Emergency Register

Emergency Department
QE 11 Hospital
249 Wickham Tce
Brisbane
4001

Dear Doctor,

30 September 2017

Re: Mr Dave Cochrane, DOB: 20/11/1964

I am writing to refer Mr Cochrane, a 52-year-old man, who is presenting with signs and symptoms of left
ventricular failure. Your urgent assessment would be highly appreciated.

Mr Cochrane lives with his wife. He is a heavy smoker and a heavy drinker.

On 12/08/17, Mr Cochrane presented with shortness of breath which was worsened when lying down
and improved when the head is raised at the end of the bed. Other symptoms were tightness in the
chest and coughing especially at night. On examination, there was high jugular venous pressure,
deviated apex beat to the mid-clavicular line and crepitations in the basal lung along with dyspnea.
Additionally, His ECG and chest X-ray revealed cardiomegaly and infection respectively. Therefore, he
was prescribed broad-spectrum antibiotics for 7days, frusemide 40mg and digoxin 0.25mg/day. In
addition, I advised him to quit smoking and drinking.

Two weeks later, Mr Cochrane’s condition had improved for which I advised him to continue his
medications and rest for one week.

On today’s visit, Mr Cochrane’s symptoms have worsened with a 2-hour history of severe shortness of
breath associated with chest pain and sweating. On examination, bilateral basal crepitations in both
lungs were noted.

In view of the above, I believe that Mr Cochrane needs admission to a Cardiology Unit for stabilization.
Please contact me for any further queries.

Yours sincerely,

Dr. Kay