified. There is no intra- or extra-hepatic biliary dilatation. The common duct measures 5 mm. There is no ascites. DOPPLER ULTRASOUND: With the exception of the left portal vein, which could not be interrogated, the main/right portal veins and hepatic veins are patent with appropriate waveforms. The main, right and left hepatic arteries show normal flow. IMPRESSION: 1. Limited exam as patient with indwelling chest tubes which limits acoustic windows. No focal hepatic lesion or evidence of biliary dilatation. 2. Patent hepatic vasculature. The left portal vein was not interrogated. The study and the report were reviewed by the staff radiologist. DR. [**First Name8 (NamePattern2) **] [**Name (STitle) 7410**] DR. [**First Name8 (NamePattern2) 814**] [**Name (STitle) 815**] Approved: MON [**2109-12-30**] 10:40 AM Imaging Lab Brief Hospital Course: Mrs. [**Known lastname **] was a same day admit and on [**12-20**] was brought to the operating room where she underwent a right posterolateral thoracotomy, replacement of the proximal descending thoracic aortic aneurysm using a 26-mm Vascutek Dacron interposition tube graft and bronchoscopy. Please see operative report for complete surgical details. Post-surgery bronchoscopy revealed right mainstem bronchus to still be collapsed. Following surgery she was transferred to the CVICU for invasive monitoring in stable condition. On post-op day one she was weaned from sedation, awoke neurologically intact and extubated. Pulmonary medicine was consulted for stent placement on post-op day two. Post-operatively she required several blood transfusions d/t anemia. Lumbar drain was removed on post-o p day two. Also on this day she had episode of atrial fibrillation and was treated appropriately. She continued to have bouts of atrial fibrillation during post-op course. On post-op day three she was brought to the operating room where she underwent Y-stent placement by interventional pulmonology. Later this day she required a bronchoscopy which found significant mucus retention and mucus plug in the lumen of the Y-stent. And had successful therapeutic aspiration. Later on this day she was again weaned from sedation and extubated. Aggressive pulmonary therapy/toilet were performed but she continued to require several bronchoscopies and increasing oxygen requirements over next several days. Overnight on post-op day six Mrs. [**Known lastname **] was progressively getting more dyspneic and was in respiratory distress the morning of post-op day seven, requiring intubation and mechanical ventilation. Respiratory distress and hypoxia seemed to be from developing pneumonia (Chest x-rays were consistent with pneumonia and acute lung failure with ground glass opacities) and acute respiratory distress syndrome. Blood cultures taken on post-op day seven were positive for Enterobacter Aerogenes and COAG negative Staphylococcus. Bronchoalveolar Lavage and Urine cultures were positive as well and she was started on broad-spectrum antibiotics until final sensitivities were performed. Also on this day she had increasing metabolic acidosis and hypotension (d/t septic shock) and required multiple pressor support. She received similar medical care over the next several days (including multiple pressors and antibiotics) and infectious disease was consulted on post-op day 11. The patient remained intubated and her condition worsened with the family asking that the patient be made comfort measures only. The patient was extubated and expired shortly thereafter. Medications on Admission: Atenolol 12.5mg qd, Lipitor 10mg qd, Restasis, Plaquenil 400mg qd, Synthroid 100mcg qd, Protonix 80mg qd, Effexor 75mg qd, Zolpidem 10mg qd, Spiriva, Advair, Albuterol Discharge Medications: Patient Expired Discharge Disposition: Expired Discharge