Medical Case Report
Patient ID: 345678
Name: Michael Johnson
Age: 29
Gender: Male
Date of Report: 2024-09-04

Chief Complaint:
The patient reports experiencing sudden episodes of intense chest pain, heart palpitations, shortness of breath, dizziness, and sweating over the past three months. These episodes typically last for about 10-20 minutes and occur without warning, usually once or twice a week. The patient describes a feeling of impending doom during these episodes and fears having a heart attack.

Medical History:
Family History: No known history of heart disease. Mother has generalized anxiety disorder; father has no significant medical history.
Personal Medical History:
Anxiety: Diagnosed at age 25; managed with cognitive behavioral therapy (CBT) and occasional use of benzodiazepines.
Gastroesophageal Reflux Disease (GERD): Diagnosed at age 27; managed with proton pump inhibitors (PPIs) and dietary changes.
Lifestyle Factors: The patient works in a high-stress job as an investment banker, reports occasional use of caffeine and alcohol, and exercises irregularly.
Medications: Lorazepam (0.5 mg as needed for anxiety), Omeprazole (20 mg daily).
Recent Lab and Diagnostic Results:
Electrocardiogram (ECG): Normal sinus rhythm; no signs of ischemia or arrhythmia detected.
Blood Tests: Cardiac enzymes (troponin, CK-MB) within normal limits; thyroid function tests normal.
Holter Monitor (24-hour monitoring): No significant arrhythmias; occasional premature ventricular contractions (PVCs) noted.
Echocardiogram: Normal cardiac structure and function; ejection fraction 60%.
Physical Examination Findings:
Vital Signs: Blood pressure 122/78 mmHg, heart rate 82 bpm, BMI 23.4.
Cardiovascular Exam: Normal heart sounds; no murmurs, gallops, or rubs.
Respiratory Exam: Clear breath sounds; no wheezing or crackles.
