Identification of a Progressively Worsening Cardiac Condition in a Patient Seen in a Home Health Care Environment

Abstract

The patient was a 53 year-old woman who was seen by a home health physical therapist following a lumbar spinal fusion revision surgery which was performed 2 weeks prior. In addition to low back pain, the patient had chronic bilateral shoulder, left upper extremity, chest, mid-back, and lower extremity pain and required moderate assistance for transfers, ambulation and activities of daily living with routine complaints of shortness of breath, lightheadedness, and fatigue. Due to concern over a progressively worsening cardiac condition, the physical therapist immediately consulted a cardiologist, who agreed to see the patient the next day. The patient was subsequently diagnosed with severe coronary artery disease and was treated with coronary artery bypass grafting, after which she was independent with all activities of daily living with only minimal complaints of low back pain.