A 58-year-old woman presents with paroxysmal nocturnal dyspnea for two weeks, in a background worsening exertional dyspnea and vague chest pain for three months. No other symptoms are present.
Her surgical history is significant for two lower segment caesarean sections (LSCS) performed at the ages of 32 and 36 respectively. Her medical, drug, allergic, and family histories are all unremarkable. She does not smoke, only drinks socially, and does not use recreational drugs.
Her basic blood tests, including a complete blood count, serum electrolyte assay, and liver and renal profiles, are all within normal parameters.