76-year-old male with a past medical history significant for hypertension, hyperlipidemia , diabetes, chronic atrial fibrillation, and CKD stage 3 presented to the ED with chest pain.
Day of presentation:
2332: EKG demonstrates atrial fibrillation with a heart rate 111 and non-specific ST-T wave changes. Troponin 0.03
2347: Diltiazem drip initiated
0250: Observation order placed
0412: H&P assessment: chest pain, multiple risk factors. Plan trend troponins, hold diltiazem, aspirin, cardiology consult
1050: Progress note update: NPO for potential cardiac catheterization
1348: Cardiac catheterization: PCI x4 stents placed
1832: Post procedure: patient developed rectal bleeding. Patient on apixaban, dual antiplatelet treatment. Plan for pantoprazole and GI consult.
1850: Inpatient order placed
1530: Discharge to home
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