PMC6882387_01
Chest X-Ray of the patient.
abc-113-03-0438-g01.jpg
PMC6882387_01_abc-113-03-0438-g01.jpg
f1
Chest x-ray showed areas of consolidation on both sides of the lungs and increased cardiothoracic ratio (Figure 1). Right ventricular inflow view in systole showing thickened, immobile leaflets of tricuspid valve in a fixed open position, causing mal-coaptation and severe regurgitation without stenosis (see Figure 3 and Video 1).
Electrocardiography of the patient. (A). Sinus rhythm with QTc
prolongation (B). Atrial flutter (C). Atrioventricular dissociation
and ventricular extra-systole (D). Holter monitorization revealed
non-sustained ventricular tachycardia.
abc-113-03-0438-g02.jpg
PMC6882387_01_abc-113-03-0438-g02.jpg
f2
The electrocardiogram showed sinus rhythm with 70/min heart rate and prolongation of QTc value with 0.46 seconds (Figure 2-A). On the seventh day of hospitalization, the electrocardiogram showed atrial flutter (Figure 2-B). In the second week, the patient developed acute renal insufficiency and the electrocardiogram showed atrioventricular dissociation and ventricular extra-systole (Figure 2-C). Holter monitorization revealed atrioventricular dissociation and non-sustained ventricular tachycardia (Figure 2-D).
Transthoracic echocardiography from the parasternal view by tilting
transducer inferomedially exploring the right atrium (RA) and right
ventricle (RV) inflow tract; immobile leaflets of the tricuspid
valve (TV) leading to severe insufficiency.
abc-113-03-0438-g03.jpg
PMC6882387_01_abc-113-03-0438-g03.jpg
f3
Right ventricular inflow view in systole showing thickened, immobile leaflets of tricuspid valve in a fixed open position, causing mal-coaptation and severe regurgitation without stenosis (see Figure 3 and Video 1).