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A 21-year-old nonsmoking male visited his GP complaining of dyspnoea on exertion. His symptoms had started 3 years earlier, but he had experienced several episodes of dyspnoea and wheezing in the previous 6 months, when he started participating in a strenuous exercise programme. His medical history included hayfever for the past 4 years and recurrent chest infections during childhood with a remission in adolescence. Physical examination Physical examination revealed a mild pectus excavatum anddoi:10.1183/18106838.0503.263 fatcat:kr5fcj7dybeuxa6wrwq76t4ptm