Physical examination
On admission, the patient looked unwell but had normal vital signs (temperature, 36.3 C; blood pressure, 133/81 mmHg; pulse, 96 beats/minute; respiratory rate, 22 breaths/minute; oxygen saturation Spo2: 97% room air). The patient had bilateral pan-digital clubbing (Figure 1) . A cardio-pulmonary examination yielded findings such as a prominent parasternal heave. Chest wall auscultation revealed a loud P2 in the left parasternal space, as well as crepts in the right lung fields.