A 38 year old male was admitted to hospital with a two month history of fatigue and a two week history of increasing edema. Congestive heart failure was diagnosed, and a cardiac catheterization revealed normal coronary arteries, but marked cardiac enlargement with four chamber dilation and mural thrombosis of the left ventricle. The cardiac index was 1.4. Further history revealed that he had been drinking a case of beer a day for many years and that he smoked one pack of cigarettes per day.
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