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A 60 - year - old woman attended her GP's surgery complaining of breathlessness on ____________________ . This has been increasing over the previous eight months , until it was producing problems around 500 meters walking on the level . There was no history of chest pain . She had had several ____________________ of fast ____________________ which lasted 20 - 30 minutes and were associated with some ____________________ of breath . She had noticed some ____________________ of her ankles by the end of the day . This disappeared overnight .