Pulmonary fibrosis with a troubling find

ICU TTE.

A 50-year-old male was admitted with worsening symptoms of his pulmonary fibrosis. The attending renal physician suspected right heart failure. The right ventricle was found to be of normal dimension with normal systolic function.

The incidental finding was of moderate left ventricular hypertrophy with a fixed restrictive diastolic profile. The myocardium appeared speckled on 2D assessment. Ejection fraction was estimated at 40%.

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