Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, COVID-19, Chest X-ray normal, Chest pain, Chills
Clinical narrative: ED to Hosp-Admission Discharged  5/2/2021 - 5/3/2021 (3 hours)  Hospital  MD Last attending ? Treatment team Epigastric pain Principal problem Discharge Summary  MD (Physician) ? ? Internal Medicine    Inpatient Discharge Summary   BRIEF OVERVIEW Admitting Provider:  MD Discharge Provider: MD Primary Care Physician at Discharge: DO 35 min.   Admission Date: 5/2/2021     Discharge Date: 5/10/2021   Discharge Diagnosis   1.  Chest pain in a patient with history of coronary artery disease cardiac catheterization and stents. 2.  Nausea vomiting diarrhea most likely secondary to COVID-19 3.  Positive COVID-19 no respiratory symptoms 4.  History of dyslipidemia    Hospital Course   Patient was admitted with chest pain and GI symptoms most likely from COVID-19 nausea vomiting diarrhea.  She decided to sign out AGAINST MEDICAL ADVICE and left the hospital Patient is a 56 y.o. female on hospital day number 0 presented with chest discomfort nausea vomiting diarrhea    Medical Problems     Hospital Problems        POA   * (Principal) Epigastric pain Yes                    Plan     1.  Chest pain in a patient with history of coronary artery disease status post cardiac catheterization with multiple stents chest pain is very atypical most likely gastric in origin as she also has history of Barrett's esophagus.  I will change the Protonix to 40 IV twice a day.  We will start the patient on chest pain protocol we will trend the troponins 2D echo cardiology consult 2.  Possible gastroesophageal reflux 3.  Nausea vomiting diarrhea with positive COVID-19 most likely GI symptoms of COVID-19 we will hydrate her with normal saline at 100 mL/h. 4.  Positive COVID-19 no respiratory symptoms pulse ox 95% on room air we will keep an eye on her inflammatory markers she has GI symptoms. 5.  History of dyslipidemia 6.  DVT prophylaxis moderate risk subcutaneous heparin bilateral compression devices. 7.  CODE STATUS she is a full code.   Patient will be admitted to med surgical floor under hospitalist service.  Medical management was discussed with the patient in detail.   Chief Complaint Patient presents with ? Chest Pain     1. *Extended Emergency Contact Information 2. Primary Emergency Contact: spouse 8. Relation: Spouse 9. Preferred language: English 10. Interpreter needed? No_     History of Present Illness     Patient is an 56 y.o. female with past medical history significant for coronary artery disease dyslipidemia status post cardiac catheterization with multiple stents presented to the ER with chief complaint of abdominal discomfort mainly epigastric region she been having pain off and on for 2 years she was in the ER the day before yesterday and signed out AGAINST MEDICAL ADVICE her troponin at that time was 0.04.  Today she started having some abdominal discomfort again nonradiating centrally located in epigastric region, she also has diarrhea she has 6-7 bowel movements loose watery as well as she is nauseated and vomited multiple times mainly yellowish stuff with food in it.  She denies any blood with stool or blood with urine.  She says that she had some chills and uncomfortable feeling and felt like she is having fever.  As her symptoms did not get any better she came to the ER. She denies any shortness of breath cough or phlegm.  Her pulse ox is 95% on room air