Diagnosis: Descending thoracic aortic aneurysm with aberrant left subclavian artery and Kumeral's diverticulum with aortic sling compressing the right main stem bronchus s/p Right posterolateral thoracotomy, replacement of the proximal descending thoracic aortic aneurysm [**12-20**] and Right Bronchial Y-stent placement [**12-23**] Post-op Pneumonia Post-op Sepsis Post-op Acute Respiratory Distress Syndrome Post-op Atrial Fibrillation Post-op Anemia PMH: s/p Left Carotid to Subclavian bypass [**7-7**], s/p Amplatzer plugging of Aberrant left subclavian [**9-6**], Coronary Artery Disease s/p Coronary artery bypass graft x 1 (LIMA to LAD), Connective tissue disorder with features of Lupus, Sjogren's and raynaud syndrome, Stroke, Interstitial lung disease, Hypothyroidism, Gastroesophageal Reflux disease, Right kidney cyst, s/p cholecystectomy, s/p carcinoid tumor removal during colonoscopy, s/p right lung resection?wedge Acute lung injury and respiratory failure Discharge Condition: Expired Discharge Instructions: Expired Followup Instructions: Expired Completed by:[**2110-1-28**]
[ "V45.81", "244.9", "530.81", "V15.82", "441.2", "747.69", "997.39", "995.91", "518.82", "429.4", "285.1" ]
icd9cm
[ [ [ 1824, 1855 ] ], [ [ 1990, 2003 ] ], [ [ 2006, 2037 ] ], [ [ 2222, 2233 ] ], [ [ 14115, 14149 ] ], [ [ 14156, 14186 ] ], [ [ 14446, 14454 ] ], [ [ 14456, 14469 ] ], [ [ 14471, 14513 ] ], [ [ 14515, 14541 ] ], [ [ 14551, 14556 ] ] ]
[]
icd9pcs
[ [ [] ] ]
14085, 14094
11153, 13827
293, 894
15100, 15109
2439, 3853
15165, 15203
2339, 2382
14045, 14062
9712, 9768
14115, 15079
13853, 14022
15133, 15142
2397, 2397
2410, 2420
234, 255
9800, 11130
922, 1531
1553, 2159
2175, 2323
97,765
118,349
39728
Discharge summary
Report
"Admission Date: [**2173-10-4**] Discharge Date: [**2173-10-16**]\n\nDate of Birth: (...TRUNCATED)
[ "456.21", "511.89", "V15.82", "572.3", "584.5", "799.4", "458.9", "V46.3", "285.9", "571.2" ]
icd9cm
[[[1061,1067]],[[1872,1888],[27994,28016]],[[2880,2910]],[[19610,19629]],[[20926,20928]],[[23665,236(...TRUNCATED)
[]
icd9pcs
[ [ [] ] ]
27838, 27921
19547, 26255
330, 359
28100, 28100
3886, 3891
29131, 30097
3010, 3028
26813, 27815
27942, 28079
26281, 26281
28279, 29108
3043, 3867
26299, 26476
6076, 19524
278, 292
387, 2631
3905, 6040
28116, 28255
2653, 2784
2800, 2994
90,233
130,846
14318
Discharge summary
Report
"Admission Date: [**2122-6-13**] Discharge Date: [**2122-6-23**]\n\n\nService: SURGE(...TRUNCATED)
["414.01","V45.01","427.31","402.91","244.9","428.0","V12.04","427.5","799.02","486","599.0","041.7"(...TRUNCATED)
icd9cm
[[[761,763]],[[769,787],[1101,1113]],[[790,808],[1115,1133]],[[1082,1084]],[[1086,1099]],[[1135,1137(...TRUNCATED)
[ "39.71", "99.60", "89.45" ]
icd9pcs
[ [ [ 291, 362 ] ], [ [ 6867, 6891 ] ], [ [ 7080, 7102 ] ] ]
11971, 12073
5692, 10593
274, 664
12142, 12142
1908, 5669
15118, 15610
1289, 1293
10780, 11948
12094, 12121
10619, 10757
12325, 14539
14565, 15095
1308, 1308
1623, 1889
222, 236
692, 1055
1322, 1609
12157, 12301
1077, 1222
1238, 1273
91,123
151,973
49512
Discharge summary
Report
"Admission Date: [**2125-11-26**] Discharge Date: [**2125-12-7**]\n\nDate of Birth: (...TRUNCATED)
[ "402.91", "491.22", "303.90", "305.1", "571.2", "486", "518.81", "291.81", "348.30", "491.21", "428.33" ]
icd9cm
[[[375,377],[2280,2291]],[[380,383],[2275,2278]],[[390,399]],[[2313,2402]],[[6790,6817],[8001,8009]](...TRUNCATED)
[ "93.90", "96.04", "96.71" ]
icd9pcs
[ [ [ 1449, 1453 ] ], [ [ 7217, 7226 ] ], [ [ 7300, 7308 ] ] ]
9636, 9642
6670, 8609
312, 319
9785, 9785
3658, 3658
12700, 13313
2496, 2567
8937, 9613
9663, 9764
8774, 8914
9936, 12677
6338, 6627
3287, 3639
3272, 3272
6641, 6647
2025, 2171
265, 274
347, 2006
3674, 6322
9800, 9912
8632, 8748
2193, 2295
2311, 2480
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