Case #14: Restless Driver
Author: Michael Gottlieb, MD
Peer Reviewer: Jenny Lu, MD
A 51 year old male truck driver with past medical history of hypertension, diabetes, and hyperlipidemia presents with palpitations and insomnia for the past 2 days. He presented to the local ED while driving cross-country delivering packages. He notes that the palpitations began about two days ago and that the subsequent night, he felt anxious and was unable to sleep. He notes mild nausea, but his review of systems is otherwise negative. He currently takes Nifedipine, HCTZ, Metformin, Glipizide, and Simvastatin. He drinks 2-3 “small” cups of coffee/day, smokes ¼ pack of cigarettes/day, and denies alcohol or illicit drug use. His physical exam is significant only for mild tremors and a tachycardia with regular rhythm. A CBC and BMP were sent from triage, which were within normal limits.
Vitals: Temp: 98.2, HR: 124, RR: 12, BP: 138/86, O2 sat: 98% on RA
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