{
  "abstract": "A male adolescent suffered a sudden syncopal episode lasting 15 s, accompanied by loss of consciousness without convulsions. On physical examination, his vital signs were stable, P2 was loud and a systolic murmur was detected at left sternal border. Laboratory tests showed decreases in haemoglobin (103 g/L; reference 129–172), platelet (126×10 9/L; reference 150–407) and serum albumin (31.4 g/L; reference 42–56) and increases in D-dimer (6585.76 ng/mL; reference 0–500), B-type natriuretic peptide (156.02 pg/mL; reference 0–96), total bile acid (91.3 µmol/L; reference 0–10) and ammonia (63 µmol/L; reference 9–47). Prothrombin time was extended to 15.8 s (reference 9–13), prothrombin time activity was 54.2% (reference 80–120%) and fibrinogen was 1.78 g/L (reference 1.8–4.0). Serological markers of viral hepatitis and the auto-immune antibodies were negative. Alpha-fetoprotein level was within normal range (2.20 ng/mL, range 0–7.0). The echocardiography revealed the right atrium and right ventricle were dilated to 63 mm and 34 mm, respectively, and the pulmonary artery was enlarged with an inner diameter of 36 mm. Right heart catheterisation identified increased pulmonary artery pressure up to 63 mm Hg. Chest radiography and thoracic contrast-enhanced CT findings are shown in figure 1.",
  "authors": [
    {
      "affiliations": [
        "Radiology, The First Hospital of Jilin University, Changchun, China"
      ],
      "name": "Jing Wang"
    },
    {
      "affiliations": [
        "Radiology, The First Hospital of Jilin University, Changchun, China"
      ],
      "name": "Boyu Kong"
    },
    {
      "affiliations": [
        "Radiology, The First Hospital of Jilin University, Changchun, China"
      ],
      "name": "Dianbo Cao"
    }
  ],
  "title": "Bizarre case of syncope in an adolescent",
  "uid": "20c8c357-8c58-50e6-a745-36421f054ea1"
}