BP 148/92. ↑ Ozempic 0.5 → 1.0 mg weekly. Referred cardiology for SOBOE × 2 wks. Atorvastatin 20 mg. Foot exam deferred.
Symptoms improved; impression non-cardiac CP/ SOBOE. ECG sinus; echo LVEF ~55%. ↑ Atorvastatin 20 → 40 mg for LDL. Continue GLP-1. Arranging stress test; will follow up with patient after.
| Mar 2026 | Dec 2025 | Jul 2025 | |
|---|---|---|---|
| A1c % | 7.8 | 8.1 | 8.2 |
| eGFR | 72 | 74 | 76 |
| UACR mg/mmol | 3.8 | 4.2 | 4.6 |
| LDL mmol/L | 2.4 | 2.6 | 2.7 |
- Ozempic tolerance at 1.0 mg?
- Confirm atorvastatin 40 started; await cardio f/u after stress test
- Foot exam still due
S: DM follow-up. Tolerating Ozempic 0.5 mg. New SOBOE × ~2 weeks (stairs/hills); no chest pain/syncope. Home sugars improved. Foot exam deferred (time).
O: BP 148/92 (home avg ~142/88). HR 78. No edema. Lungs clear. On atorvastatin 20 mg .
A: T2DM — intensify GLP-1. HTN above target. SOBOE — refer cardiology.
P: ↑ Ozempic 0.5 → 1.0 mg weekly . Continue ramipril / atorvastatin 20 mg. Cardiology referral for SOBOE × 2 wks . Labs today; foot exam next visit. RTC ~3 mo.
Dr. Heart, MD, FRCPC
Cardiology
Dear Dr. Green,
Thank you for referring Ms. Mei Chen for assessment of shortness of breath on exertion.
HPI: Referred Mar 13 for SOBOE × 2 weeks with associated atypical chest discomfort. Symptoms have improved ; now mainly with stairs. No syncope or palpitations.
PMHx: T2DM; hypertension; dyslipidemia. No known CAD.
Meds: Metformin 1000 mg BID; Ozempic 1.0 mg weekly; ramipril 5 mg daily; atorvastatin 20 mg nightly.
Investigations: ECG sinus rhythm . Echo LVEF ~55% , no significant valve disease. Fasting lipids today: LDL 3.1 , HDL 1.1, TG 1.8, TC 5.2.
Impression: Non-cardiac chest pain / exertional dyspnea. Low suspicion for acute coronary syndrome today.
Plan: Increase atorvastatin 20 → 40 mg given LDL. Continue GLP-1. I am arranging an exercise stress test and will follow up with the patient afterwards .
Sincerely,
Dr. Heart

