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REVIEW OF SYSTEMS: CARDIOVASCULAR: No chest pain. PULMONARY: Difficulty breathing. GASTROINTESTINAL: No abdominal pain. GENITOURINARY: No dysuria.
CONSTITUTIONAL: Positive fevers. MUSCULOSKELETAL: No joint swelling.
EYES: Positive visual loss. EARS, NOSE, AND THROAT: No sore throat. PSYCHIATRIC: No depression. NEUROLOGIC: No seizures.

PHYSICAL EXAMINATION:
VITAL SIGNS: Temperature 36.9, pulse 84, respirations 22, blood pressure 122/50.
GENERAL: Lovely female who is dyspneic at rest.
HEENT: Normocephalic, atraumatic. Pupils are equal, round and reactive to light. Extraocular motions are intact. Oropharynx is without exudate or erythema. Mucous membranes are moist.
NECK: Supple, nontender. The patient has JVD sitting at 90 degrees.
LUNGS: Have bibasilar crackles.
CARDIOVASCULAR: Irregular systolic, a positive systolic ejection murmur. ABDOMEN: Soft, nontender.
EXTREMITIES: Warm and well perfused. There is some lower extremity edema. NEUROLOGIC: Cranial nerves are nonfocal.