Article Text

Image challenge
A 26-year-old man with severe right ventricular hypertrophy
  1. Jordan D Awerbach1,
  2. Cary Ward1,
  3. Michael J Campbell2
  1. 1 Division of Cardiovascular Medicine, Duke University, Durham, North Carolina, USA
  2. 2 Division of Pediatric Cardiology, Duke University, Durham, North Carolina, USA
  1. Correspondence to Dr Jordan D Awerbach, Division of Cardiovascular Medicine, Duke University Medical Center, Durham NC 27710, USA; jordan.awerbach{at}


Question The aetiology of his cMRI findings is most likely:

  1. Pulmonary hypertension from chronic left-to-right shunting.

  2. Infundibular obstruction from anterior deviation of the conal septum.

  3. Subinfundibular obstruction from hypertrophied muscle bundles.

  4. Infiltrative cardiomyopathy with deposition of abnormal fibrils.


  • Cardiac Magnetic Resonance (cmr) Imaging
  • Congenital Heart Disease
  • Ventricular Septal Defect

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  • Contributors JDA drafted the initial manuscript, and selected and edited included images. CW and MJC contributed to revisions and image selection. All authors have reviewed and approved of the manuscript in its final form.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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