PMC10038749_01
Twelve-lead electrocardiogram showing normal sinus rhythm, right axis deviation, P pulmonale, and poor R wave progression in anterior precordial leads.
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Electrocardiogram (ECG) showed normal sinus rhythm, right axis deviation, P pulmonale, and poor R wave progression in anterior precordial leads ( Fig. 1 ).
Chest X-ray showing cardiomegaly and normal pulmonary parenchyma.
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Chest X-ray was suggestive of cardiomegaly and normal pulmonary parenchymal and vascular findings ( Fig. 2 ).
Echocardiogram in modified apical four-chamber view revealing dilated RA and RV (
A
). Color Doppler image revealing severe TR (
B
). RA, right atrium; RV, right ventricle; TR, tricuspid regurgitation.
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Transthoracic echocardiography in apical four-chamber view showed dilated right atrium (RA) and RV with severe functional low pressure tricuspid regurgitation (TR) and spontaneous echo contrast in RA ( Fig. 3A , 3B ; Video 1 ).
Echocardiogram in parasternal short axis view showing D-shaped LV and dilated RV. LV, left ventricle; RV, right ventricle.
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LV cavity was small (D shaped) with normal ejection fraction (left ventricle ejection fraction:55%) ( Fig. 4 ).
Magnetic resonance imaging showing bright blood sequence in four-chamber view of grossly dilated RA and RV (
A
) and in short axis view grossly dilated RV in comparison to LV (
B
). LV, left ventricle; RA, right atrium; RV, right ventricle.
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TR because of ring dilatation of tricuspid annulus (48 mm) ( Fig. 5A and B ; Video 2 ). There was neither fibro-fatty involvement of RV myocardium nor any late gadolinium enhancement.