Case Study: Peripheral VascularPatient History:Mr. S is a 63-year old gentle man who has been under your care for a variety of medical problems during the past 5 years. He has been treated for two myocardial infarctions, hypertension, non-insulin dependent diabetes and stasis dermatitis of the left leg. He had an aorto-coronary bypass one year ago.Today he presents in the office with shortness of breath which has been progressive over the past five days. He has, however, experienced episodes of shortness of breath during the past four months, especially when exerting himself. He fatigues easily and has lost "all my energy to do anything." He also complains of anorexia. Last night he awoke suddenly from sleep because "I couldn’t catch my breath" and developed a dry cough. The breathing problem improved when he sat on the edge of his bed for an hour. He generally sleeps with two, sometimes three pillows. He has not experienced chest pain, leg painor fainting spells.