<p>Cher Philippe</p>
<p>Je te remercie de m'avoir adress&eacute; pour avis M. CRESTEY Andr&eacute; Jean, n&eacute; le 14/05/1942.</p>
<p>Ce monsieur mari&eacute; a 4 enfants.Il a fum&eacute; jusqu'&agrave; l'age de 50 ans et totalise en viron 20PA.</p>
<p>Il est militaire &agrave; la retraite.</p>
<p>Dans ses ant&eacute;c&egrave;dents il a &eacute;t&eacute; op&eacute;r&eacute; de&nbsp; d'une hernie inguinale droite et gauche,du menisque droit, et pose de 2 stents.</p>
<p>Il est trait&eacute; pour hernie hiatale avec RGO,migraine,hyperuric&eacute;mie,discopathie lombaire et HBP.</p>
<p>HDM:ATL et stent IVA II en 2001.Recidive en mars 2017 .coronarographie avec stent.</p>
<p>Ce patient dit pr&eacute;senter des ronflements nocturnes avec 1 nyctiurie.Son score d'Epworth est de 11/24 avec un score de Mallampati est de 3/4.Le perim&egrave;tre cervical est de 40 cm avec un perim&egrave;tre abdominal de 101 cm.</p>
<p>L'auscultation plmonaire est dans les limites de la normale.</p>
<p>Son agenda de sommeil retrouve un r&eacute;veil nocturne toutes les nuits avec une quasi quotidienne.</p>
<p>Sa polygraphie ventilatoire en date du 15/11/2017 a retrouv&eacute; un IAH &agrave; 34/H. cet index passe &agrave; 61/H avec les dilinutions(&eacute;v&egrave;nements).Il est de 85/H en position dorsale.</p>
<p>On retrouve 100 ronflements/H avec une energie moyenne de 84db.Il existe 32 d&eacute;satutrations/H avec un NADIR de 86%. Le patient passe 2% de son temps de sommeil endessous de 90% de saturation.</p>
<p>Nous l'appareillons en PPC entre 5 et 15 cm d'eau.</p>
<p>Avec mes remerciements, veuillez agr&eacute;er, cher Confr&egrave;re, l'assurance de mes sentiments distingu&eacute;s,</p>
<p>Dr. B. 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