History of coronary artery disease and hyperlipidemia

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Patient is a 62-year-old male previously seen by Dr. David Bush 18 months ago. The patient has a history of coronary artery disease and hyperlipidemia. He underwent coronary bypass surgery in 1993 by Dr. Howard that involved a left internal mammary artery to left anterior descending. In 2013, he underwent a redo operation consisting of a right internal mammary artery to left anterior descending, saphenous vein graft to circumflex, and saphenous vein graft to right coronary artery. He did well until yesterday afternoon, when he developed an episode of moderate retrosternal chest pressure radiating to the right shoulder, which was prolonged and lasted until 3:00 a.m., at which time he presented to the ED. He apparently was given one nitroglycerin sublingual, with resolution of symptoms. The patient is currently asymptomatic on examination and his review of systems is noncontributory. PE: He is alert, oriented times three, in no acute distress. HEENT: unremarkable. Lungs: clear. Cardiovascular: Regular rate and rhythm. No murmurs and no gallops. Abdomen: Benign. Extremities: No edema. EKG: Normal sinus rhythm with myocardial changes. Lab tests completed here, today: Lipid panel: all unremarkable except for a cholesterol of 255. CBC: within normal limits. PT and PTT within normal.

Reference no: EM133794906

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