It is something I thought about though I dont know Lyme prevalence in the UK and more importantly Lyme is more associated with heart block than with heart failure. Something worth thinking about though
Disclaimer: Not a doctor.With Paul's history of being active outdoors(I also wonder if he has any pets?), I also wonder if the hospital should be checking for Lyme Disease? Depending on his other symptoms not sure how high up it would be on the differential?I know that coughing is pretty rare in it, but from the sounds of it whatever he's had has been going on for a prolonged period of time, and it kind of sounds similar to this patients story, but also maybe not entirely?I guess it could be something for the OP to ask the doctor about that they're talking with.