B. j., a 70-year-old black female has been seen in the clinic several times. the last time she was in for a check-up was 6 months ago to get her prescriptions refilled. she has returned to the clinic today because she "ran out of blood pressure medicine" and would like to get her prescriptions renewed. she has not taken any prescription medicine in approximately 6 months background: the patient indicates that she has noticed shortness of breath, especially when she is playing with her grandchildren. but, it goes away once she sits down to rest. she reports that she is also bothered by shortness of breath that wakes her up at night, but it resolves after sitting upright on 3 pillows. she also tells you that "i noticed over the last week that my legs and ankles have been swollen". she also indicates that she often feels light headed and faint while going up the stairs, but it subsides after sitting down to rest.