Assignment:
Diagnoses:
1. Rule out myocardial infarction.
2. History of tuberculosis.
3. Hemoptysis.
4. Status post embolectomy.
CHIEF COMPLAINT: Tightness in the chest shortness of breath fast heart rate
HISTORY OF PRESENT ILLNESS:
Mr. barua is a 42 year old gentleman from bangladesh who presents with chest tightness shortness of breath and tachycardia
Dr. j. k. clain of cardiology is evaluating his heart condition
The patient has had the recent onset of hemoptysis
He was treated for tuberculosis in Bangladesh 15 years ago
This has prompted the concern of whether his treatment for tuberculosis was adequate or whether there is another cause for his hemoptysis
The duration of his tuberculosis treatment was apparently adequate according to his wife but no records are available
In addition the patient had thrombosis of the axillary artery treated last year at Hillcrest
He had an embolectomy and has been on Coumadin since inr is significantly elevated at 16
Nonetheless because of the cavitary lesions that are seen in the right and left upper lobes, the possibility of tuberculosis has been raised
Ancillary history was given by the patients wife nupur with the patient translating for her from the hindi language