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History & Physical

History & Physical.

lareina-strong
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History & Physical

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  1. History & Physical • 81 yo male presented to outside hospital with acute onset severe abdominal pain. Workup with CT and ultrasound showed non-ruptured 8cm AAA and acute cholecystitis. Treated with antibiotics, but continued to be febrile with persistent pain and developed a-fib. Taken to OR for cholecystectomy and then transferred here for treatment of AAA. Also noted to have rise in creatinine at OH to 1.9 • PMH: CHF (EF 30%), CAD s/p CABG in ’89 and ‘00 and angioplasty of RCA, HTN, DM • Exam: mildly tender abdomen over surgical scars, mildly tender aneurysm, palpable distal pulses • Labs: WBC 7.1, Hct 33, Creat 1.5 • Cardiology consult: adenosine stress test showed reversible defects, high risk for surgery, recommended cath prior to any intervention

  2. NECK 22-23 mm 8.0x7.5 cm

  3. 26 x 14 x 18 cm Gore Excluder

  4. 14.5 x 14 cm contralateral limb

  5. TOTAL 55 CC visipaque

  6. Follow-up • Ruled out for MI post op • Hemodynamically stable • Creatinine stabilized at 1.3-1.5 • Transferred to SNF, will have outpatient cath by primary cardiologist

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