Case 37: Severe Dyspnea and Preload Failure

Abstract

An older patient presents with fatigue, exertional dyspnea, exertional chest tightness, and palpitations. Cardiopulmonary exercise testing (CPET) showed low biventricular filling pressure and poor peripheral oxygen extraction as a cause of dyspnea, consistent with preload failure. Tilt test demonstrated postural tachycardia syndrome (POTS), neuropathic form.