Patient: Winston Waller Physician: Morris Johnston, MD August 1,...

Patient: Winston Waller

Physician: Morris Johnston, MD

August 1, 2022

History

This patient is a 73-year-old male nonsmoker with type 2 diabetes mellitus and hypertension. He presented to this ED with shortness of breath and was found to have had an acute myocardial infarction of the anterior wall of his heart showing an ST elevation that had previously been left untreated. He developed several complications, including renal failure from a combination of cardiogenic shock and toxicity from the dye used for emergency catheterization of his heart.

Hemodialysis was started during this hospitalization because of his renal failure. After spending almost a month in the hospital and developing severe deconditioning, he was discharged to a subacute rehabilitation facility.

Examination

While he was there, he was noted to have symptoms consistent with mild depression, as well as a prior history of a major depressive episode in 2019. Mirtazapine (Remeron) 25 mg/day was started.

He was transferred to a skilled nursing unit for another month of rehabilitation management of his medical conditions and then discharged home to the care of his wife.

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