64 year old pensioner

PC: SOBOE (shortness of breath on exertion)

HPC: worsening SOB for 3 weeks

now unable to climb 1 flight of stairs or walk >200 yards

cough with white sputum, especially at night

needs 2-4 pillows at night

both ankles swollen in the evening

no chest pain, no palpitations

also noticed fine macular rash on her trunk about 1 month ago

PMH: DM Type I for 40 years

Glomerulonephritis 1978

Tinnitus (seen by ENT specialist = ear-nose-throat specialist)

DHx: Aspirin

Insulin self administered according to meals

ACE inhibitor

FHx: Daughter: protein S deficiency

Son: vitiligo

Sister: coeliac disease

SHx: lives with husband (wheelchair bound)

is main carer for husband, does all shopping and cleaning

non smoker

alcohol: sparkling wine for birthdays only