case_images: PMC11756268_01
case_images: CMR performed at 1.5 T: (A) CMR four-chamber CINE view with dilatation of all cardiac chambers, mild left pleural effusion (chevron arrow), and mild pericardial effusion (triangular arrow, also in Figure B). (B) CMR three-chamber CINE view with mitral valve prolapse and 'pseudo' mitral annular disjunction of 11 mm (notched arrow). (C) Late gadolinium enhancement (LGE) image acquired after 10 min after contrast injection showing no LGE enhancement. (D) CMR ECV map with an elevated myocardial ECV of 39%. (E) CMR native T1-mapping showing normal T1 values. (F) Abdominal magnetic resonance imaging showing progression in size and number of liver and kidney cysts over a period of 10 years.
case_images: qyaf003f1.jpg
case_images: PMC11756268_01_qyaf003f1.jpg
case_images: qyaf003-F1
case_images: Her electrocardiogram indicated left ventricular hypertrophy and repolarization abnormalities (see Supplementary data, Supplementary data online, Figure S1). Mitral valve prolapse and 'pseudo' mitral annular disjunction were present, alongside mild pleural and moderate pericardial effusions (Figure 1A and B; see Supplementary data, Supplementary data online, Video S2). CMR revealed absence of myocardial oedema or focal fibrosis (Figure 1C) but an elevated myocardial extracellular volume (ECV) of 39% (Figure 1D). T1-mapping (Figure 1E) as well as native T2-mapping values were normal. There was notable progression in liver and kidney cysts compared with previous images over 10 years (Figure 1F).