No gallops are heard. Lungs clear with good aeration. Abdomen distended and firm. Severe hepatomegaly is noted. There is a 4 cm strawberry hemangioma over the right flank region.
Pulses are slightly weak.
A nasogastric tube is inserted. The chest portion of the radiograph shows cardiomegaly. Although the central pulmonary vascularity may be slightly prominent, the lungs are largely obscured by the cardiomegaly. The abdomen is distended, and there is a paucity of bowel gas. There is a suggestion of an abdominal mass.