,HISTORY OF PRESENT ILLNESS:,  The patient is an 80-year-old white female with history of atrial fibrillation, on Coumadin, who presented as outpatient, complaining of increasing fatigue. 
,HISTORY OF PRESENT ILLNESS : , The patient is an 80 - year - old white female with history of atrial fibrillation , on Coumadin , who presented as outpatient , complaining of increasing fatigue .