Last updated on: February 10th, 2021

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You’re looking at an interactive case study from Prognosis: Your Diagnosis (one of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.

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A 44-year-old man presents with worsening exertional dyspnea and fatigability for 6 months, which has now progressed to dyspnea at rest. He also complains of orthopnea and paroxysmal nocturnal dyspnea but is otherwise asymptomatic. 

His medical history is unremarkable. There is no family history of cardiac disease. He is a very heavy drinker, having consumed around 10 drinks per day for the last 20 years. 

A full blood count is significant for a platelet count of 140,000/mm3 (normal: 150,000-400,00) and a MCV of 101 fL (normal: 75-95). A liver profile is significant for an AST of 55 IU/L (8-48), ALT of 65 IU/L (7-55), and INR of 1.3 (normal: 0.9-1.1).

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