Past medical history
His medical history was significant for cutaneous squamous cell
carcinoma (cSCC) of anterior chest wall skin for which he had undergone
wide local surgical excision many years ago (Figure 1). He had a local
recurrence a few months prior and had undergone surgical removal with
complete left axillary lymph node dissection followed by radiation
therapy to the chest wall and axilla. Additionally, he had long standing
hypertension that was well controlled and had undergone pulmonary vein
isolation for paroxysmal atrial fibrillation 2 years prior to current
symptoms. He had been maintaining sinus rhythm since his ablation but
remained on apixaban.