text:  PHYSICAL EXAM  VITAL SIGNS   He was afebrile with stable vital signs HEART  Regular rate and rhythm with a 2 out of 6 systolic ejection murmur heard loudest at the apex .  LUNGS  Clear to auscultation .  ABDOMEN  Soft   nontender   nondistended .  EXTREMITIES  No cyanosis   clubbing or edema .  Palpable DP s bilaterally  PERTINENT LABS   His hematocrit was 44  White count was 8 .  Potassium was 3.9  BUN and creatinine was 18 and 0.9 .  His troponin was 29.7