This is a 76-year-old female with pmh of diastolic CHF, atrial
   fibrillation on coumadin, presenting with Hct 16.9 and shortness
   of breath. She had routine labs drawn yesterday at her PCP's office.  Once her hematocrit came she was called and instructed to come to the ED. She is also reporting progressive shortness of breath worse with exertion over the past two weeks. She denies fevers, chills, chest pain, palpitaitons, cough,
   abdominal pain, constipation or diahrrea, melena, blood in her stool, dysuria, rash.  She reports orthopnea.
   
   In the ED: vitals were 98.4  131/49, 60 24  100% 2L.  ekg with NSR, twi in V1, no significant change from previous. Repeat CBC showed Hct 16.1
   with haptoglobin < 20, and elevated LDH to 315. In addition, her guaiac
   was reported as being positive.  
   
   Past medical history:
   Hypertension
   Atrial flutter/fibrillation, s/p cardioversion [**2797-1-27**]
   Diastolic heart failure
   Hysterectomy
   Bilateral hip replacements
   Social History:
   Married for 53 years with four children. She is retired
   from the airport. She does not smoke or drink.
   Occupation: retired from airport
   Drugs: denies
   Tobacco: denies any history
   Alcohol: denies