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16th February 2025
A 45-year-old woman with a BMI of 39 presents with breathlessness which is worse on lying down and has developed over 8 weeks.
A 45-year-old woman with a BMI of 39 presents with breathlessness which is worse on lying down and has developed over 8 weeks. She feels this has been leading to a lack of sleep and is tired during the day.
She denies chest pain, palpitations or cough. Cardiovascular and respiratory examinations are unremarkable.
Chest X-ray, ECG and echocardiogram are all normal.
Her spirometry results are as follows:
| FEV1 | FVC | FEV1/FVC ratio | |
| Standing | 2.9 L
(88% predicted) |
3.6 L
(89% predicted) |
0.8 |
| Lying | 1.5 L
(45% predicted) |
1.8 L
(44% predicted) |
0.83 |
What is the most likely cause of her presentation?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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