Sent 02/23/2026 12:10:21, Page - 13

FRASER HEALTH AUTHORITY Emerg Nete
Royal Columbian Hospital HOLAND,MARK THOMAS
ROO161840/25
Temperature 36.5 C 19/05/2025 08:25
Temperature Source | oral 19/05/2025 08:25
Pulse Rate 59L 19/05/2025 08:25
[ Respiratory Rate 16 19/05/2025 08:25
Blood Pressure 125/74 19/05/2025 08:25
Blood Pressure Mean | 91 19/05/2025 08:25
Pulse Oximetry 95 19/05/2025 08:25
Documentation
HPI:

Mark is a 46yo male who presents to the RCH ED for a 2-week history of presyncope and
hypotension, and a 2-day history of chest and epigastric pain. In March 2022, he had a massive
Upper GT bleed due to a duodenal ulcer believed to be secondary to NSAID use, requiring IR guided
embolization.

He has had dizzy speils at least once daily for the last 2 weeks, where he has palpitations and feels
lightheaded upon exertion or with transferring from sitting to standing. His symptoms are relieved
with sitting down and taking a few sips of water. He measures his blood pressures which have been
as low as 98/58. He completed a 24-hour Holter monitor last week, which returned normal. He
endorses that his baseline blond pressure is around 110/70 and his baseline heart rate is 50-60bpm.

His chest and epigastric pain started 2 days ago. Ha describes intermittent warn, sharp pain to the
lower left chest. It Is worse after eating, especially spicy foods, and relleved by sitting up. He denles
any squeezing, tightness, or radiation. He denies any frequent NSAID use, but endorses that he was
on a migraine medication from Mexico for 1 month which had both aspirin as one of the ingredients.
He discontinued this medication 1 week ago. He has minimal alcohol intake, endorsing 1 beer per
week, He denies any recent illness, dyspnea, fever, nausea, vomiting, abdominal pain, ciarrhea or
constipation.

Past medical history:

Chroni¢ spontaneous urticaria
Migraines

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Moditech Report iD: 1905-00211 Zota

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