PMC8565710_01
ECG: SR 60 bpm, negative T waves in V1-V2, QS in V3-V5
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Echocardiography: Dilated RVOT (PLAX - a, PSAX - b) and decreased FAC (c, d).
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No signs of aortic dissection or significant valvopathies were found (Figure 2).
Magnetic resonance aspect: dilated RVOT (a) with aneurisms and hypokinesia, dyskinesia and zones of akinesia located at the level of the RV free wall (b). Inhomogeneous adipose infiltration of the RV free wall, with extensive fibrosis that also involves the left ventricle (c).
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In order to confirm our suspicion and further risk stratification, we decided to perform a cardiac MRI, which showed an extremely dilated RVOT (43 mm) and RV (EDV/BSA 223 ml/m2), with aneurisms and hypokinesia, dyskinesia and zones of akinesia located at the level of the RV free wall (Figure 3).
Extensive fibrosis at biventricular level (a, b).
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Furthermore, inhomogeneous adipose infiltrations of the RV free wall and at the apical segment of the lateral wall of the LV, with extensive fibrosis at this level were observed (Figure 4).
Displaced ventricular probe - (a) radioscopy and (b) intraoperative aspect.
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The thoracic radioscopy showed displacement of the ventricular probe, suggesting a myocardial perforation (Figure 5).