The daughter called the ambulance because the patient is becoming more fatigued and short of breath each day. Three weeks ago the patient had cardiac surgery that included CABG of three vessels and an aortic valve replacement with a porcine valve. At the current time she is asymptomatic, found sitting in a wheelchair in the living room of the house. The patient is a well developed well nurished 82 year old woman who is alert to person place and time. She feels fine while sitting still but says she becomes very short of breath when she tries to do anything at all.
Lungs sound clear to auscultation bilaterally.
12 Lead unremarkable save for the irregular slow rate. Her bowel and bladder habits are unchanged and is negative for melena. She has been eating and drinking normally.