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complications related to alcohol abuse, uncontrolled diabetes, and cardiac disease. This information is third or possibly fourth-hand information from various family members over the years. Her paternal grandparents lived well into their 80s. Floyd died peacefully in his sleep at 85 from “old age”. Further questioning, however, reveals he probably died of a stroke as he had exhibited TIA like symptoms in the days leading up to his death. He had a known history of hypertension, high cholesterol, diabetes type two, TIAs, and gout. Minnie died at age 82 from diabetic complications. Her medical history inlcuded hypertension, high cholesterol, diabetes type two, peripheral vascular disease, renal failure, and right above the knee amputation.SynopsisThe patient clearly has issues regarding reproductive health most likely inherited from her mother’s side of the family. There is also strong evidence of substance abuse running on her mother’s side as well. Patient currently abuses marijuana and alcohol to a lesser extent. The chest pain is concerning regardless of “normal” EKGs in the past. I suspect this is an early indication of something for more serious than the patient cares to admit or accept.