Pe

BP 126/70 mm Hg, P 60 bpm and regular, RR 16/min, ht 5'8" (173 cm), wt 114 kg (251 lb), BMI 38.2 kg/m2

Lungs: Clear to auscultation with a prolonged expiratory phase; rales are present bilaterally

CV: RRR with normal S1 and S2; there is an S3 and a soft S4 present; there is a 2/6 systolic ejection murmur heard best at the left lower sternal border; point of maximal impulse is within normal limits at the midclavicular line; there is no JVD

Abd: Soft, nontender, and bowel sounds are present; 2+ pitting edema of extremities extending to below the knees is observed

CXR: Bilateral pleural effusions and cardiomegaly

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