A seventy-six-year-old female was hospitalized with a complaint of fatigue for one month. She complained about shortness of breath (SOB) and dyspnea on exertion (DOE) since a week. She had no abdominal pain, nausea, vomiting, diarrhea, constipation (N/V/D/C), hematemesis, melena or hematochezia. She also denied use of NSAIDs or anticoagulants. No paroxysmal nocturnal dyspnea (PND), chest pain (CP) or cough.
Past medical history (PMH) Mitral valve repair with metallic prosthesis, currently taking Coumadin, angiodysplasia of the of the duodenum, diverticulosis, HTN, PVD, CAD S/P CABG, RA, 5 cm AAA identified 6 months ago. She had a problem of acute GI bleeding 6 months ago and had both upper and lower endoscopies at that time. The upper endoscopy showed an angiodysplasia of the duodenum. It was treated with bipolar electrocoagulation. The colonoscopy showed diverticulosis but an adequate…
