Heart Failure as Herald

Bouhzam et al present a case of an 80-year-old man whose chest pain and shortness of breath led to an unexpected diagnosis. He had a history of hypertension, diabetes mellitus, and benign prostatic hyperplasia and was admitted to the cardiology department because of his cardiac complaints. Physical examination identified gross peripheral edema, distended jugular veins, hepatomegaly, and basal crackles. A diagnosis of hepatocellular carcinoma with invasion to the inferior vein cava and right atrium was established.