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A man in his 60s with a history of systemic hypertension and increasing dyspnea on exertion was referred to an outpatient pulmonary clinic for further evaluation of pulmonary hypertension. During a hospitalization for systemic hypertensive urgency, a transthoracic echocardiogram performed for increasing dyspnea revealed a mildly dilated right ventricle and an increased estimated pulmonary artery systolic pressure of 76 mm Hg (Fig 1, Video 1). He also had lower extremity swelling and rash along with joint pain in his hips, knees, and feet for the past 4 months. Further questioning revealed that his diet consisted mainly of candy and sports drinks.

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