Cardiovascular tina jones shadow health Transcript
Transcript
Started: Jun 27, 2020 | Total Time:109 min
Hello my name is Danielle I will be your provider today
Greet
06/27/20 3:27 PM CDT
Hey.
Can you verify your name
Question
06/27/20 3:27 PM CDT
Tina Jones.
Your date of birth
Question
06/27/20 3:27 PM CDT
February 17th.
Thank you
Question
06/27/20 3:27 PM CDT
You’re welcome.
What brings you in today
Question
06/27/20 3:27 PM CDT
I’ve been noticing my heart seems to be beating too fast every once in a while lately, and it started to worry me. My mom said I should make an appointment. You don’t want to ignore heart stuff, I guess.
I’m sorry to hear you’re experiencing those symptoms, they can be very uncomfortable. I’ll ask you some questions to learn more about your symptoms, and we will try to determine what’s causing you to feel this way
Empathize
06/27/20 3:29 PM CDT
Thanks for saying that.
When did you first notice these symptoms
Question
06/27/20 3:30 PM CDT
I think the first time was about a month ago.
What were you doing when you noticed these symptoms (Clarified to What were you doing when you got the palpitations?.)
Question
06/27/20 3:30 PM CDT
I usually notice them on my way to class in the mornings. My schoolwork has really been picking up and I’ve been drinking energy drinks to help keep me focused during the day, so maybe the caffeine or whatever else is in those things has something to do with it. (Clarified to what I was doing when the palpitations occured.)
How many energy drinks do you drink per day
Question
06/27/20 3:31 PM CDT
Usually just one in the morning, kind of like some people have a cup of coffee. Some mornings lately I’ve had two, though.
Drinking high levels of caffeine can make you feel stressed or anxious, and can dehydrate you. over time, lots of caffeine can make you experience “crashes” during the day, too. let’s talk about healthy alternatives
Educate
06/27/20 3:33 PM CDT
Sure, I think I understand what you mean.
How often were you experiencing these symptoms
Question
06/27/20 3:33 PM CDT
No.
How often do you notice your heart racing fast (Clarified to How often does your heart beat fast?.)
Question
06/27/20 3:33 PM CDT
It’s been about once a week for the past month. (Clarified to how often my heart beats fast.)
Can you describe it for me (Clarified to What is your heartbeat like?.)
Question
06/27/20 3:34 PM CDT
It’s usually normal, but it’s way faster during these episodes I’ve been having. (Clarified to what my heartbeat is like.)
How do you feel when your heart is racing fast
Question
06/27/20 3:34 PM CDT
Well, when my heart starts beating really fast, it just feels like a thumping in my chest. It makes me anxious and uncomfortable.
Is there anything that relieves the fast heartbeat (Clarified to Does anything relieve your symptoms?.)
Question
06/27/20 3:35 PM CDT
I haven’t tried anything specific, other than just trying to relax and breathe deep. (Clarified to if anything relieves my symptoms.)
Do you take any medications to help you with your symptoms
Question
06/27/20 3:35 PM CDT
Nope.
What medications are you taking
Question
06/27/20 3:35 PM CDT
I have a daily inhaler and a rescue inhaler for my asthma.
Are you taking any new medications
Question
06/27/20 3:36 PM CDT
Yeah, I have a daily inhaler now that I’ve been using.
What’s the name of the medication
Question
06/27/20 3:36 PM CDT
The daily inhaler is Flovent, and the rescue inhaler is Proventil.
Do you have any new allergies
Question
06/27/20 3:36 PM CDT
No, not that I know of.
Do you have a history of hypertension
Question
06/27/20 3:37 PM CDT
…I’ve never been diagnosed with blood pressure problems. But I think it can be on the high side sometimes.
Do you check your blood pressure
Question
06/27/20 3:37 PM CDT
Only when I’m here at the clinic.
Do you have any health history that would contribute to hypertension (No matching questions found.)
Question
06/27/20 3:38 PM CDT
Do you have diabetes
Question
06/27/20 3:38 PM CDT
Yeah, I was diagnosed a few years ago.
Do you have high cholesterol
Question
06/27/20 3:38 PM CDT
I’ve never had it tested. My family has problems with high cholesterol, but I don’t think I do.
Any history of a heart murmur
Question
06/27/20 3:38 PM CDT
No.
Do you have health insurance
Question
06/27/20 3:39 PM CDT
I have health insurance through work. To be honest, though, I’m not exactly sure what it covers.
