PMC7276397_01
A: 2D-Echocardiography parasternal long axis showing biventricular hypertrophy. B: 2D-Echocardiography apical four-chamber showing biventricular hypertrophy, Large ASD (arrow), and color Doppler showing left to right shunt. C: 2D-Echocardiography parasternal short axis showing, dysplastic pulmonary valve (arrow), and severe pulmonary stenosis. D: 2D-Echocardiography showing LV gradient of 64.7 mm and peak pulmonary gradient of 149 mm. E: 2D and 3D-Echocardiography left parasternal long axis showing biventricular hypertrophy.
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2D-Echocardiography showed biventricular hypertrophy, dysplastic pulmonary valve, severe pulmonary stenosis, and large ASD (Fig. 1A-D). 2D-Echocardiography and 3D-Echocardiography showed biventricular hypertrophy (Fig. 1E).
A: Still capture of the cine three-chamber view showing asymmetrical septal hypertrophy (blue star), the systolic anterior motion of the mitral valve (yellow arrow), left ventricular outflow tract flow acceleration (green arrow) and mitral regurgitation (red arrow). B: Still capture of cine short-axis view at the level of the mid ventricle in diastole showing asymmetrical septal hypertrophy (blue star) along with hypertrophy of the inferior and free of the wall of the RV (green stars). C: Still capture of the cine four-chamber view showing biventricular hypertrophy (green and blue stars). D: Still capture of the axial cine sequence showing the large ostiumsecundum atrial septal defect (purple line). E: Myocardial delayed enhancement sequence in the four-chamber view showing a mid-wall scar in the basal inferoseptal segment extending to the RV side of the septum. F: Myocardial delayed enhancement sequence in the short axis view showing mid-wall scar in the basal inferoseptal segment (white arrows) and the inferior RV wall (green arrow).
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MRI still capture of the cine three-chamber view showed asymmetrical septal hypertrophy, the systolic anterior motion of the mitral valve, left ventricular outflow tract flow acceleration, and mitral regurgitation (Fig. 2A). MRI still capture of cine short-axis view at the level of the mid ventricle in diastole showed asymmetrical septal hypertrophy, along with hypertrophy of the inferior and free wall of the Right ventricle (RV) (Fig. 2B). MRI still capture of the cine four-chamber view showed biventricular hypertrophy (Fig. 2C). MRI still capture of the axial cine sequence showed a large ostium secundum atrial septal defect (Fig. 2D). Myocardial delayed enhancement sequence in the four-chamber view showed a mid-wall scar in the basal inferoseptal segment extending to the RV side of the septum (Fig. 2E). Myocardial delayed enhancement sequence in the short axis view showed a mid-wall scar in the basal inferoseptal segment and the inferior RV wall (Fig. 2F).
A: Still capture of cine sequence in systole of the right ventricular outflow tract showing sub-pulmonic/infundibular resting flow acceleration (blue arrows). B: Still capture of the cine sequence in diastole of the right ventricular outflow tract showing pulmonary regurgitation (red arrow). The level of the pulmonary annulus appreciated (green arrow).
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MRI still captures of cine sequence in systole of the right ventricular outflow tract showed sub-pulmonic/infundibular resting flow acceleration (Fig. 3A). The level of the pulmonary annulus can be appreciated in Fig. 3B.
Pulmonary Balloon Valvuloplasty.
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She underwent a percutaneous transluminal pulmonary valvuloplasty for pulmonary stenosis and was started on metoprolol succinate for hypertrophic cardiomyopathy (Fig. 4).