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so getting a move on Rajaji youre gonna continue to join us for the next session titled heart failure drugs uses and misuses and dr. Amir Abbas who completed his cardiology training at UT San Antonio is doing an excellent job with us as an advanced heart failure fellow will present the first case and we have an expert farm D panel a Sarah burn and Oh Jill crystal in May Archie will be guiding us like they do on rounds right to keep us on as both inpatient outpatient about about these sometimes drugs that arent indicated come here all right thank you doctor you step so to start with our first patient case so this is a 59 year old gentleman with history of heifer F secondary to coronary disease history of mi diabetes CKD he presents for a routine clinic visit so he says overall hes doing well he likes to play golf but he does say he become short of breath while playing occasionally he cant finish all 18 holes at home his wife complains that he had hes having trouble mowing the lawn