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A 70-year-old man with dyspnoea and diastolic murmur
  1. Jan Ohlig,
  2. Tobias Zeus,
  3. Malte Kelm,
  4. Amin Polzin
  1. Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Medical Center Düsseldorf, Düsseldorf, Germany
  1. Correspondence to Dr Amin Polzin, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University Medical Center Düsseldorf, Moorenstrasse 5, Düsseldorf 40225, Germany; Amin.Polzin{at}med.uni-duesseldorf.de

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Clinical introduction

A 70-year-old Caucasian man presented at our chest pain unit due to progressive dyspnoea. Physical examination revealed an obese male with a quiet diastolic murmur. Cardiovascular risk factors were arterial hypertension, insulin-dependent diabetes mellitus and 70 pack-year smoking history. Inverted T waves were seen on ECG in I, V5, V6 and high sensitive troponin T (hsTnT) level was elevated (hsTnT max. 91 ng/L (cut-off <14 ng/L)). Urgent coronary angiography was performed and occlusive coronary artery disease was ruled out. Further examination by chest X-ray was unrevealing. Spirometry showed …

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