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Yjor>3 |
Worn (ne
ood
Mic Reecharyannnl. ne vfo Pmate an chee
od
ceeypaten Asin’ Reuvendemalds , cama PF?
Complams of
| > Bacathlecmecs Ar par! yer
> Palprtattons Rx part 1yeor
| dariatio 7 Juseet,
— Cough wrin os. 4 hr pe
j
| Bey oP a line cs he
Au,
Th ae
atrent was Creeecd normal bere lgeo (
whrch she devetoped a ie » which wor
Pasrclrous Mo oncet, > ig oa Mm nectar.
Srarall rade IT \wae, whah ther 9
Prwesed to grade i. :
| r Ke, Aes preuated on wating ph fa"
. | exert0> and veo ay ng
i Ho patprettons pretent B peut ier
| oggmueed Barley phgstco! actvriter, telrewedd: Yy
i Fetting aes
to Hay of cap ecteatin Ae i Jucsest
i
| ee fe Stonty Mm Amounts whrle fr coleur,
|
u Pong nok Rul oxy not blood store!
|
No poreeal vartatia
or |
wo No
Ceuaghrr awh bleu
ie i no blo f
Scanned with CamScannera: Ne hye erene pee
Faw ‘ea
dledenson months
yemal nodurnal clyapres
Relneb pao
No hJo chest pam
NO Wo syncope
nen Yo a oP lege
No ho aAbdommal — clrclensur
fe) Ne. right hypo chendrral per
SNe h/o Pactat — pub Pec
No bo clecreared Come outpul=
No W/o ce ene enna eet § pomp
We Yo staritbecann ~ lors oP wenn
me bo loss op ape
NP We vore change, etrktrastiy ee)
No be :
Patten had bo swelling oP lege _ abedommal
Bs whch she tues
Adeattted. my GrymMen, Plure}
done
teppmy cee
She was relred fe MMC rehae che wes
cleposed to have CardPac cdPteare Be ushrelh
She war ‘Freated wrtn med? catrons
Quuma her Pollaocip en MMC A modtne
age she © was dite te have a beat
aed pbat che wae cleelared uote 5
opted out oP me
Scanned with CamScannera _ i aoe PT
mmelleat
Nik]cJo Drabels
CAD
Nenshuat te mearitel h/o
she wa gravede per
Ine
Rerenal to
Potten! consumer rrxecl clret
Abt an aloha Lémoker
@ bowel ¢ bladder aber
Yo sleep lech bances preset
amy He
F No a de Paeig blo
“Treatment to
Che und geng treatmend
On‘ disconthuattor OP meclrcatron®
leustope acral — pasteness, orthopnea
Sammeny
A 45 gh Remade presente
oe hreceth ess 2 ees ’ xis tetra any
peer wrin pt
cabdemmel clntenern Or spne
hfe yivell
Qf, cordeact clea
che
d wth Complamt
d feegh with
mg of legs \
Scanned with CamScannerTRe fem myeled ft cselrovarcnlor ryttens
Foner!
é
Xm
NP reterne
ey a nerne
Preetel ee
laraphercle mopettng
i aoe
NS moartere oP Congeni-ted heornalncsse
TE. Cro. er
Vrtab-
Pulte rat: 61 beats mm .
Thor © YWermel a volume, 0° grote cherorker
Conder oP verve! wall OD.
Fett ms all pepe al
NO Radlro~ red ral elegy,
ulcer.
redw— Bmore) ley
Resprreateyy) reste 2 Jp bentithe rom
Tho racoakdere re) “yr
Be:
m , ' on
eattuy c PO JeAt fr" Cire SPH d
fomtren
Teme! peer APeberle
TvP* net i levarteal.
Scanned with CamScanner———————SS
FP xaritnaton of Carelrovatalor Wie Ba
Inc pection
P Trachea m mrdime
Apreal fmpulte not fear
Chest wall eliepitcal ™ shape 1 brlateraliy
Sprrentitial .
| No precorclral bulge
| not-seen
Corted —pulseorons
No chet wall cloRrnr
Ne" ganol, deb rrenl
No scars, emucer, delatee| vems orer Check watl
\ Palpaton !-
Tracheal pan \ confrmed 7 be PA mmedlen
Apreat Prmpalse Alp at oth Tes at
med- Clavicular Ime.
No ararte ana)’ heave
Aso thrill
Aluscultatent -
Beosch Ro loud SI]
Metral area ¢ Si, So
A ow posed wi
oP pet we
rarbling vard- cleads*
manne | Rer~ readied
worth bell A SletMe sey over ak
heard
and breath eld
a
f expereten
Scanned with CamScanner
| pases po deb decteral rGta pearel 29 marmay
ae Clrea:
Arte! area: Shs heard, Me murmur
Palmenany accear Si % heard, Pe loud sno
Murmar
Over System EF xemmenon
A eo
R
o prretto ry System + Bélatera/ wheeze heard
Creprtattone hearcl: py
Pode *
| oe v on beg acca pula 4 mafeaastiteny
Abclomens SoPk. 4
» tenden no ongenemega
ONS: No eal ae clefrcet
Des nosPs
‘A cote of aequtredl valvular heart dreate
myolvmg metral rae ae mrtral clenoste | jmobabiy
dew rte yheumaly etplogy -
Te
Peelren+ Mm senus rhythm wéthout ang syn oP CCF:
anc ahral Ft? lation .
Tove gateon
| Cee cac, Hb, ESR, CRP. Aso the
| ECG, ECHO
Chesh Xoray .
7
Treatment:
Gia ees ee cee
Drovetict.
Scanned with CamScanner