Case report: CMR work-up for a case of long QT syndrome, dilated left ventricle, and hypertension—when incidental findings unmasked the fundamental issue

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ID: 313802
2026
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Abstract
Abstract Background Cardiac magnetic resonance imaging (CMR) is increasingly used for detailed evaluation of cardiac structure and function. Its wide field of view also allows identification of extracardiac abnormalities, some of which may significantly impact clinical management. Case Summary We present a case of a 44-year-old woman referred for evaluation of prolonged QT interval and hypertension. Investigations revealed mild left ventricular dilatation, and suspicion of long QT syndrome (LQTS). CMR clarified the underlying cardiac abnormalities, identifying a patent ductus arteriosus (PDA) as the likely cause of volume overload and left ventricular dilatation. Importantly, it also revealed a right adrenal lesion. Subsequent endocrine work-up confirmed primary hyperaldosteronism (Conn’s syndrome), explaining the patient’s hypertension, hypokalaemia, and QT prolongation. The patient underwent successful radiofrequency ablation of the adrenal adenoma and percutaneous PDA closure. These interventions led to normalisation of blood pressure, serum potassium levels, and QTc interval, and allowed discontinuation of antihypertensive medications and potassium supplementation. Discussion This case highlights the importance of recognising significant extracardiac findings on CMR. Such findings can prompt the timely diagnosis of systemic conditions and lead to substantial changes in clinical management. Furthermore, the case emphasises the importance of evaluating secondary causes of hypertension and acquired long QT syndrome.
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openalex_W7160924696 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Dr Nang Aye, Eirini Velegraki, Raad Mohiaddin
Journal European Heart Journal - Case Reports
Year 2026
DOI
10.1093/ehjcr/ytag354
URL
https://doi.org/10.1093/ehjcr/ytag354
Keywords Keywords not found

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