ABSTRACT
An 80-year-old man has presented to the emergency department complaining of severe shortness of breath. He has been feeling increasingly dyspnoeic over the last fortnight and is now unable to walk even short distances before becoming short of breath, and his legs feel heavy to lift. He is short of breath at night, too, and has gone from sleeping with three pillows to sleeping upright in his chair. He has a cough productive of frothy pinkish sputum but has not experienced any fevers. He has a history of hypertension and heart problems but has stopped taking his diuretic medication recently owing to urinary frequency and occasional incontinence.
