Shadow Health - Anxiety
Chief Complaint ans: Mr. Larsen is a 48-year-old White man who presented to the ED at 6 AM with a
perceived cardiac complaint; he reports being exhausted, scared and unable to relax from last night.
History of Present Illness ans: Hx of HTN, hyperlipidemia, and osteoarthritis, presented in the ED this
morning with complaints of exhaustion, anxiety, terror, and tachycardia which started last night 3 AM.
Patient reports that the worry has been around since he was diagnosed with HTN (a year ago), but
becomes worse last night. He states that he feels like he is choking, his body is sweating, shivering and
he has been unable to control his fear since 3 AM.
He says that he is scared about everything, especially his hypertension; he tried to take a deep breath
several times to feel calm but did not work. He states that he came to the ED because he thought he was
having a heart attack from his hypertension. He says that the anxiety causes him to skip work, prevents
social interaction and that it affects his concentration and sleeping patterns. He denies any chest pain,
fever, mood changes, or suicidal thoughts.
Allergies ans: Codeine
Past Medical History ans: HTN since age 47
Osteoarthritis since age 46
Hyperlipidemia since age 45
Past Surgical History ans: Total knee replacement at age 48.
Medication History ans: Atorvastatin 20 mg P.O. daily for high cholesterol. Last dose: yesterday
Lisinopril 10 mg P.O. daily for hypertension. Last dose: yesterday
Fish oil 1 tab daily for high cholesterol. Last dose: yesterday
Family History ans: Mother, living, high cholesterol
Father died of lung cancer, had HTN, deceased age 50
No known family history of mental illness
Social History ans: Employment: Currently employed as a postal clerk.
Marital Status: Single, has no children, living alone.
Tobacco: He denies past or present tobacco use.
Alcohol/Illicit Drug Use: He drinks a beer or two on the weekend, he denies any illicit drug use.
Review of Relevant Systems ans: GENERAL: Fatigue, and diaphoresis. Negative for fever, night sweats, or
purposeful changes in weight.
RESPIRATORY: Shortness of breath.
CARDIOVASCULAR: Palpitations. Negative for chest pain, or edema.
NEUROLOGICAL: Reports weakness. Negative for fainting, numbness/tingling, dizziness, frequent
headaches, falls, or changes in coordination or memory.
PSYCHOLOGICAL: Anxiety, changes in concentration, and sleeping pattern. Denies depression, suicidal
thoughts
Chief Complaint ans: Mr. Larsen is a 48-year-old White man who presented to the ED at 6 AM with a
perceived cardiac complaint; he reports being exhausted, scared and unable to relax from last night.
History of Present Illness ans: Hx of HTN, hyperlipidemia, and osteoarthritis, presented in the ED this
morning with complaints of exhaustion, anxiety, terror, and tachycardia which started last night 3 AM.
Patient reports that the worry has been around since he was diagnosed with HTN (a year ago), but
becomes worse last night. He states that he feels like he is choking, his body is sweating, shivering and
he has been unable to control his fear since 3 AM.
He says that he is scared about everything, especially his hypertension; he tried to take a deep breath
several times to feel calm but did not work. He states that he came to the ED because he thought he was
having a heart attack from his hypertension. He says that the anxiety causes him to skip work, prevents
social interaction and that it affects his concentration and sleeping patterns. He denies any chest pain,
fever, mood changes, or suicidal thoughts.
Allergies ans: Codeine
Past Medical History ans: HTN since age 47
Osteoarthritis since age 46
Hyperlipidemia since age 45
Past Surgical History ans: Total knee replacement at age 48.
Medication History ans: Atorvastatin 20 mg P.O. daily for high cholesterol. Last dose: yesterday
Lisinopril 10 mg P.O. daily for hypertension. Last dose: yesterday
Fish oil 1 tab daily for high cholesterol. Last dose: yesterday
Family History ans: Mother, living, high cholesterol
Father died of lung cancer, had HTN, deceased age 50
No known family history of mental illness
Social History ans: Employment: Currently employed as a postal clerk.
Marital Status: Single, has no children, living alone.
Tobacco: He denies past or present tobacco use.
Alcohol/Illicit Drug Use: He drinks a beer or two on the weekend, he denies any illicit drug use.
Review of Relevant Systems ans: GENERAL: Fatigue, and diaphoresis. Negative for fever, night sweats, or
purposeful changes in weight.
RESPIRATORY: Shortness of breath.
CARDIOVASCULAR: Palpitations. Negative for chest pain, or edema.
NEUROLOGICAL: Reports weakness. Negative for fainting, numbness/tingling, dizziness, frequent
headaches, falls, or changes in coordination or memory.
PSYCHOLOGICAL: Anxiety, changes in concentration, and sleeping pattern. Denies depression, suicidal
thoughts
