Question

72 yo M w/PMH HTN, COPD, chronic back pain comes to office. Smoked 1 ppd for 40 years. Occasional consumption of alcohol at social events. BP 140/85. Mild wheezing. Irregular rhythm. ECG shows flutter waves. management?

Answer 1

The management plan for this patient would involve addressing hypertension, managing COPD, and evaluating and managing the irregular rhythm on ECG.

Step-by-step explanation:

The patient in this case is a 72-year-old male with a past medical history of hypertension (HTN), chronic obstructive pulmonary disease (COPD), and chronic back pain. He is a former smoker for 40 years, smoking 1 pack per day (ppd) and occasionally consumes alcohol at social events. His blood pressure is 140/85, he has mild wheezing, an irregular rhythm on ECG, and flutter waves.

Based on this information, the management plan for this patient would involve:

1. Addressing the hypertension: The patient's blood pressure is elevated, so antihypertensive medications may be considered to help control his blood pressure and reduce the risk of cardiovascular complications.
2. Managing the COPD: The patient's history of smoking and wheezing suggests the presence of COPD. Treatment options may include bronchodilators to improve airflow, inhaled corticosteroids to reduce inflammation, and pulmonary rehabilitation to improve lung function and quality of life.
3. Evaluating and managing the irregular rhythm: The presence of flutter waves on ECG suggests atrial flutter. Further evaluation may include a referral to a cardiologist for a comprehensive evaluation and consideration of antiarrhythmic medications or other interventions, as indicated.