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case_images: An initial chest X-ray. A chest X-ray indicated an enlarged left pulmonary artery (dotted arrow) and a protrusion of the right atrium (solid arrow), suggesting pulmonary hypertension.
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case_images: Her chest X-ray indicated an enlarged left PA and a protrusion of the right atrium (RA) (Figure 1). Contrast-enhanced computed tomography demonstrated no evidence of pulmonary embolism during the acute phase (see Supplementary material online, Figure S1).
case_images: An initial electrocardiogram. An electrocardiogram demonstrated sinus rhythm with a heart rate of 75 beats per minute. Right atrial and ventricular load was noted.
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case_images: The overloads of the RA and RV were observed (Figure 2). Pulmonary perfusion scintigraphy showed no significant reduction in blood flow (see Supplementary material online, Figure S2).
case_images: The RV overload prior to medical treatment. The findings on the echocardiogram were recorded during the diastolic phase. The apical four-chamber view revealed significant dilation of the RA and RV (left panel). Compression of the interventricular septum (solid arrow) was noted due to the RV overload (right panel). LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.
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case_images: Transthoracic echocardiography showed the dilated right atrium and ventricle, with an estimated systolic PA pressure (sPAP) of 118 mmHg (Figure 3).
case_images: Reverse remodelling of the RV. The echocardiogram at one year after comprehensive treatment demonstrated that reverse remodelling of the RV and RA. Compression of the interventricular septum disappeared. LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.
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