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Case Reports
. 2025 Mar 19;30(6 Pt 1):102938.
doi: 10.1016/j.jaccas.2024.102938. Epub 2025 Jan 8.

Reversible Right Ventricular Outflow Tract Obstruction

Jayant Ravindran  1 , Lloyd Ridley  2 , Genevieve McKew  3 , Leonard Kritharides  4
Affiliations
Case Reports

Reversible Right Ventricular Outflow Tract Obstruction

Jayant Ravindran et al. JACC Case Rep. .

Abstract

Mediastinal masses are uncommon, manifesting in <1% of the population. Reports of these masses causing reversible and dynamic right ventricular outflow tract obstruction are exceedingly rare. In this study, we present a case of an inflammatory mediastinal collection causing reversible right ventricular outflow tract obstruction.

Keywords: echocardiography; mediastinal mass; murmur; physical examination; right ventricular outflow tract obstruction; streptococcus.

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Conflict of interest statement

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Pre- and Post-ECG (A) Admission ECG showing anterolateral ST-segment elevation with associated inferior ST-segment depression. (B) Follow-up ECG showing improved ST-segment changes. ECG = electrocardiogram.
Figure 2
Figure 2
Pre- and Post-Contrast Computed Tomography Chest Rim-enhancing lesion (arrows) in sagittal (A) and axial views (C) during index admission. Absence of rim-enhancing lesion (B and D) 6 weeks post antibiotic therapy.
Figure 3
Figure 3
Pre- and Post-Gallium Study Gallium avid lesion (arrows) in sagittal (A) and axial views (C) during index admission. Absence of lesion (B and D) 6 weeks post antibiotic therapy.
Figure 4
Figure 4
Pre- and Post-Antibiotics Echocardiogram and Flow Gradients Right ventricular outflow tract obstruction (RVOTO) (arrows) as seen on transesophageal echo (A) and transthoracic echo (B). Increased flow gradient on color Doppler (C) and gradients on continous wave Doppler (D) on transthoracic echo after diagnostic aspiration. Post-treatment transthoracic echo showing absence of RVOTO (E and F) with normalization of flow on color Doppler (G) and gradients on continuous wave Doppler (H).
Figure 5
Figure 5
RVOT Velocity and Peak Gradient A and B represent change in right ventricular outflow tract (RVOT) velocity and peak gradients.
See this image and copyright information in PMC

References

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