Case 26 — Two-Dimensional Echocardiograms

Left-Sided View

Left-sided echocardiogram showing a concentrically hypertrophied right ventricle (RV) and an enlarged right atrium (RA) with an abnormal-appearing tricuspid valve apparatus.
Left-sided view. This unusual view shows a right ventricle (RV) that is concentrically hypertrophied and an enlarged right atrium (RA). The tricuspid valve apparatus appears to be abnormal.

Right Parasternal Obliqued View

Right parasternal obliqued echocardiogram showing a large mass of tissue with a small slit-like opening between the body of the right ventricle (RV) and the right ventricular outflow tract (RVOT). The right ventricular free wall appears markedly thickened. LV = left ventricle.
Right parasternal obliqued view. A large mass of tissue with a small slit-like opening sits between the body of the right ventricle (RV) and the right ventricular outflow tract (RVOT). The right ventricular free wall appears markedly thickened. LV = left ventricle.

Left Cranial View

Left cranial echocardiogram again showing the mass of tissue between the right ventricle (RV) and right ventricular outflow tract (RVOT). The right ventricular free wall is thickened and the right atrium (RA) is enlarged.
Left cranial view. Again shows the mass of tissue between the right ventricle (RV) and the right ventricular outflow tract (RVOT). The right ventricular free wall again looks thickened and the right atrium (RA) is enlarged.

Quiz

1. The thickened right ventricular myocardium suggests there is what type of overload present in the right ventricle?

2. Since there appears to be an obstruction to outflow, the overload that is present must be due to an increase in:

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