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    Urgent Oet

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    HARITH RAJAH
    Mr. William Avila, a 69-year-old retired politician, was referred for urgent assessment of acute heart failure and possible silent myocardial ischemia. He presented with worsening dyspnea, decreased stamina, ankle edema, and recent orthopnea. Examination found elevated blood pressure, shifted heart apex, murmur, and crepitations. ECG showed T inversion without ST elevation or Q waves, changed from prior. The patient has a history of diabetes, hypertension, heart disease, angioplasty, and cataract surgery. The provisional diagnosis is biventricular heart failure with reduced ejection fraction and possible silent ischemia due to uncontrolled diabetes and hypertension. Immediate assessment and management is

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    Urgent Oet

    Uploaded by

    HARITH RAJAH
    69 views2 pages
    Mr. William Avila, a 69-year-old retired politician, was referred for urgent assessment of acute heart failure and possible silent myocardial ischemia. He presented with worsening dyspnea, decreased stamina, ankle edema, and recent orthopnea. Examination found elevated blood pressure, shifted heart apex, murmur, and crepitations. ECG showed T inversion without ST elevation or Q waves, changed from prior. The patient has a history of diabetes, hypertension, heart disease, angioplasty, and cataract surgery. The provisional diagnosis is biventricular heart failure with reduced ejection fraction and possible silent ischemia due to uncontrolled diabetes and hypertension. Immediate assessment and management is

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    167634_URGENT_OET

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    Mr. William Avila, a 69-year-old retired politician, was referred for urgent assessment of acute heart failure and possible silent myocardial ischemia. He presented with worsening dyspnea, decreased stamina, ankle edema, and recent orthopnea. Examination found elevated blood pressure, shifted heart apex, murmur, and crepitations. ECG showed T inversion without ST elevation or Q waves, changed from prior. The patient has a history of diabetes, hypertension, heart disease, angioplasty, and cataract surgery. The provisional diagnosis is biventricular heart failure with reduced ejection fraction and possible silent ischemia due to uncontrolled diabetes and hypertension. Immediate assessment and management is

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    69 views2 pages

    Urgent Oet

    Uploaded by

    HARITH RAJAH
    Mr. William Avila, a 69-year-old retired politician, was referred for urgent assessment of acute heart failure and possible silent myocardial ischemia. He presented with worsening dyspnea, decreased stamina, ankle edema, and recent orthopnea. Examination found elevated blood pressure, shifted heart apex, murmur, and crepitations. ECG showed T inversion without ST elevation or Q waves, changed from prior. The patient has a history of diabetes, hypertension, heart disease, angioplasty, and cataract surgery. The provisional diagnosis is biventricular heart failure with reduced ejection fraction and possible silent ischemia due to uncontrolled diabetes and hypertension. Immediate assessment and management is

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    Ticket Id: 167634

    Emergency Cardiologist
    Emergency Department
    Hampshire Hospital
    Andover

    23. 05. 2023

    Dear Doctor,
    Re: Mr. William Avila, a 69-year-old retired politician

    Thank you for accepting Mr Avila, who is showing signs of acute heart failure and possible silent
    myocardial ischaemia, for urgent assessment and management.

    On 12. 02. 2020, Mr Avila presented with complaints of worsening dyspnea, decreased stamina and 4
    months of ankle oedema. He had orthopnea since last week. On examination, his BP was elevated to Comment [OET1]: also reported a ne-
    158/93 mmhg and temperature was 37. 2C. His chest examination showed apex shifted laterally with week history of orthopnea
    ejection pansystolic murmur. In addition, bibasal crepitations were also present. Bilateral oedema was
    confirmed, reaching the ankle. T inversion of antero- lateral leads was presented in the ECG without Q
    wave and ST elevation which changed from 6 months ago. Comment [OET2]: showing changes from
    the ne done
    Mr Avila suffers from poorly controlled DM, Mild- moderate hypertension and ischemic heart disease. His Comment [OET3]: as has
    past medical history includes coronary artery angioplasty after an acute MI in 2014 and he underwent a Comment [OET4]: m
    cataract surgery in 2016. His regular medications include Novorapid and Lantus injections along with
    Metformin 500 mg, Valsartan 20 mg, Sacubitril 24 mg, Aspirin 3 g, Rosuvastatin 10 mg, Nifedipine 30 and Comment [OET5]: m
    hydrochlorothiazide 50 mg. Comment [OET6]: v
    Comment [OET7]: s
    My provisional diagnosis is biventricular heart failure with reduced ejection fraction. He could also
    Comment [OET8]: a
    possibly be suffering from silent ischaemia due to his HTN and uncontrolled DM.
    Comment [OET9]: r

    I appreciate your immediate assessment and management would be appreciated. Comment [OET10]: n
    Comment [OET11]: with the possibility f
    silent ischaemia
    Should you require any further information, please do not hesitate to contact me.
    Comment [OET12]: In view f the above,
    Yours faithfully,
    Doctor

    Report
    Word Length 211
    Comments The purpose is clear. However, a couple of parts can be developed
    in a better way. Other inaccuracies pertain to capitalization, word
    choice and grammar. Overall, the letter needs improvements.

    Estimated Grade C+
    Estimated Score 340/500
    Advice 1. Avoid basic grammar errors.
    2. Punctuate the content appropriately.
    3. Pay attention to spelling and capitalization.
    4. Improve choice of words.
    5. Always proofread the letter after finishing it.

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