A 66-year-old man presented with progressive lower limb edema and an elevated jugular venous pressure. He had undergone renal transplantation 14 years earlier for adult polycystic kidney disease. Serum creatinine and liver function tests were normal. Echocardiogram (Fig. 1a, online video) showed normal left ventricular function (ejection fraction 68 %) but compression of the right atrium (RA) adjacent to the right ventricle (RV) by hepatic cysts (HC). Computed tomography (CT) scan confirmed compression of the right atrium (Fig. 1b) and inferior vena cava (IVC) by an enlarged liver with numerous cysts (Fig. 1c). Hepatic transplantation was considered, but the patient’s clinical condition deteriorated rapidly and he died before this could be pursued.
WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.
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Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.