Cardiac with Chath

Question 1

bed 1
pa

Answer 1

pamela anderson
75
off pump cabg x2

Question 2

bed 1
pa
full

Answer 2

uti

pamela anderson
75
off pump cabg x2 on 27/9

delayed presentation inferior stemi with TVD 17/9
Transferred from DBH
troponin leak 11k
normal LV

BG CLL

unclear micro organism
ceftriaxone 48 hours post, and 4 days on ward

resolving

Question 3

bed 2
LK

Answer 3

Laura Kelly
65
septal myectomy

Question 4

bed 2
LK
full

Answer 4

type 2 von willebrane disease

Laura Kelly
65
septal myectomy 27/9 for HOCM with LV outflow tract ostruction

-recurrent GI bleeds, nosebleeds and mennoragia
-biostate factor 8 plus vwf daily for 3 days
-stopped because vwf levels greater than 200%

use own bipap machine

plan introduce metoprolol

Question 5

bed 3
LW

Answer 5

Lindsay waites
59
CABGx4 and LAA ligation

Question 6

bed 3
LW
full

Answer 6

multinodular goitre when on ward

Lindsay waites
59
CABGx4 and LAA ligation on 26/9

SOBOE–>TVD
TF from OBH
normal LV

BG T2DM, Asthma, AF, dilated cardiomyopathy

-amiodarone loaded
-normally on apixaban, plan to restrat day 5

Question 7

bed 4
KC

Answer 7

cardiorenal syndrome

Kelly Cummins
51
TF from campelltown for workup for Viv-TAVI 23/9
BG of t AV after MRSA IE of natiive valve 2012

homeless, unemployed, prev IVDU, not surprisingly not compliant with their apixaban

recent admissions for mrsa lower limb cellulitis, ccf, aki, ecoli uti
13/9 self presented post-MVA, , CCF and APO, intubated, found to have severe AoCKD, severely acidotitis and hyper K requiring dialysis

-on heparin infusion

-treated
-also alcohol and malfd

echo 21/9
normal biventricular size/function; mod-severe lvh
severe tAV stenosis,, AV mean gradient 60, mod AR
severe tTV stenosis
-nil vegetation

Gastro
ENT
Heamatology

Question 8

bed 5
JF

Answer 8

Jacqueline Flack

nothing

Question 9

bed 6
SV

Answer 9

Susan Virgo
71
right thoracotomy and upper lobe wedge

Question 10

bed 6 full
SV

Answer 10

lung cancer diagnosed august

Susan Virgo
71
right thoracotomy and upper lobe wedge on 28/9

Question 11

bed 7
SP

Answer 11

Stephen PAge
65
redo sternotomy redo mitral valve replacmeent

Question 12

bed 7
SP
full

Answer 12

myotonic dystrophy

Stephen PAge
65m
redo sternotomy redo mitral valve replacement on 27/9

prior MVR in 2021 complicated by E faecalis endocarditis, tracheostomy, aspiration pneumonia 3/12 hospital stay

-dysphagia, peg feeds
#chornic AF

mild reduced LV function 45%

Question 13

bed 8
ME

Answer 13

Marian Elias
74F
tAVR 8/9

Question 14

bed 8
ME
full

Answer 14

Marian Elias
74F
tAVR 8/9

Isssues
Severe cardio genic shock and VT arrest on 12/9 due to stemi/left main coratony obstruction requiring VA ECMO and OT for a cabg, complicated by a RA clot on 14/9,

developed PE, nonocclusive right lower lobe segmental artery

aspiration pneumonia
tazoin 12/9 - 19/9
likely re-aspiration on 25/9 commenced on ceftriaxone

Question 15

bed 9
GS

Answer 15

Guo Shi
83
type A dissection

Question 16

bed 9
GS

full

Answer 16

large pericardial effusion

Guo Shi
83
ascending aortic replacemnt and hemiahrt
type A dissection on 25/9

#mild trop rise
#dilerium
#wet cough

aim ward clear tomorrow

Question 17

bed 10
AW

Answer 17

Anthony Woyt
63
elective aortic root ascending aorta and hemiarch replacement

Question 18

bed 10
AW

full

Answer 18

Anthony Woyt
63
elective aortic root ascending aorta and hemiarch replacement 28/9

bioproesthetic
indication bicuspid valve with AR and AS, mildly dilated ascending aorta
LV 55-60%

PMHx thrombocytopneia

Question 19

bed 11
CC

Answer 19

Chian Chun

Question 20

bed 12
RL

Answer 20

Roger LEe
69
insertion of triclip

Question 21

bed 12
RL
full

Answer 21

Roger LEe
69
insertion of triclip on 28/9

severe TR secondary to annular dilation
recent admission with decompensated right heart failure

pmhx mechanical mvr ‘98 for endocarditis related to dental procedure
AF with previous TIA while on warfarin
t2dm

improvement of TR from severe to moderate