Are you able to afford your Medications
Question
06/27/20 3:41 PM CDT
It wasn’t the cost that was a problem. I just didn’t like taking it.
What is your access to healthcare
Question
06/27/20 3:42 PM CDT
I have health insurance through my job, so I can go to the doctor if I need to. It’s always a hassle though, so I try to avoid it unless I really have to like right now.
Do you have anything that stresses you out (Clarified to Are you stressed out?.)
Question
06/27/20 3:44 PM CDT
Yeah, I’ve been pretty stressed lately. (Clarified to if I am stressed out.)
What are you stressed about
Question
06/27/20 3:44 PM CDT
School is really busy right now, like I have a lot of projects due all around the same time. And on top of that, I’ve had to cover more at work lately, and I’m in charge of a big project at work, too.
Sounds like you’re working really hard. I’m sorry you’re dealing with so much stress.
Empathize
06/27/20 3:45 PM CDT
Thanks for understanding.
Tell me about your diet (Clarified to What is your diet like?.)
Question
06/27/20 3:46 PM CDT
It’s pretty good, I think. I’m not a huge health nut or anything. (Clarified to what my diet is like.)
What are usually eat in a typical day
Question
06/27/20 3:46 PM CDT
Let’s see . . . a muffin or pumpkin bread for breakfast, a sandwich for lunch, and some kind of meat with a veggie for dinner.
Do you have snacks
Question
06/27/20 3:46 PM CDT
Yeah, I usually have some snacks during the day.
What type of snacks
Question
06/27/20 3:46 PM CDT
I try to eat snacks that are kind of healthy like pretzels–sometimes if I’ll treat myself and get french fries, but I try not to do that too often.
Do you exercise
Question
06/27/20 3:47 PM CDT
I’m pretty exhausted by the end of the day, so I don’t have the energy to do any extra exercise. But I’m on my feet all the time at work so I feel like that’s a little bit of exercise most days at least.
I understand being busy and having very little free time. however, exercise is healthy for you, and can even relieve stress. even small amounts of exercise, such as taking a short walk, can improve your health
Educate
06/27/20 3:49 PM CDT
Thanks for telling me.
Do you use any recreational drugs
Question
06/27/20 3:49 PM CDT
No.
Do you use tobacco products
Question
06/27/20 3:49 PM CDT
No. I think it’s gross.
Do you drink alcohol
Question
06/27/20 3:50 PM CDT
I do sometimes, yeah, when I go out with my friends.
How often do you drink alcohol
Question
06/27/20 3:50 PM CDT
No more than once or twice a week, sometimes less.
How much do you drink when you go out
Question
06/27/20 3:50 PM CDT
Just a few. I’m not a big drinker.
How do you feel overall
Question
06/27/20 3:51 PM CDT
I’m feeling fine right now, but I wanted to make sure there’s nothing serious going on with my heart.
Do you have any other symptoms
Question
06/27/20 3:51 PM CDT
I guess when it happens I feel a bit worried, like anxious, but that’s all.
Do you experience any fatigue
Question
06/27/20 3:51 PM CDT
Yeah, most days I feel pretty exhausted by the end of the day.
Do you have any nausea vomiting
Question
06/27/20 3:51 PM CDT
I haven’t had thrown up, or even had an upset stomach, in a long time.
Have you noticed any swelling in your legs
Question
06/27/20 3:52 PM CDT
No, not that I have noticed.
Do you have a family history of heart problems
Question
06/27/20 3:52 PM CDT
Um, none that I know of. Wait, my Poppa–that’s Mom’s dad–died of a heart attack.
Do you have a family history of heart disease
Question
06/27/20 3:52 PM CDT
Um, none that I know of. Wait, my Poppa–that’s Mom’s dad–died of a heart attack.
Any family history of high cholesterol
Question
06/27/20 3:53 PM CDT
Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.
Family history of obesity
Question
06/27/20 3:53 PM CDT
No, I don’t think so. My brother and my dad are kind of big, but I wouldn’t say they were obese or anything.
Family history of a stroke
Question
06/27/20 3:53 PM CDT
Yeah, that’s how my Nana died.
Any family history of hypertension
Question
06/27/20 3:53 PM CDT
We’ve got high blood pressure in our family for sure. Granny, Mom, and Dad had it…and honestly I think my other three grandparents might’ve had issues with that, too.
