A. Clinical Case: Altered Cardiac Metabolism in Heart Failure Patient Profile: A 60-year-old male with a history of hypertension presents to the cardiology clinic with complaints of increasing fatigue, shortness of breath, and swelling in the ankles over the past few months. Clinical Presentation: The patient appears fatigued and has difficulty breathing while lying flat (orthopnea). Physical examination reveals elevated jugular venous pressure and peripheral edema. Auscultation of the heart reveals the presence of a third heart sound (S3) and crackles in the lungs. Diagnostic Workup: Echocardiography reveals left ventricular hypertrophy and reduced ejection fraction. Blood tests show elevated levels of B-type natriuretic peptide (BNP). Electrocardiogram (ECG) indicates signs of left ventricular strain. Metabolic Assessment: Blood glucose level: Normal Fasting lipid profile: Elevated triglycerides and low-density lipoprotein cholesterol. Serum lactate: Elevated Blood pH: Slightly acidi...