724 AN UNUSUAL CASE OF ECHOCARDIOGRAPHY-ESTIMATED PULMONARY HYPERTENSION

Abstract Case Presentation 48-years-old woman was diagnosed with severe pulmonary hypertension at transthoracic echocardiography during cardiological evaluation for bariatric surgery. PAPs estimated 110 mmHg, mild-moderate tricuspidal insufficiency no dilatation of right chambers and LVEF preserved (65%). The patient had history heart murmur since childhood now presented type 2 diabetes mellitus on metformin treatment, third grade obesity (BMI 55) dyslipidemia (LDL col. 120 mg/dL). Diagnostic Workup: symptomatic dyspnea exertion (NYHA II-III). Heart-beat rhythmic 4/6 ubiquitous systolic sharp murmur. Lung auscultation normal. Bilateral pretibial edema noted. cardiac catheterization showed: A transesophageal confirmed post-tricuspidal intraventricular obstruction due to mid-ventricular fibro-muscular rims disclosed a small restrictive membranous defect interventricular septum minimum left-to-right shunt. cardiac-MRI an hypertrophic moderator band the outflow tract. patients discharged program sleeve-gastrectomy after surgical correction congenital defects. Conclusion double-chambered ventricle (DCRV) is uncommon anomaly: (RV) divided into two presence abnormally located muscular or anomalous muscle hypertrophy in sub-infundibular part RV tract, variable obstruction. This anomaly may be missed by estimation high pressure through regurgitation. Due limitations adult additional imaging methods, such as MRI, combined data are required definitive diagnosis.