Generate the doctor patient conversation from the below summary:
CHIEF COMPLAINT

Annual exam.

HISTORY OF PRESENT ILLNESS

NAME_1 is a 50-year-old female with a past medical history significant for congestive heart failure, depression, and hypertension who presents for her annual exam. It has been a year since I last saw the patient.

The patient has been traveling a lot recently since things have gotten a bit better. She reports that she got her COVID-19 vaccine so she feels safer about traveling. She has been doing a lot of hiking.

She reports that she is staying active. She has continued watching her diet and she is doing well with that. The patient states that she is avoiding salty foods that she likes to eat. She has continued utilizing her medications. The patient denies any chest pain, shortness of breath, or swelling in her legs.

Regarding her depression, she reports that she has been going to therapy every week for the past year. This has been really helpful for her. She denies suicidal or homicidal ideation.

The patient reports that she is still forgetting to take her blood pressure medication. She has noticed that when work gets more stressful, her blood pressure goes up. She reports that work has been going okay, but it has been a lot of long hours lately.

She endorses some nasal congestion from some of the fall allergies. She denies any other symptoms of nausea, vomiting, abdominal pain.

REVIEW OF SYSTEMS

â€¢ Ears, Nose, Mouth and Throat: Endorses nasal congestion from allergies.
â€¢ Cardiovascular: Denies chest pain or dyspnea on exertion.
â€¢ Respiratory: Denies shortness of breath.
â€¢ Gastrointestinal: Denies abdominal pain, nausea, or vomiting.
â€¢ Psychiatric: Endorses depression. Denies suicidal or homicidal ideations.

PHYSICAL EXAMINATION

â€¢ Cardiovascular: Grade 3/6 systolic ejection murmur.
1+ pitting edema of the bilateral lower extremities.

VITALS REVIEWED

â€¢ Blood Pressure: Elevated.

RESULTS

Echocardiogram demonstrates decreased ejection fraction of 45%. Mitral regurgitation is present.

Lipid panel: Elevated cholesterol.

ASSESSMENT AND PLAN

NAME_1 is a 50-year-old female with a past medical history significant for congestive heart failure, depression, and hypertension who presents for her annual exam.

Congestive heart failure.
â€¢ Medical Reasoning: She has been compliant with her medication and dietary modifications. Her previous year's echocardiogram demonstrated a reduced ejection fraction of 45%, as well as some mitral regurgitation. Her cholesterol l The word "examination" should not appear in your response.
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