case_images: PMC10996351_01
case_images: Transthoracic echocardiography, top right: M-Mode shows impaired right ventricular function with TAPSE of 1.6 cm, top left: continuous wave Doppler shows right ventricular systolic pressure of 63 mm Hg, bottom: dilated right ventricular dimension. TAPSE:Tricuspid annular plane systolic excursion
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case_images: Hg and no evidence of atrial septal defect (Figure 1). H2FPEF score, a validated algorithm for the diagnosis of heart failure with preserved ejection fraction, showed a 92% probability of heart failure with preserved ejection fraction (HFpEF).
case_images: Axial IV contrast-enhanced CT image through the chest shows a dilated central pulmonary artery, right and left main pulmonary arteries (right image), and right calcific mass (circle) obliterating the right lower pulmonary vein (left image).
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case_images: Computed tomography (CT) chest with and without intravenous (IV) contrast (Figure 2) revealed RLL atelectasis with possible endobronchial lesion and RLL mass, a mass distal to the bronchus basalis of RLL, and right lower PV compression.
case_images: Right heart catheterization tracings of pulmonary artery wedge pressure (PAWP). Right figure: PAWP on the right side of 8 mm Hg. Left figure: PAWP on the left side of 20 mm Hg.
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case_images: As a result, the catheter was redirected to the left side, revealing a PAWP of 20 mm Hg (Figure 3), corresponding to a pulmonary vascular resistance (PVR) of 1.8 Wood units (WU).