Physician's Assistant

Patient Details

Refined clerking (10 days ago 16:10)

Refined clerking Fri 27 March 2026 16:10

Last Modified: 10 days ago

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Content:

Medical ST5 Miller Clerking

Presenting Complaint:
Palpitations

History of Presenting Complaint:
31-year-old man with a background of Brugada syndrome and atrial fibrillation, with previous cryoablation in Exeter. He presented with palpitations დაწყening at 07:00, described as an irregular racing heartbeat. He has had similar episodes previously and is awaiting another ablation. He felt generally well otherwise, with no fevers or other clear triggers. Prior to review he was given 2.5mg IV metoprolol, with no improvement in symptoms. He also took 2.5mg bisoprolol without change.

Past Medical History:
• Brugada syndrome
• Atrial fibrillation
• March 2024: admitted with palpitations and persistent AF, cardioverted with DC cardioversion
• Previous cryoablation in Exeter

Drug History:
• Bisoprolol 2.5mg PO PRN

Investigations:
• TSH: normal
• Bone profile: normal
• Magnesium: normal
• CRP: normal
• Urea: 3.7
• Troponin: 11
• Eosinophils: normal
• ALT: 52
• Albumin: 52
• ALT March 2024: 38
• ECG: AF with rate 115 bpm; ST changes in V2 consistent with Brugada syndrome

Impression:
Atrial fibrillation on a background of Brugada syndrome.

Management Plan:
1. Move to CCU for cardiology review.
2. Continue cardiac monitoring.
3. Discuss with CCU sister, who agreed to accept the patient there.

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Patient Details

Refined clerking Fri 27 March 2026 16:10

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