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Image challenge
Severe aortic regurgitation and heart failure
  1. Xinli Guo,
  2. Rizhen Song,
  3. Yucheng Chen
  1. Department of Cardiology, Sichuan University, Chengdu, China
  1. Correspondence to Dr Yucheng Chen, Department of Cardiology, Sichuan University, Chengdu, China; chenyucheng2003{at}126.com

https://doi.org/10.1136/heartjnl-2021-319612

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    Clinical introduction

    A woman in her 70s was evaluated for fatigue and chest tightness for 4 months and oedema of both lower extremities for 1 month. She denied any medical history and family history of heart disorders. ECG showed normal QRS voltages with intraventricular block and left ventricular (LV) hypertrophy. Echocardiography showed severe aortic regurgitation (AR), asymmetric LV hypertrophy (maximum wall thickness of the septum 15 mm and 11 mm of the posterior wall) and normal LV size and ejection fraction of 60%. Transcatheter aortic valve replacement (TAVR) was successfully performed, and myocardial biopsy was made in the patient considering severe heart failure (HF) symptoms and high EuroSCORE of 22.5%. However, previous HF …

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    Footnotes

    • XG and RS are joint first authors.

    • XG and RS contributed equally.

    • Contributors All authors contributed to acquisition of clinical and imaging data, ideation and draft of the article.

    • Funding 1·3·5 project for disciplines of excellence–Clinical Research Incubation Project, West China Hospital, Sichuan University (ZYJC18013).

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.