Fatigue and Palpitations in a 53-year-old Woman

Physical Examination

  • General appearance: Slender middle-aged woman in no apparent distress.

  • Vital signs:
  • Temperature: 37.2° C
  • Pulse: 58 beats/min
  • BP: 125/74 mm Hg
  • Respirations: 14/min
  • Oxygen saturation: 96% on room air

  • Skin: No rashes noted.

  • HEENT: Oropharynx clear.

  • Pulmonary: Lungs clear to auscultation bilaterally. No wheeze, rhonchi, or rales.

  • Cardiovascular: Regular rate and rhythm, normal S1 and S2; no murmurs, rubs, or gallops. Brisk carotid upstrokes. No jugular venous distention.

  • Gastrointestinal: Soft, nontender, nondistended abdomen; positive bowel sounds.

  • Genitourinary: Unremarkable

  • Musculoskeletal: Unremarkable

  • Neurologic: Unremarkable

  • Mental status: Unremarkable