{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:17:12Z","timestamp":1759882632604,"version":"build-2065373602"},"reference-count":3,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2018,8,22]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Clinical\u00a0introduction<\/jats:title>\n                  <jats:p>A 14-year-old boy presented with history of decreased appetite and bilateral swelling of feet for 6 months. He did not give any associated history of orthopnoea or paroxysmal nocturnal dyspnoea. He was born by a normal delivery after a non-consanguineous marriage. He had an unremarkable birth and childhood health history. There was no family history of significant cardiovascular illness or sudden death. Clinical examination showed an average built boy with elevated jugular venous pressure with prominent v wave and bilateral pitting pedal oedema. Cardiovascular examination showed normal first (S1) and second (S2) heart sounds and a short early systolic murmur over tricuspid region. Other systems examination was remarkable for soft tender hepatomegaly.<\/jats:p>\n                  <jats:p>ECG showed sinus rhythm with tall, peaked p waves. Chest X-ray revealed enlargement along the right cardiac border. Transthoracic echocardiographic images are shown in figure 1A (apical four-chamber view) and figure 1B (tricuspid inflow Doppler). There was no colour Doppler evidence of interatrial shunt.<\/jats:p>\n                  <jats:fig id=\"F1\" position=\"float\" orientation=\"portrait\">\n                     <jats:label>Figure 1<\/jats:label>\n                     <jats:caption>\n                        <jats:p>(A) Transthoracic echocardiographic apical four-chamber view.\u00a0(B)\u00a0Tricuspid inflow continuous wave Doppler image.<\/jats:p>\n                     <\/jats:caption>\n                     <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"heartjnl-2018-313646f1\" position=\"float\" orientation=\"portrait\"\/>\n                  <\/jats:fig>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Question<\/jats:title>\n                  <jats:p>What is the most likely diagnosis of his condition? <jats:list list-type=\"alpha-upper\">\n                        <jats:list-item>\n                           <jats:p>Endomyocardial fibrosis (EMF)<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                           <jats:p>Ebstein\u2019s anomaly<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                           <jats:p>Arrhythmogenic right ventricular dysplasia (ARVD)<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                           <jats:p>Idiopathic dilatation of right atrium<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                           <jats:p>Restrictive cardiomyopathy<\/jats:p>\n                        <\/jats:list-item>\n                     <\/jats:list>\n                  <\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heartjnl-2018-313646","type":"journal-article","created":{"date-parts":[[2018,9,21]],"date-time":"2018-09-21T14:13:33Z","timestamp":1537539213000},"page":"405-413","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Fourteen-year-old boy with decreased appetite and pedal swelling"],"prefix":"10.1136","volume":"105","author":[{"given":"Gopal Chandra","family":"Ghosh","sequence":"first","affiliation":[{"name":"Department of Cardiology, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aparna","family":"S","sequence":"additional","affiliation":[{"name":"Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oomen K","family":"George","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,9,21]]},"reference":[{"key":"2025100703495240000_105.5.405.1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.4103\/0971-3026.33620","article-title":"Cardiac magnetic resonancein the assessment of cardiomyopathies","volume":"17","author":"Jagia","year":"2007","journal-title":"Indian J Radiol Imaging"},{"key":"2025100703495240000_105.5.405.2","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jer292"},{"key":"2025100703495240000_105.5.405.3","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1111\/echo.12312","article-title":"Idiopathic dilatation of the right atrium: clinical and diagnostic pitfalls - a series of 3 cases","volume":"30","author":"Srinivasa","year":"2013","journal-title":"Echocardiography"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/heartjnl-2018-313646","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T10:49:57Z","timestamp":1759834197000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/heartjnl-2018-313646"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,21]]},"references-count":3,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,2,12]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/heartjnl-2018-313646"],"URL":"https:\/\/doi.org\/10.1136\/heartjnl-2018-313646","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"type":"print","value":"1355-6037"},{"type":"electronic","value":"1468-201X"}],"subject":[],"published":{"date-parts":[[2018,9,21]]}}}