ASSESSMENT and PLAN
MYOCARDIAL INFARCTION (aspirin, metoprolol, clopidogrel)
5/8/2017	- 4-vessel coronary artery bypass grafts, tolerated well. J Smith
5/7/2017	- troponin T 40 ng/mL, chest pain persists, Thoracic Surgery has seen. J Smith
5/6/2017	- troponin T 25 ng/mL, recurrence of chest pain at rest. J Paul
5/5/2017	- several 10-beat runs of symptomatic ventricular tachycardia. J Paul
5/4/2017	- heart catheterization: Occlusion of obtuse marginal. J Smith
5/3/2017	- troponin T 10 ng/mL, no chest pain, heart catheterization in AM. J Smith
5/2/2017	- troponin T 15 ng/mL, heart rate 35 beats per minute, temporary pacemaker placed. J Smith
5/1/2017	- troponin T 35 ng/mL, new onset of chest pain with ST elevation in a patient who had angioplasty in obtuse marginal 9 months ago. Aspirin and metoprolol started. J Smith
ACUTE KIDNEY INJURY (prednisone)
5/7/2017	- creatinine 5.9 mg/dL, hemodialysis started. J Smith
5/6/2017	- creatinine 4.6 mg/dL, acute interstitial nephritis found on renal biopsy, steroids started. J Paul
5/5/2017	- creatinine 3.4 mg/dL, input 2000 mL, output 500 mL, nausea and vomiting worse. J Paul
5/4/2017	- creatinine 2.4 mg/dL, input 2000 mL, output 600 mL, renal biopsy. J Smith
5/3/2017	- creatinine 1.8 mg/dL, input 2000 mL, output 600 mL, no response to volume. J Smith
5/2/2017	- creatinine 1.6 mg/dL, input 1000 mL, output 400 mL, volume depleted? Will give normal saline. Renal ultrasound: Normal renal size, no obstruction. J Smith
HYPERTENSION (lisinopril, chlorthalidone, metoprolol) normal renal angiogram 2013
5/4/2017	- blood pressure 185/96 mmHg, intravenous antihypertensives stopped. J Smith
5/3/2017	- blood pressure 200/99 mmHg, now having headaches and new leg edema probably due to amlodipine so will stop amlodipine and add metoprolol 50 mg/d. J Smith
5/2/2017	- blood pressure 205/105 mmHg, no symptoms, chlorthalidone 25 mg/d added. J Smith
5/1/2017	- blood pressure 210/125 mmHg, not taking any blood pressure medications at home for months, no papilledema, started on amlodipine 10 mg/d and lisinopril 20 mg/d, will give intravenous hydralazine for systolic BP >200 mmHg as needed. J Smith