PMC8207261_01
An apical view of the right ventricle. (a) The red circles indicate the deep sinusoidal recesses with the encompassing deep trabecular meshwork. (b) The red circles indicate the recesses and crypts. The white eclipse indicates the marked right ventricular enlargement relative to the left ventricle.
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There was also moderate-severe tricuspid regurgitation and pulmonary hypertension with mean right ventricular systolic pressures of 56 mm Hg (Table 2). The RV appeared to have marked trabeculations with deep sinusoidal recesses and crypts, whereas the LV displayed mild concentric left ventricular hypertrophy (Figure 1).
Computed tomography scan, pulmonary embolism protocol. (a) The red circle indicates right ventricular dilatation, whereas the red arrow indicates the trabecular meshwork at the right ventricular apex. (b) The red circle indicates a more focused image of the right ventricular enlargement with marked sinusoids amidst the trabecular mesh.
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This also revealed right ventricular enlargement with prominent myocardial trabeculations and recesses similar to the bedside echocardiographic findings (Figure 2).
Computed tomography scan, pulmonary embolism (PE) protocol. The red circle indicates the left pulmonary artery, which appears visually dilated, and the red arrows indicate the substantial, serpiginous thrombus burden, presumably arising from the isolated right ventricular noncompaction, consistent with a hemodynamically significant, submassive PE.
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Also, there was a relatively large, serpiginous filling defect almost occluding the left pulmonary artery, consistent with a hemodynamically significant PE (Figure 3).
Contrast-enhanced cardiac magnetic resonance imaging with gadobutrol. The red triangle indicates a focused short-axis view of the right ventricle apex, indicating the prominent trabeculae with the interspersed recesses.
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During the remainder of his 1-week hospitalization, he also underwent a contrast-enhanced cMRI scan with gadobutrol, which affirmed the iRVNC morphologic findings (Figure 4).