83   years old male pateint 
HTN 
dm   For the last  n 15   years   
CHF   WITH  EJECTION FRACTION  30%  STENT
DLD 
GOUT


PRESENTED WIT LEFT FLANK PAIN


BASERLINE   1.9 
PRESENTED WITH  LEFT FLANK PAIN AND  GENERALZED WEAKNESS 

EJECTION FRACTION    FOUND TO N BE  62  ON THE LAST  ECHO  1/2025 
ABDOMINAL US  UNREMAKRAB LE 

HE W AS  TAKING  CODIOVAN  160/12.5  INSPITE OF HIS BLOOD PRESSURE  80/40 

PLAN 
STOP LASIX 
STOP  SITGLUMET 
STOP CO DIOVAN 
ADD FLATEX 
ADD  SCOBUTYL  CO