Patient Details

Arthur Ryan

64

M

Candesartan 16mg PO mane

Hydrochlorothiazide 12.5mg PO mane

Atorvastatin 40mg nocte

Esomeprazole 40mg mane

Mr Ryan has been referred by his GP to the vascular surgery clinic at John Hunter Hospital after worsening intermittent left leg claudication when walking and worsening aching in this leg when he is lying in bed. Symptoms began 12 months ago when he noticed an ache in his left calf when going for a long walk. This has gradually worsened over time and he is now only able to mobilise a few metres before the severe pain commences. The aching gets worse the further he tries to walk. The only thing that will relieve the pain is rest. He has recently noticed that when he lies flat in bed with the left leg up, a mild ache will develop. He saw the GP who organised an ankle brachial index (ABI) and a toe brachial index (TBI) for the left leg. The result of the ABI was 0.50 and the TBI was 0.25. The GP then referred onto the vascular surgery clinic for further assessment and management.

Cholecystectomy – From cholelithiasis.  

Hypertension

Dyslipidaemia

GORD

ACE inhibitors – Cough.  

His mother is 87 and has ischaemic heart disease. She had one previous acute myocardial infarction eight years ago but made a good recovery. His father died of bowel cancer 15 years ago at the age of 73. 

Mr Ryan is a chef who lives in Singleton with his de facto partner of 12 years. He has three adult children from a previous marriage who all live away. On average he drinks 2 standard beers per night and has a 50 pack year smoking history, starting at age 15. He remains a current pack-a-day smoker.