Case Presentation: A 73-year-old male presented to the Emergency Department for a 2-month history of progressive dyspnea on exertion, orthopnea, and bilateral lower extremity edema on a background of long-standing COPD with active tobacco use. Exam was relevant for sarcopenia, mild tachypnea, decreased breath sounds in the bases, no wheezing or JVD, 2-3 + bilateral [...]