PMC5613682_01
(a) ECHO at diagnosis showing a short access view of the ventricles at systole with interventricular septal thickening and flattening; LV: left ventricle; RV: right ventricle. (b) At follow-up (after treatment); significant improvement in the interventricular septal morphology.
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fig1
The transthoracic echocardiogram (ECHO) showed evidence of significant pulmonary hypertension with a right ventricular systolic pressure (RVSP) estimated to be suprasystemic, dilated right ventricle (RV), septal flattening in systole, and diastole with dilated main pulmonary artery (MPA) and excluded the presence of congenital heart disease (Figure 1(a)). The ECHO showed a significant reduction in the pulmonary pressures from previous and estimated at <1/2 systemic RVSP as the septum was mildly flat in systole, RVSP (TR) 50 mmHg (Figure 1(b)).
(a) 3-minute polysomnographical recording showing the periodic breathing pattern. (b) Hypnogram from the entire night illustrating the sleep stages; W: wakefulness, R: REM, N1-N3: non-REM sleep (stage 1-3), SpO2: oxygen saturation, and EtCO2: end tidal carbon dioxide. Supplemental oxygen was added during the last third of the night.
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fig2
Those events were terminated by central events occurring in a PB fashion (Figure 2).
(a) 3-minute polysomnographical recording showing the normalization of the breathing pattern. (b) Hypnogram from the entire night illustrating the sleep stages; W: wakefulness, R: REM, N1-N3: non-REM sleep (stage 1-3), SpO2: oxygen saturation, and EtCO2: end tidal carbon dioxide.
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fig3
The PSG reflected a normalization of her breathing pattern with no evidence of PB (Figure 3).