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs
Educate
06/27/20 3:55 PM CDT
Alright, thanks for letting me know.
I am going to examine you now
Question
06/27/20 3:56 PM CDT
Alright.
Inspected anterior chest wall
Exam Action
06/27/20 3:56 PM CDT
Inspected right side chest wall
Exam Action
06/27/20 3:56 PM CDT
Inspected anterior chest wall
Exam Action
06/27/20 3:56 PM CDT
Inspected left side chest wall
Exam Action
06/27/20 3:56 PM CDT
Inspected anterior chest wall
Exam Action
06/27/20 3:56 PM CDT
Inspected for jugular venous distention: JVP 1 cm above sternal angle
Exam Action
06/27/20 3:56 PM CDT
Inspected fingernails of right hand
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06/27/20 3:57 PM CDT
Checked capillary refill in fingernails
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06/27/20 3:57 PM CDT
Checked capillary refill in fingernails
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06/27/20 3:57 PM CDT
Checked capillary refill in fingernails
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06/27/20 3:57 PM CDT
Checked capillary refill in fingernails
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06/27/20 3:57 PM CDT
Inspected fingernails of left hand
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06/27/20 3:57 PM CDT
Checked capillary refill in fingernails
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06/27/20 3:58 PM CDT
Checked capillary refill in fingernails
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06/27/20 3:58 PM CDT
Checked capillary refill in fingernails
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06/27/20 3:58 PM CDT
Checked capillary refill in fingernails
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06/27/20 3:58 PM CDT
Inspected fingernails of right hand
Exam Action
06/27/20 3:58 PM CDT
Inspected legs
Exam Action
06/27/20 3:59 PM CDT
Inspected right leg
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06/27/20 3:59 PM CDT
Inspected legs
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06/27/20 3:59 PM CDT
Inspected left leg
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06/27/20 3:59 PM CDT
Inspected legs
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06/27/20 3:59 PM CDT
Inspected right leg for edema: No edema
Exam Action
06/27/20 3:59 PM CDT
Inspected toenails
Exam Action
06/27/20 3:59 PM CDT
Checked capillary refill in toenails
Exam Action
06/27/20 3:59 PM CDT
Checked capillary refill in toenails
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06/27/20 3:59 PM CDT
Checked capillary refill in toenails
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06/27/20 4:00 PM CDT
Checked capillary refill in toenails
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06/27/20 4:00 PM CDT
Checked capillary refill in toenails
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06/27/20 4:00 PM CDT
Checked capillary refill in toenails
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06/27/20 4:00 PM CDT
Checked capillary refill in toenails
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06/27/20 4:00 PM CDT
Checked capillary refill in toenails
Exam Action
06/27/20 4:00 PM CDT
Checked capillary refill in toenails
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06/27/20 4:00 PM CDT
Checked capillary refill in toenails
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06/27/20 4:00 PM CDT
Inspected legs
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06/27/20 4:00 PM CDT
Inspected left leg for edema: No edema
Exam Action
06/27/20 4:00 PM CDT
Palpated temporal arteries: No thrill on either side, 2+ on both sides
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06/27/20 4:02 PM CDT
Palpated temporal arteries: No thrill on either side, 2+ on both sides
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06/27/20 4:03 PM CDT
Palpated right carotid pulse: No thrill, 2+
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06/27/20 4:03 PM CDT
Palpated left carotid pulse: No thrill, 2+
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06/27/20 4:03 PM CDT
Palpated chest at PMI: Present at midclavicular line and 5th intercostal space, brisk and tapping, diameter 2 cm
Exam Action
06/27/20 4:04 PM CDT
Palpated right radial pulse: No thrill, 2+
Exam Action
06/27/20 4:05 PM CDT
Palpated left radial pulse: No thrill, 2+
Exam Action
06/27/20 4:05 PM CDT
Palpated right brachial pulse: No thrill, 2+
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06/27/20 4:05 PM CDT
Palpated left brachial pulse: No thrill, 2+
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06/27/20 4:05 PM CDT
Palpated right femoral pulse: No thrill, 2+
Exam Action
06/27/20 4:06 PM CDT
Palpated left femoral pulse: No thrill, 2+
Exam Action
06/27/20 4:06 PM CDT
Palpated right popliteal pulse: No thrill, 2+
Exam Action
06/27/20 4:06 PM CDT
Palpated left popliteal pulse: No thrill, 2+
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06/27/20 4:06 PM CDT
Palpated right tibial pulse: No thrill, 2+
