the patient i saw today was misses palmer she reported chest pain had complaints about pre syncope space the final frontier these are the voyages of the starship enterprise its five year mission to explore strange new worlds to seek out new life and new civilizations to bodly go where no one has gone before could not tolerate physical activity had palpitations was short of breath upon review of systems she had palpitations wheezing dyspnea orthopnea and lower extremity edema  misses palmer is currently taking lisinopril and prednisone her blood pressure was one hundred and fifty she had a heart rate of one hundred and thirty beats per minute she claimed she was fatigued and had weight gain upon inspection i observed no carotid bruit jvd present pmi normal inspection she had pedal edema in lower extremities her calf was non tender murmur present rales and no chest wall tenderness looking at the diagnostic labs misses palmer did not elevated bnp ekg xray ap chest 2d echo sinus rhythm she had pulmonary edema and increased wall thickness all findings indicate sarcoidosis restrictive cardiomyopathy with a she will be on dvt prophylaxis i will consult the cardiologist and hospitalist she will be put on furosemide aspirin to manage heart congestion and nasal cannula to manage respiratory rate
