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A 75-year-old man with chronic obstructive pulmonary disease and hypertension was admitted with left ventricular failure. Cardiac catheterisation 2 years earlier had revealed unobstructed coronary arteries and preserved left ventricular function. ECG showed sinus rhythm with old left bundle branch block. Transthoracic echocardiography demonstrated that his left ventricle was now dilated with severe globally impaired systolic function. There was no visible ventricular thrombus. An incidental patent …
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