A 38-year-old man presented with a few days' history of increasing shortness of breath and chest discomfort on exertion. He has diabetes newly diagnosed this year and was on metformin 500 mg bd. Physical examination revealed no evidence of heart failure but the oxygen saturation was only 90% in room air. There was no pitting edema but the left lower limb was mildly swollen. Chest X-ray showed normal heart size with clear lung fields. Electrocardiography (ECG) showed mild T inversion lead III.
Troponin-I was elevated to 0.23 ng/ml. An echocardiogram was done, which showed normal left ventricular size and function with no regional wall motion abnormalities. However, the right ventricle was dilated with moderate tricuspid regurgitation and pulmonary hypertension. What could be the most probable diagnosis of this condition? *This image based case is from Docplexus editorial team for…
