Silent broken heart (Can @entity1353 be the only presentation of XXXX ?).

@entity1 @entity662 @entity101 @entity1353 @entity4 @entity439 @entity583 @entity285
A 55-year-old previously healthy @entity1 was referred to our cardiology outpatient department (by the respiratory team) due to @entity1353 that started 2-3   months prior. He suddenly became breathless after changing a car wheel with no other associated symptoms. Specifically, he denied ever having had @entity662 . His breathlessness got gradually worse preventing him from performing simple everyday activities, such as climbing stairs, and a couple of weeks before presentation, the @entity1 noticed ankle @entity4 . He was an ex-smoker and drank 3-4   units of @entity285 daily. There was a family history of @entity101 . He worked as a contract manager in the construction industry. After clinical examination, a transthoracic echocardiogram was performed and the @entity1 was admitted for further investigations. Clinical examination and investigation confirmed missed @entity583 with a complication of @entity439 . The @entity1 was referred to cardiothoracic surgeons for surgical correction of the defect.
