case_images: PMC8565710_01
case_images: ECG: SR 60 bpm, negative T waves in V1-V2, QS in V3-V5
case_images: acc-06-04-96-g001.jpg
case_images: PMC8565710_01_acc-06-04-96-g001.jpg
case_images: acc-06-04-96-g001
case_images: Echocardiography: Dilated RVOT (PLAX - a, PSAX - b) and decreased FAC (c, d).
case_images: acc-06-04-96-g002.jpg
case_images: PMC8565710_01_acc-06-04-96-g002.jpg
case_images: acc-06-04-96-g002
case_images: No signs of aortic dissection or significant valvopathies were found (Figure 2).
case_images: Magnetic resonance aspect: dilated RVOT (a) with aneurisms and hypokinesia, dyskinesia and zones of akinesia located at the level of the RV free wall (b). Inhomogeneous adipose infiltration of the RV free wall, with extensive fibrosis that also involves the left ventricle (c).
case_images: acc-06-04-96-g003.jpg
case_images: PMC8565710_01_acc-06-04-96-g003.jpg
case_images: acc-06-04-96-g003
case_images: In order to confirm our suspicion and further risk stratification, we decided to perform a cardiac MRI, which showed an extremely dilated RVOT (43 mm) and RV (EDV/BSA 223 ml/m2), with aneurisms and hypokinesia, dyskinesia and zones of akinesia located at the level of the RV free wall (Figure 3).
case_images: Extensive fibrosis at biventricular level (a, b).
case_images: acc-06-04-96-g004.jpg
case_images: PMC8565710_01_acc-06-04-96-g004.jpg
case_images: acc-06-04-96-g004
case_images: Furthermore, inhomogeneous adipose infiltrations of the RV free wall and at the apical segment of the lateral wall of the LV, with extensive fibrosis at this level were observed (Figure 4).
case_images: Displaced ventricular probe - (a) radioscopy and (b) intraoperative aspect.
case_images: acc-06-04-96-g005.jpg
case_images: PMC8565710_01_acc-06-04-96-g005.jpg
case_images: acc-06-04-96-g005
case_images: The thoracic radioscopy showed displacement of the ventricular probe, suggesting a myocardial perforation (Figure 5).