A 50-year-old male who was a heavy smoker, presented with complaints of gradually progressive exertional dyspnoea and cough with minimal sputum production for the last seven years. There was no history of chest or abdominal pain, fever, wheezing or vomiting. He also denied any history of trauma. On examination, the patient was comfortable; vital signs and oxygen saturation on pulse oximetry were normal. There was no cyanosis, peripheral oedema or clubbing. On respiratory system examination, vesicular breath sounds with prolonged expiration all over the chest and reduced intensity in the left infrascapular region were evident. Rest of the systemic examination was unremarkable.
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