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REVIEW OF SYSTEMS: The patient denies any recent fevers, chills, myalgias, arthralgias, joint pains or swelling. No history of recent upper respiratory infection or respiratory symptomatology. No recent exertional chest pains, PND or orthopnea. He has had rapid heartbeat episodes in the past. He denies any lower gastrointestinal symptoms. He did have 1 episode of vomiting tonight. Some loose stools have been noted. All other review of systems are negative for acute problems.

PHYSICAL EXAMINATION:
GENERAL: Reveals a pleasant woman in no distress.
VITAL SIGNS: Blood pressure is 130/70, heart rate is 70. The patient is afebrile.
HEENT: Head is normocephalic, atraumatic. Mucous membranes are moist.
NECK: There is no jugular venous distension. No carotid bruits appreciated.
CHEST: Clear to auscultation bilaterally.
HEART: Regular rate and rhythm. Normal S1, S2. No S3, no S4, no murmur.
ABDOMEN: Soft, nontender, nondistended, without organomegaly or palpable masses.
EXTREMITIES: Notable for +1 pitting edema to the mid calf bilaterally.
NEUROLOGIC: Nonfocal.
MUSCULOSKELETAL: Without amputation or deformity.
PSYCHIATRIC: Appropriate mood and affect.