Chana Kumar EA: 86-year-old female patient who consulted for a clinical picture of some hours of evolution consisting of dyspnea that worsens with exertion and 120bpm tachycardia during your exercise routine, no chest pain. Associated she reports 2-month

Chana Kumar EA: 86-year-old female patient who consulted for a clinical picture of some hours of evolution consisting of dyspnea that worsens with exertion and 120bpm tachycardia during your exercise routine, no chest pain. Associated she reports 2-month progressive dyspnea with daily activities. As background of importance presents HTN, CAD, S / P CABG 8 years 33-year-old female patient with the following diagnoses: Pyelonephritis Subjective: Alert patient, oriented in the 3 spheres, reports dyspnea that worse with exertion and tachycardia Aim: Conscious patient oriented in the 3 spheres, hydrated, afebrile, with the following vital signs: PA: 138/92 FR: 16 FC: 110 Head and neck: Anicteric sclera, conjunctival-rim pallor present, normoreactive isochoric, moist oral mucosa, no jugular engorgement. Thorax: Atraumatic, symmetrical, breath sounds preserved without aggregates, heart sounds with presence of murmur and PMI laterally and inferiorly displaced Abdomen: Abdomen soft, nondistended, no palpable mass or herniation Extremities: Eutrophic, capillary filling less than 3 seconds Neurological: Conscious, oriented in the 3 spheres, without signs of irritation meningeal and without signs suggestive of targeting. Laboratory: TIBC: Elevated ECG: Sinus tachycardia IRON: Low CBC: Microcytic Hypochromic anemia Analysis