Mrs. Strichen says that over the course of the last two weeks she noted increased fatigue, more difficulty sleeping and dyspnea on exertion.
Today she says that her abdomen and shoulders hurt, so she sought medical attention. She denies any chest pain, cough, change in bowel habits, jaundice, history of liver disease, vaginal or rectal bleeding.
She lives with her husband and has three healthy children. She has no family history of similar problems; her parents both died of heart disease.