68   years  old female pt 
ablasion    before   7 years 
c cath    before   3 months  normal 
echo in  9/2025

medications 
forxiga   10 mg once   
insulin     lantus   30 
apidra 10 
concor 5 mg once 
nexium 40 mg once 
crestor  40 mg once 
amitryptulin 
escitalopram  once 
acamol
alloril  300 mg once 
valsan  hct 
filrenone 
forxiga 

plan 
hold valsan 
hold  filrinone 
hold forxiga 
dorenal us 
do labs 
reevalaution after  one week 
add  delfazacort  for  5  days 
add  dee d ense 
add   amicor  if  blood pressure  high 
in the clinic her blood pressure  is    114/70