From a cardiovascular standpoint, he has no known history of hypertension, coronary artery disease, or arrhythmias. Clinical examination is unremarkable, but I think, it will be reasonable to proceed with an echocardiographic evaluation. He has not seen a pulmonologist, and since he has symptom of dyspnea, I think it will be reasonable for him to see a pulmonary specialist. Today, the blood pressure is high, but at home, she maintains a perfect blood pressure. So, I am not going to react to this reading. From a cardiovascular standpoint, she has no new symptoms. History of hypothyroidism, being treated with thyroid supplement. Also, I have reviewed her labs, which are unremarkable. Cardiac wise, no issues. History of CABG, stable, being treated appropriately. The reason is not very clear to me, but even without Cardizem, his blood pressure is 108/70 and his heart rate of 64 beats/min. So probably, he can be managed without any beta-block...
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