A 30-year-old male from a rural area in sub-Saharan Africa presents with a 3-week history of progressive shortness of breath, fatigue, and swelling in his legs. He reports that the symptoms began after a recent viral illness, which included fever, sore throat, and body aches that lasted for about a week. Since then, he has noticed increasing difficulty breathing, especially when lying flat, and has also developed swelling in his lower legs.

On examination, the patient appears tired and slightly dyspnoeic at rest. His blood pressure is 110/70 mmHg, heart rate is 115 beats per minute, and respiratory rate is elevated. There is bilateral pitting oedema in the lower extremities, and a faint S3 heart sound is heard. Lung auscultation reveals crackles at the lung bases. An electrocardiogram (ECG) shows sinus tachycardia with nonspecific ST changes. Blood tests reveal elevated cardiac biomarkers (troponin and BNP), and an echocardiogram shows a dilated left ventricle with reduced systolic function, consistent with dilated cardiomyopathy likely due to viral myocarditis.

The patient is diagnosed with dilated myocarditis and is started on diuretics for fluid management, along with heart failure medications. He is referred for further evaluation and possible follow-up with a cardiologist for long-term management.