Chief Complaint: Difficulty breathing, hypertension, tachycardia History of Patient Illness: Patient was brought to the ER by her family because of difficulty breathing and palpitations. Patient reports that she has experienced these symptoms for the past six months, this episode is more severe than any previous. Upon admission to the ER, heart rate was 120 beats per minute and blood pressure was 180/110. The results of an EKG and cardiac enzyme blood tests were normal. She was admitted for a complete workup for tachycardia and hypertension.

Summary of Hospital Course: Patient underwent a full battery of diagnostic tests. A prolapsed mitral valve was observed by echocardiography. A stress test had to be stopped early due to onset of severe difficulty breathing. Angiocardiography failed to demonstrate significant CAD. Blood pressure and tachycardia were controlled with medications. At discharge, HR was 88 beats per minute and blood pressure was 165/98.

Discharge Plans: There was no evidence of a myocardial infarction or significant CAD. Patient was placed on a low-salt and low-cholesterol diet. She received instructions on beginning a carefully graded exercise program. She is to continue her medications. If symptoms are not controlled by these measures, a mitral valve replacement will be considered.