UNIVERSITY OF SANTO TOMAS HOSPITAL

Department of Medicine, Cardiovascular Medicine

26 JULY 2009 – Sunday

Room No. / R / Name Age Sex / Diagnosis / Cardiac Dx / Risk / Xray/ECG/2D-Echo/Labs / Medications / Pending/ Remarks
St. Blaise ward
457 D / C / Cornelio Maeyama 67/M
457G / R / Rogel Sanares
54/M / SCCA of the larynx, s/p rafiotherapy, s/p chemotherapy 6 cycles, Pneumothorax, Pneumonia s/p E CTT insertion, s/p E tracheostomy (7/22) / C –M / ECG: Sinus Tachycardia. Inferior wall infarct. Artifact tremor
CXR: Pneumothorax R, Right mid and lower lung infiltrates. No cardiomegaly
459 I / C / Tolentino Catherine
33/F / Tetrapod Fracute R / Essentially normal CV findinds / C L-M / CXR: Normal chest
ECG: NSR. LVH by Sokolow and Lyon / ORIF Monday
(7/27/09)
San Damian Ward
317 A / C / Armando Villaricente
69/M / BPH grade 3 / SAH Stage 1 / ECG: Sinus Rtyhm, Frequent PVCS in trigeminy and guadrigeminy, poor R wave progression V1-V3 CXR: basal pulmonary findings may be positional cannot rule out pneumonitis; Cardiomegaly; Atheromatous aorta
2D Echo” Concentric LVH and adequate wall motion and contractility w/ Doppler. Evidence of relaxation abnormality Thickened anterior mtral valve leaflet w/p restriction of motion. Mild MR, mitral annulus calcification mild TR, mild pulmonary hypertension. / Bisoprolol 2.5 mg/tab 1 tab OD
Atorvastatin 20mg/tab ODHS
317 F / R / Eusebio Rumbaoa 81/M
319 C / R / Olga De Luna 34/F / Invasive Ductal Carcinoma St III. s/p 2 cycles of chemotherapy / SAH St. II / Amlodipine 10 mg/tab 1 tab OD / Awaiting ECG and CXR results
319 D / C / Rosal Apuya 52/F / Obstructive Uropathy 2 to Distal Uterolithiasis s/p RPG / ASHD CAD HCVD NIF Class IIIC
SAH St. II / C-M / Sinus Rhythm LVH w/ strain or ischemia. Anterior lateral wall ischemia
CXR: Cardiomegaly
2D Echo: MR, AR / Ramipril 10 mg/tab 1 tab OD
Metoprolol 50 mg/tab BID
319 F / C / Narcisa Hernandez 78/F / t/c Thyroid malignancy / SAH St 2 / C-M / ECG: Sinus rhythmn Normal tracing / Telmisartan 40 mg/tab OD / Awaiting OR sched
321I / C / Jose Tan, 69/F / Rhematogenous retianal detachment, OD Phthisis bulbis, OS s/p PPV I silicon oil injection 7/17 / Essentially Normal CV findings / C-L / CXR: Suspicious left upper lobe infiltrate, Heart is not enlarged.
Aorta is atherosclerotic. Diaphragm and sinuses are intact.
ECG: Primary AV block (SB) with Nonspecific ST-T wave changes
SICU)
SICU C
(307 J) / C / Nemesio Agustín 88/M / GIST, s/p Ureteral stenting (7/24/09)
s/p IJ catheter insertion (7/24/09),
s/p Exploratory Laparotomy (7/24/09) / ASHD, 3 vessel CAD NIF Class IIID / ECG: Sinus Rhythm with isolated PVC. Nonspecific ST-T wave changes
CXR: 7/1 Basal Emphysema Bilateral
Atheromatous aorta
Initial 2D echo: (7/6/09) Normal LV w/ GWMC and NRSF w/ Grade 1 diastolic dysfunction (impaired relaxation). Mitral annular thickening w/ mild to moderate MR. Aortic annular thickening w/ mild MR. TR mild.
