This is a case report of an unusual cause of bilateral diaphragmatic palsy. A 54-year-old gentleman. presented to us with exertional dyspnea and chest heaviness for the past 6 months which had increased in the last 6 days. Dyspnea increased on lying down. https://www.roneverhart.com/Castello-di-Amorosa-Il-Barone-Napa-Valley-Cabernet-Sauvignon-2007/