Dept of Cardiology, King’s College Hospital, 14 October 2015
This 87-year-old gentleman was reviewed today in Professor McCarthy’s clinic with a remote history of bypass grafting in 1995 (LIMA to LAD, RIMA to OM, SVG to diagonal and RCA). There was an angiogram in 2014 prior to undergoing vascular intervention which showed that all of his grafts are patent. He underwent left leg angioplasty a few months ago for critical ischaemia of the limb and has previously had an EVAR in 2010. His main ongoing problem at the moment seems to be related to myeloproliferative disease with anaemia and increasing need for transfusion.
This gentleman attended today along with his wife and from a cardiology point of view he is actually asymptomatic with respect to any undue shortness of breath and he does not experience any angina whatsoever.
His exercise tolerance is very much limited by general fatigue secondary to the myeloproliferative disease and he does not describe any features of incipient heart failure,