Aotogram: Distal Aortography showed aneurismal dilatation of the abdominal aorta. Infrarenal with thrombus formation and with 70% stenosis in the right common iliac aretery at its origin. Conclusion: 3 vessel coronary artery disease / Digoxin 0.25 mg q 48h / Duplex sacan of the lower extremities
Awaiting repeat ECG 6 hours postop
For repeat CBC
Male Surgery
307 F / C / Danilo Aquino / Soft Tissue Tumor, L thigh / Essentially N CV findings / ECG: Sinus Rhythm
CXR: Suspicious infiltrates are ssen in the RUL. The heart is not enlarged. Diaphragm and sinuses are intact / Awaiting OR sched
307 H / C / Loreto Hinay / L Scrotal mass / Essentially N CV findings / C-L-M / ECG: Sinus Rhythm with isolated premature ventricular complexes Nonsp ST-T wave changes
CXR: Basal emphysema bilateral
Atheromatous aorta
309 C / C / Fortunato Vinuya
43/M
309H / C & E / Danny Boy Dasas 20/M / Valvular Heart Defect / Congenital heart defect; bicuspid aortic valve; AR, MR, IF, Class IV D / C M / Bicuspid aortic regurgitation 4+, Dilated LV w/segmental wall motion abn of ant IVS & anterolat, Dilated LA + mild pulmo HPN w/PR
ECG: SR. LVH by Cornell and Sokolow Lyon, ST-T wave changes 2 to straining/ischemia. Inferolateral wall ischemia / ISMN40mg/tab ½ tab OD
Spironolactone 25mg/tab OD
Furosemde 40mg/tab OD
Digoxin 0.25mg/tab OD
Enalapril 20mg/tab OD
Caredilol 6.25 mg/tab 1 tab OD / For TEE
Retrieve 2d echo video done outside
Awaiting OR sched
311 D / C / Ariel Santiago 43/M / Fracture gr 3A, segmental displaced D3 tibia, fibula, L fracture, L clavicle sec to MVA s/p E debridement w/ insertion of steel pin (7/1-09) s/p debridement L leg 7/9/09 / SAH st II
DM type 2
Acute osteomyelitis / C-M
P-H / ECG sinus rhythm, LVH
CXR: Pulmonary edema (+) hazy opacities on the rihg tmid and lower lung. May suggest contusion. (-) Pmeumothorax.Increase transverse
diameter of the is elevated. / Losartan 100mg/tab OD
Amlodipine 5 mg/tab OD
Atorvastatin 20 mg/tan OD hs
ASA 80 mg/tab OD
311 H
(311J) / C / Carlito Halog
43/M / L thalamic ICH w/ IVE + acute hydrocephalus s/p E ventriculostomy / SAH st II / C M-H / ECG: SR. LAE, RAE, LVH, Poor R wave progression V1-V4. ST-T wave changes secondary to ischemia/straining / Amlodipine 10mg BID
Atenolol 100mg OD
Irbesartan+HCTL 300 OD
313 A
(309C) / C / Reyanldo Parada 64/M / SCCA, L Thigh / Hypertension suspect / ECG: Sinus rhythm, Early repolarization phenomenon
CXR: Pneumonia, Right lower lobe
Atheromatous aorta
313 F / E / Jose Antonio
32/M / Grade IV renal injury sec to multiple stab wounds, lymphedema L lower ext, penis, scrotum with edema blisters s/p E ex lap ff by L nephrectomy 5/26 s/p wound debridement 6/10 s/p wound debridement L LE 6/11 s/p wound debridement L LE 6/14 / Episode of BP elevation in this patient may be secondary to pain compounded by stress of hospitalization / C-I
P-I / ECG NSR, nonspecific ST-T wave changes
CXR ff up study min regression of pulmonary congestion; both lungs hyperaerated associated with elevation of diaphragm, increase in the transverse diameter of the heart. Bilateral thoracostomy tube. CVP at R subclavian vein. Slight diminution of subQ emphysema on the L / Atenolol 50 mg/tab BID
Amlodipine 10 mg/tab OD / MGH
313 I / Dominador Gascon 81/M / L fronto-parietal CSH s/p E burholing 7/12/09 / Essentially normal CV findings / C-H / ECG: Sinus Rythm, Early repolarization / MGH
OB-GYNE WARD
109 A / C / Nennette Paalmitan 56/F / Ovarian New Growth
109 C / C / Roquita Barbo 56/F / AUB 2 to endometrial polyp, s/p TAHBSO / ASHD CAD HCVD NIF classIIIC / C-M / 2D ném: N LV i GWMC, NRSF & GTI diastolic dysfunction (IR) EF 77%. Dialated LA i no némiar of thrombi; thickened NC, TR/MR/AR mild
