PMC10203762_01
A. Electrocardiography shows a normal sinus rhythm with negative T waves in V1-4. B. The chest radiograph documents mild cardiomegaly and a dilated right pulmonary artery. C. Transthoracic echocardiogram reveals a dilated right ventricle along with compression of the left ventricle. D. Lung ventilation-perfusion scintigraphy shows no mismatch.
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Electrocardiography revealed negative T waves in V1-4 (Fig. 1A). Chest radiography demonstrated mild cardiomegaly and dilated right pulmonary artery (Fig. 1B). TTE showed an elevated transtricuspid pressure gradient of 54 mmHg and a compressed left ventricle, forming a D-shape (Fig. 1C). Lung ventilation-perfusion scintigraphy revealed no mismatches (Fig. 1D).
Trends in hemodynamics and plasma BNP concentration after the discontinuation of cyclophosphamide. BNP, brain natriuretic peptide; PVR, pulmonary vascular resistance; mPAP, mean pulmonary artery pressure; CI, cardiac index.
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RHC performed 2 months after treatment initiation showed hemodynamic improvement with an mPAP of 24 mmHg, PAWP of 8 mmHg, CO of 4.05 L/min, CI of 2.22 L/min/m2, and PVR of 4.0 WU (Fig. 2).