# Clinical Note Analysis
## Clinical Note
### Chief Complaint
- Scrotal and leg swelling
### History of Present Illness
- In the last 3 days, swelling has become quite swollen. Similar swelling occurred during admission for acute CHF.
- EKG changes consistent with prior NSR, NANI, ************.
- Left ventricle mildly enlarged. Treated with diuretics (good UOP).
### Past Medical History
- Diabetes
- Hypertension
- CKD, stage 3
- GERD
- Depression
- Amputation of ************
- Pneumonia
- Osteoarthritis
- History of ************, Asthma
### Family History
- No family history of ************ artery
### Physical Exam
- **LUNG**: Bibasilar rales (no clear with deep inspiration)
- **ABDOMEN**: Nondistended, ************ all quadrants. Extremities: bilateral pitting edema to sacrum, extending to abdomen. Warm, well-perfused.
- **HEENT**: AT/NC, EOMI, PERRL
### Pertinent Results
- **03:50PM**:
- WBC: 8.0
- RBC: 3.26*
- Hgb: 9.3*
- Hct: 30.9*
- MCHC: 29.9*
- **11:30AM**:
- proBNP: 3843
- **Overall**: Left ventricular systolic function mildly depressed (LVEF=45-50%) without regional wall motion abnormalities. Imaging suggests increased ************ filling pressure (PCWP>*************Hg).
## Rationale
- Peripheral edema is a sign of heart failure.
- Hypertension is a risk factor for heart failure.
- NT-proBNP ≥125pg/ml is a diagnostic criterion of strong HF.
- Cardiac structure abnormalities are diagnostic criteria of heart failure.
- Cardiac systolic dysfunction (~49%) can lead to HFmrEF diagnosis.
## Diagnosis
1. **Suspected HF**
2. **Strongly Suspected HF**
3. **HF**
4. **HFmrEF**
## Notes
- No charts/diagrams present. All data extracted from textual clinical note.
- Lab values and BNP levels included as numerical data points.
- No other languages detected.
