Videos 1A and 1B. Echocardiography in the short-axis view with a non-blood-based ultrasound contrast agent showing how the ventricle was moderately dilated. The systolic function was severely reduced with an ejection fraction estimated at 20% (Video 1A). There was mild concentric hypertrophy. Features were consistent with a pseudo normal left ventricular filling pattern, with concomitant abnormal relaxation and increased filling pressure (grade 2 diastolic dysfunction). There was evidence of a mild mitral annular dilatation and moderate regurgitation in the apical four-chamber view (Video 1B, shown here). The left atrium was moderately dilated and the ventricle was mildly dilated, with mildly reduced systolic function where estimated peak pressure was at least 35 mmHg.
Virginia Perez-Andreu1, MD, PhD, Michael Tedla1, MD, Hossein Akhondi1, MD, FACP, Dominic Robine2, DO, FACC, Ali R. Rahimi1, MD, FACP, AGSF, Navid Kazemi2, MD, FACC
1Division of Internal Medicine, Graduate Medical Education, MountainView Hospital, University of Nevada, Reno, Nevada; 2Division of Cardiology and Interventional Cardiology, MountainView Hospital, Las Vegas, Nevada