When Clinical Suspicion Leads to the Heart of the Matter

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Presentation transcript:

When Clinical Suspicion Leads to the Heart of the Matter Colette E. Jackson, BSC (Hons), MBChB, MRCP, Jonathan R. Dalzell, MBChB, MRCP, Giles H. Roditi, MBChB, FRCP, FRCR, Roy S. Gardner, MBChB, MD, MRCP The American Journal of Medicine Volume 122, Issue 5, Pages e3-e4 (May 2009) DOI: 10.1016/j.amjmed.2008.11.020 Copyright © 2009 Elsevier Inc. Terms and Conditions

Figure 1 Composite image showing selected scans from CMR imaging study of cardiac amyloidosis features. Transverse T1-weighted black blood image (top left) showing small ventricles with thickened myocardium, particularly the right ventricle. Markedly dilated right atrium showing increased “spontaneous” signal in the atrium because of sluggish blood flow, particularly adjacent to the atrial wall. Contrast this with the steady-state free precession gradient echo image in the same orientation (top right), where a normal thin atrial wall is appreciated; note small bilateral pleural effusions. Lower images are short-axis, mid-cavity, and 4-chamber orientations. Delayed enhancement images with inversion recovery preparation showing failure to appropriately null the myocardium because of global enhancement. Interatrial thickening is best appreciated on 4-chamber post-contrast image (lower right). The American Journal of Medicine 2009 122, e3-e4DOI: (10.1016/j.amjmed.2008.11.020) Copyright © 2009 Elsevier Inc. Terms and Conditions