Clinical History 250

Seventy-six year old gentleman with two prior coronary artery bypass graft surgeries and moderate left ventricular systolic dysfunction who returns for outpatient cardiology follow-up. The patient is being seen preoperatively prior to a planned carotid endarterectomy. His co-morbid conditions include severe chronic obstructive pulmonary disease, paroxysmal atrial fibrillation and chronic renal insufficiency. His medications included prednisone, digoxin, enalapril.furosemide and warfarin.
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