Question
Upon presentation: A 65-year-old female, Ella Jarvis, presents to her physician after an episode of near fainting and persistent nausea. She is alert and cooperative and she appears fatigued, short-of-breath and unsteady moving from the chair to the exam table. Her skin is cool, clammy and mild pallor with slight icterus (yellowing of skin). Heart rate is irregular and tachycardic and there is an S3 heart sound present. Jugular venous distension is present at 45 degrees. Bilateral +2-pitting edema is present.
List several findings that would be concerning in this initial presentation.
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