Abstract
We present the case of a 42-year-old male patient with a history of bilateral lung transplantation and chronic graft dysfunction. The patient presented to the adult emergency department due to acute heart failure. During his stay in the emergency room and in outpatient follow-up, cardiac multi-imaging led to the diagnosis of double-chambered right ventricle with associated hypertrophic cardiomyopathy. Given the presence of advanced lung disease and poor adherence to immunosuppressant medication as well as clinical follow-ups, the patient was deemed unsuitable for re-lung transplantation. The optimization of his immunosuppressive medication was prioritized, and beta-blockers were added as part of the treatment for dynamic right ventricular outflow obstruction. He was referred to pulmonary rehabilitation, currently showing a partially favorable evolution to functional class II.