FAMILY HEALTH

ORTHOPAEDICS

GENERAL MEDICINE

GYNAECOLOGY - IVF

<p>A 57-year-old female presented on 5 July 2023 with complaints of a sudden episode of tachycardia and bradycardia, accompanied by elevated Serial Troponin-1 levels. Notably, she did not report any chest pain or shortness of breath at the time of presentation. Initially, the patient was managed with a dual antiplatelet therapy and statin treatment regimen. Importantly, she underwent a right Total Knee Replacement procedure on 27 June 2023, and her postoperative recovery was closely monitored. Upon clinical examination, her vital signs were as follows: heart rate (HR) and respiratory rate (RR) within normal limits, a minimum temperature of 98.0&deg;F, BP at 140/90 mmHg, and SpO2 at 98%. Additionally, her GCS score was 15/15. A cardiac examination revealed a subtle splitting of the S2. Respiratory examination yielded unremarkable findings with no added sounds. Abdominal examination showed a soft abdomen with audible bowel sounds. Neurologically, the patient was conscious, alert, and oriented to time, place, and person. During the postoperative phase, she was closely monitored. However, her recovery was complicated by the onset of dysrhythmias, leading to further examination. A decision was taken to opt for Dual Antiplatelet Therapy (DAPT) and statins as part of her management strategy.<br />
To better understand the nature of the arrhythmia, a Holter examination was conducted. However, two days into the evaluation, the patient and her husband refused further treatment and hospital stay despite thoroughly explaining the associated risks and benefits. This decision was made despite being fully apprised of the risks and benefits. Regrettably, the patient removed the Holter patch before its designated recording duration. The potential consequences of leaving the hospital prematurely with treatment termination have been explained to them. Upon discharge, she was prescribed a multiple regimen of medications. They have also been instructed to closely follow up with a cardiologist over the next few months to ensure continued care and monitoring.</p>