65 year old woman with a five day history of right upper quadrant
abdominal pain associated with nausea and vomiting.
History of the Present Illness:
The patient had a history of congestive heart failure, hypertension,
myocardial infarction, and a left ventricular ejection fraction of 25%. She
was in her usual state of health until 5 days prior to admission. She started
to experience right upper quadrant pain which has progressively worsened over
the last 2 days. The pain does not change with position or eating.
She had 3 episodes of vomiting but denies any history of hematemesis,
melena, or hematochezia.
Previous Medical Diagnoses, Hospitalizations, and Operations:
hypertension for 20 years
myocardial infarction one year ago
Class III congestivc heart failure with ejection fraction
of 25%
Medications:
Aspirin, Lasix, digoxin, ACE inhibitor
Personal and Social History:
No alcohol or tobacco use; no substance abuse.
Family History:
Father died of myocardial infarction at the age of 60.
