78 year old female with PMHx HTN, dCHF, Diabetes, CKD, Atrial fibrillation on coumadin, ischemic stroke, admitted after presenting to cardiology clinic today with confusion and Somnolence. Of note, she was recently discharged after presyncope/falls.  At that time, lasix was stopped and atenolol was switched to metoprolol as there was concern that blunting of tachycardia could be contributing to falls. She was discharged to rehab (previously living at home).  Per report from the ER, patient has had confusion at home for 3 weeks, though no family accompanies her to corroborate this story, and patient denies this. The patient is not sure why she is in the hospital. She saw her cardiologist today, who referred her to the ER after she appeared to be dehydrated, somnolent, and confused.  The patient denies headache, blurry vision, numbness, tingling or weakness. No CP. +SOB, worsening DOE.  No nausea, vomiting.