19 Mantua Road, Mt. Royal, NJ 08061, U.S.A.
Phone: 856-423-8955 - Fax: 856-423-3420 - E-Mail: hq@scmr.org
MySQL: 0.0495 s, 21 request(s), PHP: 0.4870 s, total: 0.5365 s, document retrieved from database.
© SCMR. • By BlueFigment.com
Home » Case of the Week - Archive
Cases of the Week 2010
How to Submit a Case
Cases of the Week 2010
| Number 10-07: Sludge infarcts due to homozygous sickle cell anemia History: 16 y/o male with homozygous sickle cell anemia presenting with a history of chest pain and normal coronary angiography. |
| Number 10-06: Common Trick, Uncommon Application History: An incorrect diagnosis of Gerbode defect by CMR clarifed by echocardiography with agitated saline. |
| Number 10-05: Dobutamine inducible ischaemia: Case 2 History: An 48 year old male was admitted to hospital with 6 hours of crushing central chest pain. |
| Number 10-04: Hemorrhagic myocardial infarction History: Case demonstrating CMR sequences which can aid in the effective diagnosis of hemorrhagic infarct |
| Number 10-03: Unicuspid aortic valve and associated anomalies History: A 24-year-old male underwent a subclavian flap repair for aortic coarctation at the age of 1. A recent echocardiogram had been reported as showing mild aortic regurgitation and a dilated aortic root. |
| Number 10-02: Dobutamine inducible ischaemia: Case 1 History: 62 year old asthmatic male presented to the cardiologists with worsening atypical chest pain and breathlessness on exertion. |
| Number 10-01: Myofibroblastic tumor of the right atrium in a 2-year old boy History: A 2 year-old male with a history of one week febrile illness and cough was evaluated by his pediatrician |
Cases of the Week 2009
| Number 09-19: Pulmonary embolism by CMR History: A 34-year-old white female with a history of anxiety, mild asthma, and allergic rhinitis was recently hospitalized with an episode of SVT |
| Number 09-18: Traumatic interventricular septal dissection History: A 15-year-old boy fell down into a 10 meters gutter, he was found spleen bleeding and pansystolic cardiac murmur at the left sternal border without rib fracture. |
| Number 09-17: Characterization of a left atrial anomaly with CMR History: A 67-year-old female with hypertension presented with a 5-month history of exertional chest pain and dyspnea. |
| Number 09-16: A large and mysterious mass in the LV History: A 59 y/o female with history of breast CA s/p right lumpectomy and ovarian CA was referred for CMR |
| Number 09-15: Peripartum Cardiomyopathy? History: CMR in possible Peripartum Cardiomyopathy demonstrates Duchenne muscular dystrophy in a carrier - scar burden reinforces decision for ICD implantation |
| Number 09-14: CMR in Systemic Sclerosis History: A 28 years old female with Scleroderma (SSc) for 11 years and acute angina and elevated creatine kinase (CK). |
| Number 09-13: Severe AI in a bicuspid AV assessed with CMR History: A nice example of how CMR can be used to evaluate the severity of AI using cine and phase contrast CMR imaging. |
| Number 09-12: Role of CMR in acute myocardial infarction, primary angioplasty, and autologous stem cell therapy History: 50 y/o male with a 3 week history of accelerated angina... |
| Number 09-11: Gerbode Ventricular Septal Defect after Ross Procedure History: A 26-year-old male patient with past medical history of aortic coarctation repair... |
| Number 09-10: An unusual complication of the Ross procedure and the role of CMR in its assessment History: A 26 year old male had previously undergone a Ross procedure for a stenosed bicuspid aortic valve when aged 17yrs. |
| Number 09-09: Left Atrial Appendage Clot and Atrial Fibrillation History: Atrial appendage thrombus post thoracoscopic atrial appendage amputation imaged with CMR. |
| Number 09-08: Syncopal Event in a Case of Kawasaki's History: Kawasaki's Disease and Atrial Septal Aneurysm. Single imaging modality for complete assessment. |
| Number 09-07: All That Elevates Is Not Plaque Rupture History: A 75-year-old woman with atrial fibrillation |
| Number 09-06: Heterogeneous etiologies affecting a patient with cardiac amyloidosis History: 81 year-old male with history of atrial fibrillation |
| Number 09-05: Locating the leaks History: 61 year old female with endocardial cushion referred for CMR to measure shunt flow. |
| Number 09-04: Diagnosing RV dilatation by CMR (2) History: A 52 year old male with a dilated right ventricle and elevated pulmonary artery pressures on echocardiography. |
| Number 09-03: Coincident Hypertrophic Cardiomyopathy and Left Ventricular Non-Compaction History: Woman, 44 y/o, diagnosed by echocardiography of Non-Obstructive Hypertrophic Cardiomyopathy (HCM) |
| Number 09-02: Giant LV Pseudoaneurysm by CMR History: A 79 year old male with late-presentation lateral STEMI 3days earlier.. |
| Number 09-01: Is it or isn't it coronary artery disease? History: A 46-year-old man presents with breathlessness, heart failure and chest pain. Troponin borderline |
Cases of the Week 2008
| Number 08-23: A tricky diagnostic challenge History: A man in his 40s presenting to respiratory medicine with 6 months breathlessness and hemoptysis. |
| Number 08-22: A Segmented thoracic mass History: A 32 yrs old man was referred for assessment of iron loading by measurement of cardiac T2*. Past medical history of transfusion dependent thalassaemia (thalassemia) major and chronic iron chelation therapy. |
| Number 08-21: Myocardial scarring from 2 distinct pathologies History: Asymptomatic 62 yr ?. Diagnosed with HCM more than 20 with an abnormal ECG. Recent echo demonstrated concentric LVH. CMR to further assess this. |