ECG: SR, Nonspecfic ST T wave changes, LVH / Atorvastatin 40mg ODHS
Losartan 100mg OD
ISMN 30mg ODHS
Amlodipine 10mg BID
Metoprolol 50mg BID / 2D echo
109 D / C / Ma Luisa Madriaga 45/F / Myome Uteri / Essentially Normal CV findings / C-M / ECG: Sinus rythm
CXR: Normal chest
109 E / C / Nelly Bumanglang
40/F / Myoma Uteri w/ possible dégénération / SAH St II / Losartan 50 mg/tab 1 tab OD
109 H / C / Analia Auai
43/F / Endometriod Adenocarcinoma
s/p PFC, EHBSO, BLND (7/25/09) / SAH St II / C-M / ECG: NSR i freq némiaré ventricular complexes; generalized low voltage complexes
CXR: Normal chest
2D Echo Normal LV w/ good wall motion. Gr 1 Diastolic dysfunction Dilated LA w/ no évidence of thickening. EF 77%. MR mild, TR mild, AR mild. / Metoprolol 50 mg/tab 1 tab BID / Awaiting OR sched
112 B / C / Rowena Tesorero 39/F / Early Fetal Demise
s/p D and C (7/23/09) / C-M / CXR Initial: Both hemidiaphragm were slightly elevated with slight élévation of pulmonary vascular markings in the lower lung field. The rest of the llungfields are clear. Herat is not enlarged. Diaphragm and sinus are intact. Above findings meybe secondary to inadéquate inspiratory effort otherwise normal
FEMALE SURGERY WARD
306C / Erlinda Costamos
48/F / Obstructive hydrocephalus 20 to L thalamic ICH w/ IVE; SAH; s/p ‘E’ Ventriculostomy 7/15 / SAH st II / C-H / CXR 7/8: Pneumonia in progression
ECG: SR, LVH / Atenolol 100mg/tab OD
Amlodipine 10mg/tab BID
Perindopril 10mg/tab OD
Clonidine 75 mcg/tab BID
Kalium durule 1 durule BID
306E / R / Carmen Solana 58/F / Obstructive jaundice 2 to pancreatic head mass / SAH st II / Atheromatous aorta / For 2D Echo w/ Doppler
306F / R / Lydia Elepano 62/F / Hurthle cell lesion thyroid gland / SAH st II / C-M / For TT on Friday 7/24/09
308 D / E / Cristeta Gullan / t/c gastric cancer s/p Explore lap s/p R hemicolectomy 7/9/09 / SAH st II / C-H / Losartan 50m306 Eg OD / MGH
308 F / R / Rosalinda Pore 42/F / Soft Tissue Sarcoma on the Right medial thigh / Essentially normal CV findings / C-M / CXR: Normal Chest
308 H / Oyangoren, Analiza 39/F / Cholelithiasis, Nontoxic goiter / SAH st II / C-L-M / ECG: Sinus Tach, LAE, LVH / Losartan 50mg/tab OD
Metoprolo 50 mg/tab BID
Amlodipine 5 mg/ tab OD / For CXR, Open Chole 7/24
310 E / R / Josefina Alfonso / PAOD R Ulnar artery / ADH CAD LVH NIF Class IV C, CKD 2 to DM Nephropathy / ECG: Sinus rhythm. First degree AV Block. NSTTWC
2D Echo Initial: Concentric LVH c SWMA (hypokinetuc basal septum) and preserved systolic function) EF 62% Dilated RV. Dilated LA c no evidence of thrombi. Aortic sclerosis. Mitral annular calcification. Mitral calve leaflets thickening / For 2D Echo with Doppler
Neurology
202 A / R / Corazon Aquino 45 / Intracranial Mass L fronto-temporal area w/ mass effect / Essentially normal CV findings / C-M / ECG: SR, 1st degree aV block, LVH / Atorvastatin 40mg ODHS / Awaiting OR sched
202 C / R / Christina Ilano 59/F / Pontomedullary Infarct R prob atherothrombotic NIHSS 9 / SAH St2 DM type 2 / ECG: Sinus arrythmia. 1st degree AV Block. NSSTTWC / Diltiazem 0.25 mg/tab
Clopidogrel 75 mg/tab 1 tab
OD
202 E / R / Laura Calabio / TACI, RMCA territory probably athero-sclerotic, IHSS 18 / HPN stage 2 / 7/14 Follow-up study done last 6/17 still shows the tracheostomy tube, Heart is enlarged. Pulmonary vascularity is prominent. There is haziness in the R mid and lower fields with blunted right costophrenic sulcus. Thee maybe secondary to pneumonic process with a concomitant pleural effusion. Similar densities are seen on the left mid and lower lung fields. Left costophrenic sulcus is also noted.
