An unusual cause of dyspnoea in a patient with chronic ischemic heart disease

A 70-year old male was referred to our attention for worsening dyspnea in the last three months. His past medical history was characterized by an acute myocardial infarction and an episode of ventricular tachycardia with positioning of an implantable cardioverter defibrillator. At the physical examination “velcro” inspiratory crackles were present, however lung volumes, diffusing capacity of the carbon monoxide and arterial blood gases values were within the normal limits, whereas the computed tomography of the chest showed a typical pattern of idiopathic pulmonary fibrosis. Long-term treatment with pirfenidone was started. Conclusions: Idiopathic pulmonary fibrosis is a rare chronic, progressive lung disease that may present with progressive dyspnea which may be confused with cardiogenic dyspnea