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Dr George Isaacson
Cardiotogist
45 Inkerman Street
Caulfield 3162
31/03/2018
Dear Dr ssaacson,
Re: MrJing2U
1am writing to refer Mr. ZU whose presentation is suggestive of ischemic heart disease. Your
help would be highly appreciated.
(Mr 2U is a 72-year-old retired school teacher. Hédemaniedand nonsmokes, He is a known
«ase of hypertension for 18 years, with IHD and Ml for many years. In addition, he has been
suffering from CCF for the last S years. He is on Lasix 40mg, Enalapril, slow K, nifedipine and
anginine sublingual as needed, He has reported anginal symptoms on gardening which Comment (brchmnrk}:
relieved by rest and anginine use. Moreover, he has mild postural dizziness. On examination,
there were features of CCF with normal heart sounds and unremarkable abdominal
examination. His diagnosis was stable CCF associated with mild angina thus raquired-onby
Me 2U presented 2 weeks later with deteriorating CCF which manifested as worsening
dyspnea, orthopnea, lung crepitation to mid zone along with further engorgement in the IVP.
ECG was done: and the patient commenced on high dose of Lasix 80mg with review plan in
two days. Today he has improved, his JVP and lung congestion were better. He still has
anginal symptoms on activity and ECG detected anterolateral ischemia.
In light of the above, my provisional diagnosis is |HD. | am referring him for further
‘management. If you have any queries, please contact me.
Yours sincerely,
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21 March 2015,
Ticket: 16352
Dr Tony jones
12 NewStreet
Stilaater
Dear DrJones,
RE: Ms Betty Johnsen, Age:81 years
| am weting to update you on Ms Johnson, who underwenta right total knee replacement operation on
25/02/15 due to increasing pain and immobility
During the post-operative parted, her vital signs were stable; and she was commenced on intravenotss
cephalathinfor24 hours and analgesics. Her investigations were also unremarkable except fora low
hemoglobin leva! of €04/ for which an intravenous transfusion was given and Feratab was started. On
28/02/15, she began to walk with crutches as her wound was healthy. Hence, clips were removed, and she
\was transferred to the rehabilitation on 07/03/15.
Inthe rehabilitation, her mobility improved gradualy, and she could carry cut physiotherapy exercises and
take showers with minimal assistance. On 14/03/15, her pathology results showed an INK of 3.8 and
Improving hemoglobin level (1128/1
Today, Ms Johnson's being discharged witha home nurse, who will ook after her parscnal hygiene,
‘wound, and mobility. Her discharge medications include warfarin 4mg nocte, Feratab 150mg mane,
paracetamal 1g.qds.and oxycodone S-10mg prn. Please note, her rehabilitation appointment isin two
weeks,
It would be appreciated if you could provide her ongoing care and arrange a fullblood examination and
INR,
IH you have any queries, pleaze contact me.
Yours sincerely,
Doctor Zubair
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