Long-lasting symptoms and diagnostics in a patient with unrecognized right sided heart failure: Why listening to the heart is so important

Figure 1 Electrocardiography showing atrial fibrillation, ventricular response 80 beats/min, intermediate axis, right bundle branch block.

Figure 2 Chest X-ray showing marked cardiomegaly caused by right atrium enlargement, cor/thorax ratio 15. 5/24.5.

Figure 3 Echocardiography apical 4 chamber view showing the apically displaced tricuspid valve orifice, small right ventricle, large atrialized right ventricle and dilated right atrial.

Figure 4 Echocardiography: Low right parasternal view visualizing a large mural thrombus in the large atrialized right ventricle and right atrial (arrow).