Case history and examination
A 42-year-old male presented to our cardiology clinic with a three-week
history of low-grade fever, backache, and exertional dyspnoea,
progressing to severe dyspnoea at rest after one week.
He has history of smoking 20 pack-year and no chronic drugs use. His
family history includes paternal myocardial infarction at 50 and
maternal type two diabetes diagnosed at 55.
On examination, an averagely built, fully conscious male was sitting in
distress with dyspnoea. He exhibited normal vesicular breathing without
added sounds. Cardiac examination revealed muffled heart sounds and an
elevated jugular venous pressure (JVP) at 9cm. His abdomen was soft,
non-tender, with no visible pulsating mass. No cyanosis or peripheral
oedema was noted. Vital signs were as follows: BP 111/87 mmHg, RR 26
breath/min, PR 87 beat/min, Temp 39.1 Celsius, and oxygen saturation at
88% on room air.