Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Coronary arterial stent insertion, Coronary artery occlusion, Dyslipidaemia, Ejection fraction, Electrocardiogram abnormal
Clinical narrative: Discharge Summary: Private MD (Physician) Cardiology; D/C summary. > 35 min. spent on D/C. Discharge Summary: Private (Physician) Cardiology- from Local Medical Center Discharge Summary: PATIENT NAME: Private; PHYSICIAN: Private MD- PT ACCOUNT NO: Private. ADMIT DATE: 07/07/2022- DATE OF BIRTH: 10/24/1976; DISCHARGE DATE: 07/10/2022. IDENTIFYING DATA:  45-year-old female. REASON FOR ADMISSION: Acute myocardial infarction. HISTORY: The patient presented to the emergency department with severe chest pain. EKG showed an acute anterior wall myocardial infarction. She was brought to the catheterization laboratory as an emergency. There was no previous history of cardiac disease. She is a smoker, but no other known risk factors. She was not taking any medication prior to admission. HOSPITAL COURSE: The patient was brought to the catheterization laboratory as an emergency on the day of admission, 07/07/2022. She had a complete occlusion of the proximal left anterior descending. The vessel was reopened. A stent was placed in the proximal left anterior descending which is a 2.75/22 Medtronic Resolute Onyx drug-eluting stent which was dilated to 3.0. Good angiographic result. There was also a 50% stenosis in the distal left anterior descending which did not require treatment. The patient also tested positive for COVID-19, although she was not symptomatic in this regard. The patient was transferred to a telemetry bed. She recovered uneventfully. An echocardiogram the next day demonstrated severe anteroseptal hypokinesia and apical akinesia. Ejection fraction was calculated to be 64%. There was a trace of regurgitation of all four cardiac valves, but no significant valvular disease. She was seen by infectious disease in consultation because of the COVID-19 positive test. They did not recommend any specific treatment other than vitamins. She did not require steroids or remdesivir. The patient was feeling extremely well today. She was extremely eager to go home. She was not having any chest pain or shortness of breath. No symptoms. She was eating well. The lungs were clear to auscultation. Heart was regular without murmur or gallop. The right groin was healing well. No peripheral edema. X-RAYS/LABS: Laboratory studies were satisfactory. CBC today: WBC 5.9, hemoglobin 13.9, hematocrit 41.4%, platelets 227,000. Serum chemistry was normal to date except the blood sugar was mildly elevated. Lipid panel on July 8: Total cholesterol 232, triglycerides 105, HDL 46, LDL 165. The serum troponin peaked at 40.93. The EKGs showed evolutionary changes of the recent anterior myocardial infarction. A portable chest x-ray did not show any acute changes. A follow-up chest x-ray yesterday was also normal with no acute findings. The patient is deemed stable for discharge. She will be discharged with the below stated medications. I shall see her in approximately one week. She was instructed to quarantine for 10 days after her positive test. Call back sooner for any significant change in symptoms. FINAL DIAGNOSIS: Responsible for this admission.    1. Acute anterior wall myocardial infarction secondary to atherosclerosis.    2. Dyslipidemia.    3. Active smoker.    4. Positive for COVID-19, although, no symptoms directly related to the COVID-19. MEDICATIONS:    1. Tylenol 500 milligrams every 4 hours as needed for minor pain.    2. Vitamin C 500 milligrams twice a day.    3. Aspirin 81 milligrams daily.    4. Lipitor 80 milligrams daily.    5. Vitamin D 4000 units daily.    6. Lopressor 25 milligrams twice a day.    7. NicoDerm patch 21 milligrams daily.    8. Nitroglycerin 0.4 milligrams sublingual as needed for chest pain.    9. Protonix 40 milligrams daily.    10.Brilinta 90 milligrams twice a day. DISPOSITION: Discharged to her home in satisfactory condition. Post cardiac catheterization instructions. Quarantine for a total of 10 days after the positive test. Appointment with Dr. in one week. The patient was referred to cardiac rehabilitation. Call back sooner for any significant change in symptoms.