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Patiënt meldt een afgenomen inspanningstolerantie, lichte bilaterale enkeloedeemvorming en vermoeidheid. Objectief Patiënt is alert en georiënteerd, geen tekenen van acute nood. Licht bilateraal enkeloedeem aanwezig. Longen zijn helder bij auscultatie. Regelmatige hartfrequentie en hartritme. Beoordeling Inspanningsgebonden dyspneu Intermitterend drukkend gevoel op de borst Bilateraal oedeem van de onderste extremiteiten Coronaire hartziekte (CAD) Diabetes mellitus type 2 Hyperlipidemie
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Een 62-jarige man presenteert zich met progressieve inspanningsgebonden kortademigheid en intermitterend drukkend gevoel op de borst sinds drie weken. Patiënt meldt een afgenomen inspanningstolerantie, lichte bilaterale enkeloedeemvorming en vermoeidheid. Objectief Patiënt is alert en georiënteerd, geen tekenen van acute nood. Licht bilateraal enkeloedeem aanwezig. Longen zijn helder bij auscultatie. Regelmatige hartfrequentie en hartritme. Beoordeling Inspanningsgebonden dyspneu Intermitterend drukkend gevoel op de borst Bilateraal oedeem van de onderste extremiteiten Coronaire hartziekte (CAD) Diabetes mellitus type 2 Hyperlipidemie
 Plan ECG en laboratoriumonderzoek aanvragen. Overweeg een thoraxfoto en echocardiografie. Huidige medicatie continueren. Verwijzing naar de cardioloog voor verdere evaluatie. Adviseer beoordeling op de spoedeisende hulp bij verergering van pijn op de borst of kortademigheid.","absoluteBoundingBox":{"x":6073.0,"y":16680.0,"width":305.0,"height":344.0},"isolatedAbsoluteRenderBounds":{"x":6073.11865234375,"y":16682.779296875,"width":301.5361328125,"height":339.349609375},"relativeTransform":[[1.0,0.0,20.0],[0.0,1.0,63.0]],"size":{"x":305.0,"y":344.0},"fills":[{"blendMode":"NORMAL","type":"SOLID","color":{"r":0.0,"g":0.0,"b":0.0,"a":1.0},"visible":true,"opacity":1.0}],"constraintValues":{"left":{"pixelOffset":20.0,"sizeFraction":0.0},"top":{"pixelOffset":63.0,"sizeFraction":0.0}},"strokeAlign":"OUTSIDE","strokes":[],"strokeWeight":0.412667959928513,"accessibleHTMLTag":"AUTO","isDecorativeImage":false,"ariaAttributes":{},"interactions":[],"characterStyleOverrides":[3,3,3,3,3,3,3,3,3,3,3,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,2,3,3,3,3,3,3,3,3,3,3,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,2,4,4,4,4,4,4,4,4,4,4,4,4,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,4,4,4,4,4],"characters":"Subjectief\nEen 62-jarige man presenteert zich met progressieve inspanningsgebonden kortademigheid en intermitterend drukkend gevoel op de borst sinds drie weken. Patiënt meldt een afgenomen inspanningstolerantie, lichte bilaterale enkeloedeemvorming en vermoeidheid. \n\nObjectief\nPatiënt is alert en georiënteerd, geen tekenen van acute nood. Licht bilateraal enkeloedeem aanwezig. Longen zijn helder bij auscultatie. Regelmatige hartfrequentie en hartritme.\n\nBeoordeling\n Inspanningsgebonden dyspneu\n Intermitterend drukkend gevoel op de borst\n Bilateraal oedeem van de onderste extremiteiten\n Coronaire hartziekte (CAD)\n Diabetes mellitus type 2\n Hyperlipidemie
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