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A septuagenarian patient with history of high blood pressure was referred to the cardiology clinic for right heart failure. The patient complained of progressive increase of dyspnoea for the past 6 months. Physical examination revealed a 4/6 systolic murmur and signs of right-sided heart failure including important peripheral oedema, jugular venous distension and hepatojugular reflux. The ECG showed normal sinus rhythm (55 beats per minute) with right axis deviation and abnormal repolarisation. The echocardiography (figure 1A) and CT (figure B) are presented (online supplementary video).
Contributors All authors contributed to the care of the patient. All authors have read and contributed to the manuscript (draft, critical revision and final approval). All authors agree to be accountable for all aspects of the work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.