Young adult with left ventricular dysfunction

Clinical introduction A patient in their 30s had been diagnosed with peripartum cardiomyopathy, pulmonary oedema, with severe left ventricular dysfunction at the seventh month of gestation in the third pregnancy in their late 20s. The patient had pregnancy-induced hypertension and hypothyroidism and was treated accordingly. The patient was managed medically and was referred to us in view of worsening symptoms with severe left ventricular dysfunction and moderate aortic regurgitation. Echocardiogram, CT aortogram and late gadolinium imaging of the aorta have been shown in figure 1. The coronary angiogram was normal. C reactive protein and erythrocyte sedimentation rate were elevated. The carotid Doppler was normal, and autoimmune antibody markers (antinuclear antibody and other connective tissue disease markers) turned out to be negative. The renal and carotid Doppler tests were normal. Figure 1(A) Two-dimensional echocardiogram short-axis basal view showing aortic valve; (B) volume-rendered CT aortogram...
Source: Heart - Category: Cardiology Authors: Tags: Image challenges Source Type: research