Shadow Health - Anxiety
Chief Complaint
Mr. Larsen is a 48-year-old White man who presented to the ED at 6 AM with a
perceived cardiac complaint; he reports being exhausted, scared and unable to relax
from last night.
History of Present Illness
Hx of HTN, hyperlipidemia, and osteoarthritis, presented in the ED this morning with
complaints of exhaustion, anxiety, terror, and tachycardia which started last night 3 AM.
Patient reports that the worry has been around since he was diagnosed with HTN (a
year ago), but becomes worse last night. He states that he feels like he is choking, his
body is sweating, shivering and he has been unable to control his fear since 3 AM.
He says that he is scared about everything, especially his hypertension; he tried to take
a deep breath several times to feel calm but did not work. He states that he came to the
ED because he thought he was having a heart attack from his hypertension. He says
that the anxiety causes him to skip work, prevents social interaction and that it affects
his concentration and sleeping patterns. He denies any chest pain, fever, mood
changes, or suicidal thoughts BrainRead More
Allergies
Codeine
Past Medical History
HTN since age 47
Osteoarthritis since age 46
Hyperlipidemia since age 45
Past Surgical History
Total knee replacement at age 48.
Medication History
Atorvastatin 20 mg P.O. daily for high cholesterol. Last dose: yesterday
Lisinopril 10 mg P.O. daily for hypertension. Last dose: yesterday
Fish oil 1 tab daily for high cholesterol. Last dose: yesterday
Family History
Mother, living, high cholesterol
Father died of lung cancer, had HTN, deceased age 50
No known family history of mental illness
Social History
Employment: Currently employed as a postal clerk.
Marital Status: Single, has no children, living alone.
Tobacco: He denies past or present tobacco use.
Alcohol/Illicit Drug Use: He drinks a beer or two on the weekend, he denies any illicit
drug use.
Review of Relevant Systems
GENERAL: Fatigue, and diaphoresis. Negative for fever, night sweats, or purposeful
changes in weight.
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