Case 2 – for index purposes: a 50 year old and past heavy drinker man admitted to treat decompensated heart failure.

Physical examination on that date revealed weight of 130 kg; height 1.72 m; BMI = 43.9 kg/m2, tachypnea 36 breaths per minute, heart rate 80 bpm, blood pressure 100 x 90 mmHg. There were crackles in both lung bases; heart sounds were arrhythmic and systolic murmurs ++/6+ in the mitral area; the abdomen was distended, visceromegalies were not palpated and there was edema ++++/4+ in the lower limbs. The patient was an ex-drinker (six beers/day for 20 years) and had hip osteoarthritis.