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A 58-year-old obese farmer (BMI=31.4 kg/m2) presented with increasing breathlessness and reduced exercise tolerance for 2 years associated with discomfort after meals, increased snoring and daytime sleepiness. Past medical history included multiple repairs for Fallot'sTetralogy (TOF), asthma and kyphosis. Blood tests were normal. ECG showed RBBB (QRSd=154msecs). Echocardiogram revealed normal left ventricle, and mildly dilated well-contracting right ventricle (RV). Chest X-ray (CXR) showed …
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