Cardiology Telephone Consult

Telephone consult Time: 18:42-19:42

Dear Dr. Alex Carter,  
Margaret was seen virtually for follow-up of her hypertension management.  

Diagnosis:  
1. Hypertension: Margaret has a history of hypertension, managed with prescribed medications. A hypertensive response was noted during a cardiac CT, but no significant coronary artery disease was identified. There is no evidence of hyperaldosteronism or small vessel disease. She has not reported significant challenges with diuretic therapy.  
2. Frailty: Margaret exhibits signs of frailty, including reduced muscle tone and physical activity levels, which may impact her overall health and ability to manage her condition.  

Medications:  
Margaret is managing her hypertension with prescribed medications, which she appears to be taking regularly based on pharmacy records.  

Investigations:  
Cardiac CT: No significant coronary artery disease was identified. A hypertensive response was noted during the test.  

Impression and Plan:  
Margaret's condition appears stable, with no new or worsening cardiovascular symptoms reported. However, her physical activity and muscle tone are suboptimal, and she has expressed challenges in accessing in-person care.  

Hypertension: Margaret will be referred to Dr. Alex Carter for further evaluation and management of hypertension, including potential secondary hypertension workup. Her medication adherence and effectiveness will be monitored through pharmacy records and follow-up consultations.  

Frailty: It was discussed with Margaret that engaging in strengthening exercises could improve her muscle tone and physical activity levels. A referral to Jamie Bennett, a physiotherapist, will be made for a tailored exercise program.  

Access to Care: Alternative care settings will be explored, including potential use of hospital facilities or other community resources, to facilitate in-person visits. Coordination with Dr. Alex Carter and Jamie Bennett will be arranged to provide care in settings that are more accessible to Margaret.  

I recommend proceeding with the outlined plan and will remain available for further collaboration as needed.  

2025-07-13, Dr. Riley Morgan  
Regional Medical Center