History: 60-year-old woman with constipation of three months

History

A 60-year-old woman with constipation of three months duration. Her exercise tolerance has been decreased. She has coarse, rough skin.

Blood pressure is increased. Pulse rate is 80 bpm. Swollen ankles. Lung sounds are normal.

Exam

Use the 'auscultation' link above to virtually listen to this patient's heart and carotid sounds.