Patient Details

Kyle Hughes

68

M

Aspirin 100mg mane

Metoprolol 25mg BD

Atorvastatin 40mg nocte

Ramipril 10mg daily

GTN spray SL PRN

Pantoprazole 40mg mane

Panadol osteo 2 PO TDS

Mr Hughes is being seen in the cardiac surgery clinic at John Hunter Hospital for assessment of a CABG after a previously failed stent. He underwent a Percutaneous coronary intervention (PCI) with failed stenting about two months ago. The cardiologist believes a revascularisation procedure will benefit this patient as he is on appropriate medical management and he has worsening ischaemic heart disease. Currently Mr Hughes is complaining of intermittent central chest discomfort which is occurring if he walks for more than five minutes or climbs one flight of stairs. On the stairs, he needs to have a break due to the discomfort in his chest. This intermittent chest pain resolves either with rest or with the use of his GTN spray. He has never previously had an acute myocardial infarction. After his failed cardiac stent, the cardiologist referred Mr Hughes to the cardiac surgery clinic for further assessment.

Percutaneous coronary intervention with failed stenting

Laparoscopic cholecystectomy

Hypertension

Dyslipidaemia

Ischaemic Heart Disease

GORD

Osteoarthritis

NKDA  

Mr Hughes’ father died of a heart attack at the age of 59. His mother is still alive at 91 years of age and lives in a low-level nursing home. She has no significant medical issues. Mr Hughes is the eldest of four siblings; one also suffers from ischaemic heart disease.

Mr Hughes is a retired butcher from Port Stephens who lives at home with his wife. They are both independent in all their ADLs.

Mr Hughes drinks only occasional alcohol but smokes. He has a 50 pack year smoking history, smoking a pack a day since he was 18 years old.