Nexilin mutations, a cause of chronic heart failure: A state-of-the-art review starting from a clinical case

Figure 1  The 12-lead electrocardiogram showing sinus rhythm and non-specific intraventricular conduction delay.

Figure 2 Transthoracic echocardiography in anatomic M-mode, parasternal short axis at papillary muscles view. Septal to posterior wall motion delay: 180 ms.

Figure 3 Contrast enhanced cardiovascular magnetic resonance. A: Balanced steady state-free precession cine diastolic frame in 4-chamber (4C) view, showing dilated left ventricle with mild hypertrophy; B: T2 weighted sequence in 4C view showing homogenous signal of the myocardial - suggestive of no myocardial oedema; C-F: Late gadolinium enhancement in 4C, 3C and short axis views respectively, showing extensive areas of intramyocardial hyperenhancement without coronary topography (orange arrows).

Figure 4 Timeline depicting the essential stages of the patient’s diagnosis. CRT with defibrillator - cardiac resynchronization therapy device with defibrillator support. LVEF: Left ventricular ejection fraction; MRI: Magnetic resonance imaging; CRT-D: Cardiac resynchronization therapy with defibrillator.