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A case of heart failure and diarrhoea
  1. Bradley Anderson1,
  2. Sumera Rizvi1,
  3. Grace Lin2,
  4. Vandana Nehra1
  1. 1 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
  2. 2 Cardiovascular Division, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Bradley Anderson, Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Anderson.Bradley{at}mayo.edu

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Clinical presentation

A 20-year-old man with no significant medical history presented with a 5-day history of intermittent chest pain and dyspnoea. He also reported a 3-month history of daily diarrhoea characterised by multiple, loose, watery, non-bloody stools. Physical examination was notable for tachycardia and a soft systolic murmur at the apex. Laboratory evaluation was significant for microcytic anaemia (serum iron 17 μg/dL; normal range 50–150 μg/dL) and an NT-proBNP (N-terminal pro-brain natriuretic peptide) of 18 995 pg/mL (normal <51 pg/mL). A colonoscopy with random biopsies for evaluation of diarrhoea was unremarkable. Esophagogastroduodenoscopy demonstrated a scalloped and mosaic pattern in the second and …

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