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History

History of Present Illness:
77 year old African American male with a history of atrial fibrillation, hypertension and Type B thoracoabdominal anueurysm was well until 6 days prior to admission when he developed nausea and vomiting of "black pieces and digested food" 2 hours after eating what he thought was "bad fish." He took a few doses of Pepto-bismol and noted 4-5 loose black stools for the next 4 days. Since then he has not had a BM in 2 days. Over this time he has noted progressive dyspnea on exertion.

Review of Symptoms:
Intermittent chest pain for which he takes aspirin about three time a week. Denies dysphagia, odynophagia, early satiety, abd pain, or BRBPR. He also notes purposeful weight loss of about 20 lbs over 3 months, and has mild chronic constipation (about QOD BM).

Past Medical History: Peripheral vascular disease, borderline type 2 diabetes
Surgical History: right above-the-knee amputation
Medications: Cardizem, Atenolol (non-compliant), ASA 325 mg PO PRN
Allergies: NKDA
Social History: 40 pk-yr, no ETOH, retired sanitation worker
Family History: no colon cancer