Murmur- New Consult

Dear Dr. 

SURGICAL AND INTERVENTIONAL HISTORY: 
None.

NON CARDIAC COMORBIDITIES:
None.
MEDICATIONS: Alex is currently taking a 40mg medication for attention and focus concerns.
ALLERGIES:
None.
KNOWN IMMUNIZATIONS:

CURRENT CLINICAL STATUS:
Thank you for referring Alex for assessment of attention and focus concerns. Alex was seen in clinic today on 2026-02-06. He reports improved focus with his current medication, especially in science, but continues to have difficulty focusing in math, which he finds boring. He enjoys physical education and basketball, and reports increased confidence during sports. His parents have noted increased fatigue and difficulty falling asleep despite going to bed by 9:30 PM. Appetite is decreased, with minimal intake in the morning and incomplete lunches. These symptoms are discussed as potential side effects of his current medication.

PHYSICAL EXAMINATION: 
Alex's height is in the 85th percentile and his weight is average for his age.

IMPRESSION AND PLAN: 
Alex has attention-deficit hyperactivity disorder, predominantly inattentive type, with medication side effects including insomnia and decreased appetite. The plan is to continue his current medication regimen at 40mg, monitor sleep patterns, appetite, and school performance, encourage use of a visual checklist for morning routines, advise limiting sugary drinks and consider switching to no-sugar sparkling water, and reassess in the summer for follow-up.