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Video 1: Transthoracic echocardiogram showed LV dyssynchrony with severely depressed ejection fraction.
Video 2: Transthoracic echocardiogram showed improved LV synchrony and ejection fraction after cardiac resynchronization therapy.
Opmerkingen
Video online
The online version of this article contains two videos. The article and the videos are online available (https://doi.org/10.1007/s12471-021-01548-9). The videos can be found in the article back matter as “Electronic Supplementary Material”.
A 48-year-old woman presented with progressive exertional dyspnoea, orthopnoea and weight gain. Physical examination revealed bilateral rales, a third heart sound, a holosystolic murmur over the apex, abdominal and peripheral oedema.
Electrocardiogram showed left bundle branch block (Fig. 1 panel a). Heart size was markedly increased on chest X‑ray (Fig. 1 panel b). On transthoracic echocardiography left ventricular ejection fraction was severely depressed (LVEF 16%; video 1) with severe secondary mitral regurgitation. This was corroborated by cardiac magnetic resonance imaging (LVEF 18%). Coronary artery disease was excluded on coronary computed tomography. The patient was diagnosed with dilated cardiomyopathy and treated with optimal medical therapy.
Fig. 1
Electrocardiogram and chest X‑ray before (panel a and panel b) and after (panel c and d) cardiac resynchronisation therapy
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Cardiac resynchronisation therapy was initiated under which QRS duration decreased significantly (Fig. 1 panel c), as well as a marked reduction in heart size on chest X‑ray and transthoracic echocardiography (Fig. 1 panel d; video 2). The patient rapidly recovered and shows no signs or symptoms of heart failure.
Conflict of interest
S. Bouwmeester and L.X. van Nunen declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...
