case_images: PMC10038749_01
case_images: Twelve-lead electrocardiogram showing normal sinus rhythm, right axis deviation, P pulmonale, and poor R wave progression in anterior precordial leads.
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case_images: PMC10038749_01_10-1055-s-0043-1764376-i220145-1.jpg
case_images: FI220145-1
case_images: Electrocardiogram (ECG) showed normal sinus rhythm, right axis deviation, P pulmonale, and poor R wave progression in anterior precordial leads ( Fig. 1 ).
case_images: Chest X-ray showing cardiomegaly and normal pulmonary parenchyma.
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case_images: PMC10038749_01_10-1055-s-0043-1764376-i220145-2.jpg
case_images: FI220145-2
case_images: Chest X-ray was suggestive of cardiomegaly and normal pulmonary parenchymal and vascular findings ( Fig. 2 ).
case_images: Echocardiogram in modified apical four-chamber view revealing dilated RA and RV (
  A
  ). Color Doppler image revealing severe TR (
  B
  ). RA, right atrium; RV, right ventricle; TR, tricuspid regurgitation.
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case_images: PMC10038749_01_10-1055-s-0043-1764376-i220145-3.jpg
case_images: FI220145-3
case_images: Transthoracic echocardiography in apical four-chamber view showed dilated right atrium (RA) and RV with severe functional low pressure tricuspid regurgitation (TR) and spontaneous echo contrast in RA ( Fig. 3A , 3B ; Video 1 ).
case_images: Echocardiogram in parasternal short axis view showing D-shaped LV and dilated RV. LV, left ventricle; RV, right ventricle.
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case_images: PMC10038749_01_10-1055-s-0043-1764376-i220145-4.jpg
case_images: FI220145-4
case_images: LV cavity was small (D shaped) with normal ejection fraction (left ventricle ejection fraction:55%) ( Fig. 4 ).
case_images: Magnetic resonance imaging showing bright blood sequence in four-chamber view of grossly dilated RA and RV (
  A
  ) and in short axis view grossly dilated RV in comparison to LV (
  B
  ). LV, left ventricle; RA, right atrium; RV, right ventricle.
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case_images: PMC10038749_01_10-1055-s-0043-1764376-i220145-5.jpg
case_images: FI220145-5
case_images: TR because of ring dilatation of tricuspid annulus (48 mm) ( Fig. 5A and B ; Video 2 ). There was neither fibro-fatty involvement of RV myocardium nor any late gadolinium enhancement.