Spanish to English Medical Medical (general)

Hi all,

I'm translating a decree of abandonment that contains some information about the health of the abandoned children.

I don't know what the abbreviation "D/" might mean in the following sentences:

Se tiene que el diagnostico clinico del estado fisico y mental del menor XXX "es de un niño con Tonos Cardiacos irregulares, D/Nutricion Calorico proteica", y el del menor XXX es "Arritmia Cardiaca D/ Soplos Desnutricion Calorico Proteica G II y Deshidratacion"

I thought the first one possibly means "deficit" (so the full term would be "protein-calorie malnutrition") but I'm completely lost about the second one.

Any ideas?

Thanks in advance