Blue letter
p.s. Dear Medical colleagues,

Thank you for seeing this 24/C/M
Past history of Mobitz I second degree heart block
Now p/w recurrent episodes of fatigue, fatigue and fatigue.
Will appreciate your kind input and further F/U — KIV start barbiturate coma x 3/52
Thank you!

Dear Surgical colleagues,

Thank you for your referral.

24 yo / Ch / Male
PMH: Mobitz I 2′ degreen heartblock. No IHD/DM/CVA
Now c/o:
1. Recurrent fatigue
No CP/palpitations / decreased effort tolerance/swelling of LL/ orthopnoea / PND.
No rashes/ bone pain / fever / LOA / LOW. No dysuria/abdo pain/diarrhoea.

PE: unremarkable except for crabby mood.

Imp:
- work exhaustion tro cardiac event
- diff dx: depression with ?suicidal ideation, kiv refer psy.

Plan:
- bloods: FBC, RP#1, CRP, Ca panel, Mg, phosphate, ACS + ECG x3
- kiv septic work up if TW, CRP elevated
- kiv refer psy cm.

Please update us when results are back. We are NOT for medical takeover.

Thank you.

Dopey (15/5/07)