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This Concept Map, created with IHMC CmapTools, has information related to: Lolita Ramirez, 2 months ago upon which pt visited walk-in clinic, backup into pulmonary veins resulting in pulmonary hypertension, left atrial pressure increasing preload to left ventricle, walk-in clinic which diagnosed pt with viral infection, negative mono test, Lolita Ramirez underwent diagnostic testing, increased stretching of muscle fibers increases Frank-Starling mechanism, hemorrhage and infarction presenting as Janeway lesions, mitral valve vegetation causes chronic bacteremia, stroke volume reduce cardiac output, backflow into left atria presents as RR with 4/6 blowing holosystolic murmur over apex obscuring S2. Normal S1., diagnostic testing results showed Echocardiogram with vegetation and regurgitant jet noted during systole in left atrium, increased end-diastolic volume causes increased stretching of muscle fibers, diagnostic testing results showed Rheumatiod Factor Positive, backflow into left atria increases left atrial pressure, left atrial pressure causes backup into pulmonary veins, endocarditis treated with diuretic therapy - furosemide 40mg IV given in ED, Lolita Ramirez has a social history of balanced diet, potential entry for bacteria most likely Viridans group Streptococcus, fever, malaise, fatigue with assessment revealing osteopathic structural exam of flattened upper thoracic kyphosis, focal bogginess, paravertebral musculature L lateral T4 with no clear bony restriction, Lolita Ramirez vitals include BP: 126/76 HR: 88