So next patient is tracy gibbons 803749 49 year old lady investigations urea 10.2 creatinine 82 sodium and potassium normal lfts normal troponins 14 and 8 d dimer naught 0.2 white cells 11.7 with lymphocytes 5.8 recent mri cardiac myocardial viability study demonstrating signal in the anterior and septal regions throughout suggestive of myocardial edema no evidence of lv infarction normal lv volumes left bundle branch block invasive cardiac catheterization may 2025 ejection fraction 33% unobstructed coronaries ct pulmonary angiogram may 2025 05/23/2025 to be exact small volume pulmonary emboli bilaterally in the segmental arteries e g medial and posterior segmental left lower lobe arteries yeah of course it's the 1 I think jess spoke to you about oh yes for sure we don't with the pe guy yes yeah we he's got a pe I don't think it'll change anything will it the bloods and they've just found apparently they just found out that he's okay fine so his prostate is felt abnormal apparently okay we can have a look can't we but but I haven't seen the result about the scan pe positive non stifle changes enlarged prostate so I don't know what they've said at clinic but apparently his prostate felt bad bone metastases he hasn't got any metastases but they think his prostate looks feels malignant and it looks enlarged on the needs an mri of his pelvis probably a biopsy to really tell yeah but obviously that's the urologist basically he's just here for blood thinner medications exactly for anticoagulation yeah yeah I don't know why right could they not have done that incident absolutely no idea yeah but that's what we do he literally just been to the clinic is that why we've got all his notes and stuff so I'm guessing so invisible denature in there this was fourteenth of the saddle disease yeah so you didn't have prescribers aren't you yeah they said something didn't they hematuria clinic large smooth prostate no sensitive features okay medical aesthetic fine stay on penastatin twok 3 months so they don't think it feels malignant that's good isn't it mhmm fine so we'll just treat his pe that's literally all in check for and they've left their clinic list in there just the notes com comment comment that's just his note his list so I can pop him back in the waiting area yeah pop him back in the waiting area thanks so much cheers take care all of that stuff about the ecg is a different patient observations restricted to 16 suctions oxygen saturation 96% on air blood pressure a 125 every 7 pulse a 100 per minute temperature 36.8 ecg stable 1 mm elevation borderline left bundle branch block no dynamic changes echocardiogram may 26 severely dilated lv with eccentric lvh severely impaired systolic function ejection fraction 33% mild ar dilated la borderline ra dilatation normal rv no mobile echogenic material tracy gibbons please tracy gibbons tracy gibbons medical history hepatitis c without cirrhosis iv drug use yeah pulmonary embolism 2025 recent admission in from may late may to early june 20 25 treated for bilateral small volume pulmonary emboli infectious aspiration of cpd and possible myocarditis past medical history previous dvt. Do you plan for follow-up mri in 3 months