The case
A 44-year-old woman with cardiac sarcoidosis receives a DDD pacemaker for complete atrioventricular block. Two weeks after discharge she presents for follow-up. She mentions breathlessness on exertion which seems more pronounced than before pacemaker implantation. The onset of dyspnea is very sudden during exertion. Her weight is unchanged and she denies peripheral oedema or orthopnea.
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