Case presentation A 79-year-old man presented with generalized fatigue, palpitations, dyspnea, and progressive bilateral lower limb weakness that impaired his ability to walk. He was referred to the hospital for further evaluation after the onset of tachycardia.
Medical history Gastrectomy for gastric cancer 45 years earlier Past pulmonary tuberculosis No recent use of prescribed medications or routine medical follow-up Chronic alcohol intake (1 liter of beer daily) and a nutritionally unbalanced diet consisting mainly of instant noodles Physical examination Pulse: 160 bpm Blood pressure: 78/50 mmHg Oxygen saturation: 96% Body weight: 39 kg BMI: 15.4 kg/m 2 Manual muscle test: 2/5 in the lower extremities Blood tests Normal liver, renal, and thyroid function N-terminal pro-brain natriuretic peptide (NT-proBNP): 1,978 pg/mL Chest radiography (Figure 1A) Calcifications in the right upper…
