Exertional Dyspnea in a 76 YO Man

• Medical history: Hypertension, hyperlipidemia, type 2 diabetes mellitus, end-stage renal disease on hemodialysis.


• Surgical history: Left knee replacement at age 65 years.


• Medications: Lisinopril 10 mg orally daily, atorvastatin 40 mg orally daily, insulin glargine 50 U subcutaneously daily, calcium carbonate 500 mg orally twice a day with meals, darbepoietin 40 mcg IV weekly.


• Allergies: No known drug allergies.


• Family history: Father had hypertension and stroke. Mother had type 2 diabetes mellitus.


• Social history: Patient is married and is a retired teacher. He has never smoked and does not use alcohol or illicit drugs.