Busy Beyond Belief 2-4-24

Velta Dupuy is a 85 y.o. female with stage IV CKD, type 2 diabetes, congestive heart failure, B-cell lymphoma, PAD status post RLE endovascular intervention of right great toe ulcer, presents to ED for ongoing chest pressure. She states chest pressure his midsternum, on and off for minutes to hours at a time and has been ongoing for several weeks. Chest pressure does not radiate and there is no associated palpitations. She feels the pressure is "building up and building up." Chest pressure appear at rest and without cause. She has associated nausea and vomiting. She denies fevers, chills, difficulty urinating, or abdominal pain.

Patient was admitted here to BAS recently on 01/16-01/19/24 for syncopal episode while at her PCP's office. She was also positive for C diff infection and was treated with 10 days of oral vancomycin. She states her stools are more formed and diarrhea has improved. On discharged, she followed up with Dr. Hamadeh, cardiologist for the syncopal events. She was placed on a 30 day Holter monitor, told to stop clonidine and started on Toprol-XL 25 mg for mitral stenosis. She is to continue aspirin and Plavix for recent PTA, follows Dr. Chou.

Regarding her B-cell lymphoma, she was seeing Dr. Trang for several months last year, but has not been able to due to dehydration and poor appetite. She is scheduled to see Dr. Ooman and get a pet scan on 2/22/24. Her niece told her to stop her ibrutinib (Imbruvica) two days prior to this admission as she believes it was making her more sic