Patient’s Data​

Patient’s name: Arun Sharma

Age: 73-year-old male

Past medical history

• Hypertension
• High cholesterol

Drug and Allergy History 

• Amlodipine 10 mg once daily
• Ramipril 10 mg once daily
• Bisoprolol 1.25 mg once daily
• Atorvastatin 20 mg once daily
• No Known Drug Allergy 

Recent Notes/ Consultation

A&E Discharge Summary 4 weeks ago:

Mr Arun Sharma presented to the Emergency Department with complaints of recurrent palpitations over the past week. 

On examination, he was haemodynamically stable. Cardiovascular examination revealed normal heart sounds with no audible murmurs. Initial investigations including 12-lead ECG, blood tests, and bedside echocardiography were unremarkable.

During a period of cardiac monitoring in the department, the patient had brief runs of sinus tachycardia (heart rate reaching 110–115 bpm) temporally associated with the sensation of palpitations. These were self-limiting, with no associated haemodynamic compromise.

In view of symptomatic palpitations correlating with benign rhythm disturbances, and no evidence of structural heart disease, he was started on bisoprolol 1.25 mg once daily for symptom control.

A referral has been made to the cardiology outpatient clinic for further evaluation.

Seen and discharged by:
Dr Luke Palmer, MBBS, FRCEM
Emergency Medicine ST6 Registrar

Cardiology Clinic Letter 3 weeks ago

To: GP Practice
Re: Mr Arun Sharma (Age: 73 years old)

Dear Colleague,

I am writing regarding Mr Arun Sharma, who was reviewed in the cardiology clinic following his recent presentation with palpitations. He reported no associated symptoms such as chest pain, syncope, or breathlessness, and confirmed that his symptoms had fully resolved by the time of the appointment.

As part of his assessment, he underwent a 7-day Holter monitor and a transthoracic echocardiogram. Both were entirely normal, with no evidence of arrhythmia or structural heart disease.

Considering his benign clinical picture and the absence of any concerning findings, no further cardiology follow-up is required. He had been started on bisoprolol 1.25 mg once daily in A&E for symptomatic palpitations, and this may be continued at your discretion if he remains well and tolerates it.

He has now been discharged back to your care. Please feel free to contact me if further information is needed.

Kind regards,
Dr Kelechi Peters MBBS, MRCP (UK)
Consultant Cardiologist

Seen 2 days ago by Evelyn Walter (Practice Nurse)

Mr Arun Sharma attended the surgery for his routine influenza vaccination. Blood pressure was recorded as 100/60 mmHg.

The vaccine was administered without issue, and the patient tolerated the procedure well. 

Patient booked urgent telephone consultation to discuss some concerns