• Henry Smith is an 83 year old man whom you see in your GP practice.
• He presents with breathlessness on exertion, increasing over the preceding year. His exercise tolerance is limited to approximately 200 metres on the flat and a single flight of stairs, having been able to walk several miles beforehand. He feels very tired.
• His past medical history includes hypertension, for which he takes Ramipril.
• He has no other significant past medical history and is a non-smoker.