A 47-year-old man employed as a sound technician presented to our clinic with 3-month history of chronic cough and shortness of breath. His symptoms included marked worsening dyspnea initially with activity but later with only minimal exertion. He had also noticed worsening cough, orthopnea, and ankle swelling. Based on his history of congestive heart failure, he was treated with diuretics with only mild improvements in symptoms. At presentation, dyspnea would develop with approximately 100 yards of walking.