PMC5358942_01
Sinus rhythm, right axis deviation, dominant R wave in the V1, deep S wave in the leads V5-6, and T wave inversions in V1-4 leads, suggesting right ventricular hypertrophy with right ventricular pressure overload.
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The ECG revealed signs of right ventricular hypertrophy with right ventricular pressure overload (Fig. 1).
Cardiac magnetic resonance angiography 3D rendered image, lateral projection. Ao: aorta; PDA: patent ductus arteriosus; PA: pulmonary artery.
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Cardiac magnetic resonance imaging (MRI) revealed PDA connecting the aortic isthmus to the main pulmonary artery, reduced RV ejection fraction to 51% and the RV stroke volume of 26.28 ml/m2 (Fig. 2).
Presentation of clinical and laboratory changes in a patient with ES receiving disease-specific treatment for PAH from 2010 to 2016. A: An improvement in the heart failure marker (NT-proBNP). B: An improvement in exercise capacity (a 6-min walking test).
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The initiation of sildenafil treatment improved her clinical status and exercise tolerance, NT-pro BNP levels decreased (Fig. 3A and B). The level of NT-pro BNP elevated to 1003 pg/ml (Fig. 3A).