Howard Van, MD, FRCP(C), FACC

Cardiology

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December 14, 2018

Dr. Farouq Manji

Dr. Mark Tomen

RE: Franken, (John) Murray

DOB: 09/04/1948

Dear Dr. Tomen and Dr. Manji,

It is my pleasure to see Mr. Franken here in the outpatient cardiology clinic today.

History of Present Illness: As you know, this is a 70-year-old gentleman who has been a
patient of mine since 2016. This is a gentleman who had significant history of atrial fibrillation.
He had a cardiac arrest with a prolonged hospital stay. He recently had significant anemia and
found to have a lot of mass in his colon and was scheduled for upcoming surgery including
laparotomy with open right colectomy and possible stoma on Monday, December 17th.

Cardiac Risk Factors: I reviewed his cardiac risk factors including hypertension, dyslipidemia,
and atrial fibrillation.

Current Medications: He is on Pantoloc 40 mg, Senokot 86 mg, furosemide 40 mg,

rivaroxaban 20 mg, amiodarone 200 mg, and bisoprolol 10 mg.

Assessment and Plan: Regarding to upcoming surgery, he had a dobutamine stress test, which
shows that there is no evidence of ischemia. I would recommend to go ahead with the surgery.
We will ask him to wean off the Xarelto three days prior to the surgery and restarting the Xarelto
postoperatively. Other medication we would recommend to go ahead to continue on including
 Franken, (John) Murray DOB: 09/04/1948 Page 2

the bisoprolol and amiodarone.

Modified medication today: Wean off Xarelto three days prior to the surgery and restarting
postoperatively.

Thank you so much for letting me involved in the care of this patient. If you have any further
questions or concerns, do not hesitate to give us a call.

Sincerely,

Dictated but not read

Howard Van, MD, FRCP(C), FACC

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