202 D / E / Ma Teresa Cruz
54/F / ICH, L basal ganglia prob hypertensive in origin
HPN 2 / Metoprolol 50/tab 1 tab BID (6A-6P)
Perindopril 10 mg/tab 1 tab OD
Amlodipine 10 mg/tab 1 tab BID (6A-6P)
Eposartan if SBP >140 / Lipid profile
2D echo
202 H / R / Purita Agpaoa
58/F / ICH, L basal ganglia prob hypertensive in origin
HPN 2 / ASHD< CAD at risk LVH< NIF Class IIIB, SAH st II / Trop I 0.01
ECG (7/15): SR, LAE, LVH / Amlodipine 10mg/tab BID
Bisoprolol 5 mg/tab 1 tab OD
Eprosartan 600mg/tab OD / 2D echo
202 I / R / Ben Ngo 59/M / Sphenoidal meningioma / Essentially normal CV findings / 2D echo: concentric LVH I good wall motion and contractility & N resting systolic function; pulmonary regurgitation / Simvastatin 40mg/tab OD
Atenolol 50mg/tab BID
Amlodipine 10mg/tab BID / OR sched
202 J / Antonio Cadiz / R Cerebellar mass prob hemangioma S astrocytoma; obstructive hydrocephalus s/p E VPS 6/5
s/p posterior fossa surgery (7/3/09) / SAH st 2, CAD at risk / C-M / ECG normal tracing
CXR normal chest / Amlodipine 5 mg/tab OD
Atorvastatin 10 mg/tab ODHS
Losartan 50mg OD / MGH
202 M / C / Loreto Austria 51/M / L frontoparasagittal meningioma / ASHD CAD at risk HCVD NIF IIB
SAH St I / Atenolol 100mg/tab BID
Amlodipine 10mg/tab BID / MGH
202 N / E / Francisco Gibas
47/M / Parasellar mass prob lymphoma s.p Transphenoidal surgery (7/23/09) / ASHD, single vessel CAD, s/p NSTEMI NIF class IIB s/p cpronary angiography (2004)
SAH stage 2
Dyslipidemia / Concentric LVH with good wall motion and conture. Normal resting systolic function with grade 1 diastolic dysfuncton. MR trivial, Aortic Regurgitation, mild, Tricuspicd regurgitation mild. / Trimetazidine 35 mg/tab OD
Omacor 1 tab OD
202 P / C / Joseph Cataluña
49/M / t/c LACI, L MCA territory probably artery to artery embolism NIHSS 2 / SAH st. 1 / Carotid Doppler: 1)carotid atherosclerosis Type III plaque mid and distal L common carotid artery. 2) diffuse intima media thickening, L common carotid artery
2D Echo: R coronary cusp, non-coronary cusp and L coronary cusp of the aortic valve cannot be visualized.
ECG sinus tachycardia
CXR normal chest / Amlodipine 5mg/tab ½ tab OD
Diltiazem 30 mga/tab 1 tab TID
FORBES WARD
203 A / E / Talunton Elizabeth 60/F / Massive Pleural Effusion, prob 2 to malignancy or PTB s/p CTT 7/17 / C M-H / ECG: Sinus Rhythm, Anterolateral wall ischemia, persistent artifacts
CXR: Pleural effusiom / Awaiting venous and duplex scan
ESPANA WARD
MICU
INTERVENTIONAL CARDIOLOGY REFERRAL
205 A / R / Nenita Gonazales 57/F / ASHD CAD NIF Clas IIIC / ASHD CAD NIF Clas IIIC / CXR: Non specific Infiltrates left paracardiac area with prominent vascular markings. Top normal heart size – left venricular form
Mild levoscoliosis / ASA 80 mg/tab OD / for Coro Angio
207 B / R / Ricky Carrasco 37/M / CKD 2dary to DM nephropathy, complicated UTI; CAP infection, inPx, nonICU / Asa 80mg/tab OD
207 F / R / Roberto Barbon 79/M / ASHD CAD AF in RVR / ASHD CAD AF in RVR / Normal Chest
Atrial Fibrillation tupe I with 2: 1 AV conduction. Incomplete rifgt bundle branch block.
2D Echo Eccentric LVH w/ multisegmental wall motion abnormality and adequate systolic function with Doppler evidence of diastolic abnormality (reversible restrictive pattern) top normal left atrium. Dilated right atrium. Mitral sclerosis w/ moderate mitral regurgitation. Aortic sclerosis w/ mild aortic regurgitation. Tricuspid regurgitation. Pulmonic regiurgitation. Moderate pulmonary hypertension.

1