A 39-year-old man presented to the emergency department with a complaint of progressive dyspnea and intermittent chest pain over several months. His medical history was unremarkable except for a recent workup for epigastric discomfort and early satiety. Results of esophagogastroduodenoscopy, gastric mucosal biopsies, and testing for Helicobacter pylori were negative. The patient also had intermittent episodes of chest pain for which he underwent dobutamine stress echocardiography. Pertinent findings included mild dilation of the right ventricle and right ventricular systolic pressures of 35 to 40 mm Hg. The patient also admitted to daily marijuana use for the past 20 years. In addition to his other symptoms, he reported an approximate 20-pound weight loss over the past year.