case_images: PMC10465249_01
case_images: Admission CXR (a) showing clear lung fields and normal cardiac silhouette. High-resolution CT chest scan (b-f) showing bilateral peri-bronchovascular ground glass densities involving upper and lower lobes with smooth interlobar septal thickening, mediastinal lymphadenopathy, and pulmonary trunk dilatation.
case_images: CRIC2023-4846338.001.jpg
case_images: PMC10465249_01_CRIC2023-4846338.001.jpg
case_images: fig1
case_images: A genetic study was planned but the patient traveled to her town and did not attend the appointment (Figures 1 and 2).
case_images: Transthoracic echocardiography revealed severe dilatation and systolic dysfunction of the right ventricle while normal left ventricle and moderate pericardial effusion (a). There was severe TR with an estimated PASP >80 mmHg and TRV 4.01 m/s (b). The right atrium was severely dilated with a small atrial septal defect (c). TEE revealed a positive agitated saline test confirming interatrial shunting (d).
case_images: CRIC2023-4846338.002.jpg
case_images: PMC10465249_01_CRIC2023-4846338.002.jpg
case_images: fig2
case_images: A genetic study was planned but the patient traveled to her town and did not attend the appointment (Figures 1 and 2).
case_images: Transthoracic echocardiography revealed severe dilatation and systolic dysfunction of the right ventricle while normal left ventricle and a large pericardial effusion without tamponade (a). There was a severe TR with an estimated PASP >120 mmHg and a TRV 5.58 m/s (b).
case_images: CRIC2023-4846338.003.jpg
case_images: PMC10465249_01_CRIC2023-4846338.003.jpg
case_images: fig3
case_images: TR with a peak TRV of 558 cm/seconds and an estimated PASP > 120 mmHg. There was a large-sized pericardial effusion without signs of tamponade (Figure 3).
case_images: Post-lung transplant CXR with diffuse ground glass opacity and airspace consolidation (a) with jugular and femoral ECMO cannulas (blue arrows) in the line view (b). Complete opacification of both lungs occurred (c) with prolonged mechanical ventilation, tracheostomy, and VV-ECMO support via Avalon cannula (blue arrow) in line view (d).
case_images: CRIC2023-4846338.004.jpg
case_images: PMC10465249_01_CRIC2023-4846338.004.jpg
case_images: fig4
case_images: Unfortunately, the patient developed acute graft rejection as diagnosed by transbronchial biopsy and required prolonged mechanical ventilation and ECMO was changed to veno-venous configuration (VV-ECMO; Figure 4).
case_images: Predischarge CXR (a) revealed clear lung fields with a normal cardiac shadow. TTE (b) showed mild TR with a TRV of 1.98 m/s.
case_images: CRIC2023-4846338.005.jpg
case_images: PMC10465249_01_CRIC2023-4846338.005.jpg
case_images: fig5
case_images: TR. The patient was discharged with stable hemodynamics and SPO2% 98% on room air (Figure 5).