Cardiac magnetic resonance imaging in Holmes’ heart: Decoding a rare variant of double-inlet left ventricle

Holmes’ heart, a rare variant of double-inlet left ventricle with rudimentary right ventricle and ventriculoarterial concordance, predisposes to pulmonary overcirculation and heart failure due to unrestricted shunting. We report the case of a 32-year-old male, in whom cardiac magnetic resonance (CMR) revealed Holmes’ heart with marked pulmonary artery dilation and advanced heart failure after long-term clinical management. This case highlights the value of CMR in characterizing complex anatomy and reinforces the importance of early surgical palliation to prevent late decompensation.