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A24-year-old man with a history of moderate hypertension, treated with ramipril for two years, presented to the emergency department with progressive swelling of the arms and tingling in his hands. Five days earlier, he had done a short-duration (9 min) high-intensity exercise session that included 84 pull-ups and 84 overhead shoulder presses with 30-lb dumbbells. He regularly lifted weights and ran as part of his exercise routine, although short-duration high-intensity weight training was something new to him. No traumatic events had occurred between the workout and his visit to the emergency department. Immediately after the high-intensity exercise, his arms felt "tired and sore," but this was not out of keeping with his normal postworkout fatigue. On the day of his visit,...