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CLINICAL INTRODUCTION
An elderly patient was known with generalised osteoarthritis and destruction of the right hip. Six months before, this patient was admitted to a general hospital because of oedema and ventricular tachycardia. No coronary artery disease was found on coronary angiogram and the tachycardia was successfully converted to sinus rhythm. MRI 3 months later showed diffuse asymmetric hypertrophy of the right and LV walls, with diffuse subendocardial and midwall late gadolinium enhancement, and a diminished LVEF of 35%, indicating a restrictive cardiomyopathy.
At referral to our hospital, the only complaints were fatigue and dyspnoea when climbing the stairs. Physical examination showed no additional abnormalities. Serum analysis revealed elevated levels of N-terminal …
Footnotes
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Contributors All the authors have contributed equally to this work. The corresponding author is responsible for the overall content of this Image Challenge.
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Competing interests None.
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Provenance and peer review Not commissioned; internally peer reviewed.
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