Reference no: EM133360889

Case Study: The patient reports intermittent CP (three episodes) occurring for the past month. He describes the pain as "tight and uncomfortable" and rates it 5/10. The location of the pain is at the mid sternum, does not radiates, and is aggravated by physical exertions, such as yard work and going up the stairs. He denies palpitations and shortness of breath. He gets relief by resting. At this time, the patient denies CP.

Cardiac: chest symmetrical, S1 S2 S3 Audible. Gallop heard. PMI displaced laterally. Peripheral vascular: Right side carotid bruit. JVP 3cm above the sternal angle. Right carotid pulse with thrill,3+. Left carotid pulse without thrill, 2+. Brachial, radial, femoral pulses without thrill, 2+. Popliteal, tibial, and dorsalis pedis pulses without thrill, 1+. Cap refill less than 3 seconds on four extremities. Respiratory: No signs of distress.Fine crackles in posterior bases of L/R lungs, otherwise CTA.

Make recommendations on the following:

Diagnostic Test/Labs: Include any labs, x-rays, or other diagnostics needed to develop the differential diagnoses with rationale for each documented OR one mentioned during the SH assignment.

ASSESSMENT: List your priority diagnosis(es). For each priority diagnosis, list at least three differential diagnoses, each of which must be supported with evidence and guidelines. For holistic care, you need to include previous diagnoses and indicate whether these are controlled or not controlled.