Exam Action
06/27/20 4:07 PM CDT
Palpated left tibial pulse: No thrill, 2+
Exam Action
06/27/20 4:07 PM CDT
Palpated right dorsalis pedis pulse: No thrill, 2+
Exam Action
06/27/20 4:07 PM CDT
Palpated left dorsalis pedis pulse: No thrill, 2+
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06/27/20 4:07 PM CDT
Auscultated right temporal pulse
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06/27/20 4:08 PM CDT
Auscultated left temporal pulse
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06/27/20 4:08 PM CDT
Auscultated right temporal pulse
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06/27/20 4:08 PM CDT
Auscultated right carotid pulse
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06/27/20 4:12 PM CDT
Auscultated left carotid pulse
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06/27/20 4:12 PM CDT
Auscultated right carotid pulse
Exam Action
06/27/20 4:12 PM CDT
Auscultated breath sounds in posterior left upper lobe
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06/27/20 4:13 PM CDT
Auscultated right temporal pulse
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06/27/20 4:13 PM CDT
Auscultated breath sounds in anterior left upper lobe
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06/27/20 4:13 PM CDT
Auscultated breath sounds in anterior right upper lobe
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06/27/20 4:13 PM CDT
Auscultated breath sounds in anterior right middle lobe
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06/27/20 4:13 PM CDT
Auscultated breath sounds in anterior left mid-chest (upper lobe)
Exam Action
06/27/20 4:13 PM CDT
Auscultated breath sounds in anterior right lower lobe
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06/27/20 4:13 PM CDT
Auscultated breath sounds in anterior left lower lobe
Exam Action
06/27/20 4:14 PM CDT
Auscultated breath sounds in posterior left lower lobe on side
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06/27/20 4:14 PM CDT
Auscultated breath sounds in posterior left lower lobe near spine
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06/27/20 4:14 PM CDT
Auscultated breath sounds in posterior right lower lobe near spine
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06/27/20 4:14 PM CDT
Auscultated breath sounds in posterior right lower lobe on side
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06/27/20 4:14 PM CDT
Auscultated breath sounds in posterior right lower lobe
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06/27/20 4:14 PM CDT
Auscultated aortic area with the bell
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06/27/20 4:14 PM CDT
Auscultated aortic area with the diaphragm
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06/27/20 4:14 PM CDT
Auscultated pulmonic area with the diaphragm
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06/27/20 4:15 PM CDT
Auscultated Erb’s point with the diaphragm
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06/27/20 4:15 PM CDT
Auscultated tricuspid area with the diaphragm
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06/27/20 4:15 PM CDT
Auscultated mitral area with the diaphragm
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06/27/20 4:15 PM CDT
Auscultated aorta in abdomen
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06/27/20 4:15 PM CDT
Auscultated right renal pulse
Exam Action
06/27/20 4:15 PM CDT
Auscultated left renal pulse
Exam Action
06/27/20 4:15 PM CDT
Auscultated right iliac pulse
Exam Action
06/27/20 4:16 PM CDT
Auscultated left iliac pulse
Exam Action
06/27/20 4:16 PM CDT
Auscultated right femoral pulse
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06/27/20 4:16 PM CDT
Auscultated left femoral pulse
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06/27/20 4:16 PM CDT
Tested ABI: 141/145 = 0.972
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06/27/20 4:16 PM CDT
Performed EKG: Regular sinus rhythm, no ST changes
Exam Action
06/27/20 4:17 PM CDT
Tested ABI: 141/145 = 0.972
Exam Action
06/27/20 4:17 PM CDT
Any family history of high cholesterol
Question
06/27/20 5:40 PM CDT
Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs
Educate
06/27/20 5:40 PM CDT
That makes sense.
Any family history of high cholesterol
Question
06/27/20 5:41 PM CDT
Cholesterol runs high in my family. All four of my grandparents have high cholesterol, and Mom and Dad, too.
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs
Empathize
06/27/20 5:42 PM CDT
Thanks for understanding.
Do you know your family history of high blood pressure is a risk for heart disease
Question
06/27/20 5:45 PM CDT
Yeah, I know.
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs
Educate
06/27/20 5:45 PM CDT
Alright, thanks for letting me know.
A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. keeping your blood pressure low is important to avoid health problems in the future with your health and other organs
Empathize
06/27/20 5:45 PM CDT
Thanks for saying that.