| Number 08-20: Imaging Restrictive cardiomyopathy by CMR History: A 23 year old male presented with increasing dyspnea, abdominal distension, pedal edema and orthopnea over 18 months. |
| Number 08-19 Diagnosing RV dilatation by CMR History: ** Case of the year winner, 2008 |
| Number 08-18 'Bystander' ST elevation MI in DCM History: A 52 yr old lady, previously asymptomatic with no previous medical history, underwent a primary PCI for acute chest pain with inferior STEMI and LBBB. The left coronary system was unobstructed and RCA was occluded distally. PCI successfully established flow into the postero-lateral branch but not posterior descending branch of the RCA. |
| Number 08-17: Isolated Left Ventricular Apical Hypoplasia History: 35yr male. Known previous DCM diagnosed via echocardiography. Currently stable, NYHA Class I, and well controlled. No significant arrhythmias noted. Referred for CMR. |
| Number 08-16: Advanced late gadolinium enhancement optimisation History: 48 Y/O male from Kuwait presented with dyspnea and palpitations. Holter shows 2:1 heart block episodes. PMH: severe asthma. |
| Number 08-15: Danon Disease - A rare cause of LV hypertrophy History: 20 years old male, history of RF ablation for WPW syndrome, without prior history of heart failure. |
| Number 08-14: Erdheim-Chester Disease by CMR History: 41 year old black female admitted for chest pain, malaise, weakness and increasing peripheral edema. Tibial biopsy had demonstrated typical findings of Erdheim-Chester disease (ECD) 8 years earlier. She has previously documented involvement of the long bones, pancreas, pericardium and thoracic aorta with her ECD. Cardiac biomarkers were negative for myocardial necrosis. |
| Number 08-13: Viral Myocarditis by CMR History: A 22-year-old college student noted chest pain one week after recovering from flu-like symptoms. His ECG revealed inferolateral ST-elevation and his cardiac biomarkers were elevated. |
| Number 08-12: Congenital Bicuspid Aortic Valve with Ascending Aortic Dilatation History: 35 year old man. Known congenital bicuspid aortic valve. Recently noted ascending aortic dilatation on routine echocardiogram. Referred for a cardiac MRI for LV functional and morphologic assessment and contrast MRA for aortic evaluation. |
| Number 08-11: CMR for RA Mass characterization History: A 37 yr female had an echocardiogram for chest pain showing a possible mass in the right atrium. CMR was performed to further characterise this. |
| Number 08-10: Interrupted Aortic Arch History: 2 day old female, mild respiratory distress |
| Number 08-09: Lipomatous Hypertrophy of the Interatrial Septum (LHIAS) History: 73 year male. 1 year hx of myalgia and weight loss. RA mass on echo. |
| Number 08-08: Incidental chest findings - is CT needed? History: A 54 yr old man with abnormal ECG and apical obliteration on LVgram but normal echo, was referred for CMR (possible apical hypertrophic cardiomyopathy). |
| Number 08-07: Left Ventricular Trabeculae, Non-Compaction and DCM History: 18 Y/O male presented with dyspnea and palpitations. His father had died suddenly at age 32. |
| Number 08-06: Coarctation & aortic stenosis? History: A 46 year old male with 6 months breathlessness. Previous patch repair of “adult type†CoA. |
| Number 08-05: Acute MI, normal coronaries History: A 44 yr old lady transferred for primary PCI for chest pain with lateral ST elevation. Troponin I 26, CK 1233. Normal lipids (TC:HDL 3.17). Only risk factor for IHD was hypertension: non-smoker. |
| Number 08-04: Where is the murmur from? History: A 20 year-old Hispanic male with a murmur since childhood presented with worsening exertional chest pressure and dyspnea. CMR was ordered for further evaluation. |
| Number 08-03: Primary Pericardial Echinococcosis History: A 47 year male previously admitted with a severe pericardial effusion which was drained and an associated left pleural effusion. Subsequently referred for a CMR scan with as a structure “like a cyst†was noted near the heart on echocardiography. |
| Number 08-02: Apical HCM, fibrosis and sustained VT History: An 82 yr man admitted with palpitations, presyncope and sustained monomorphic VT. Family history, his brother died age 6 of unknown cause. |
| Number 08-01: Measuring Dyssynchrony in Pulmonary Hypertension History: A stable, idiopathic pulmonary artery hypertensive (IPAH) 38 year old female (PAP 110 mmHg, WHO functional class III) underwent CMR. |
Cases of the Week 2007
| Number 07-22: LV Thrombus History: A 59 year old man with previous anterior MI presented with a 6 hour history of acute dyspnoea without chest pain |
| Number 07-21: An unexpected cause of ascites History: A 31 year old male with a 2 year History of recurrent ascites, peripheral oedema and deranged LFTs. Budd-Chiari syndrome suspected. Proteinuria noted so Renal MRA requested to exclude renal vein thrombosis |
| Number 07-20: ASD First pass contrast bolus tracking History: A 28 year old white male with incidental CXR abnormalities: cardiomegally, right heart enlargement and R pleural effusion ECG: RVH |
| Number 07-19: CMR guided revascularisation History: 72 yr old man with a 3 week history of chest pain and shortness of breath presented in cardiogenic shock with pulmonary edema, acute renal failure and VT |
| Number 07-18: Right Atrial Tumour - or not? History: An incidental mass was identified in the right atrium of a middle aged female on pre-operative trans thoracic echocardiography (top left). CMR requested for further characterization. |
| Number 07-17: ARVC mimic - congenital partial absence of the pericardium History: Family screening implemented for ARVC after a 1st degree relative died of cardiomyopathy with ventricular dilatation. In this individual, and abnormal ECG with right pre-cordial T wave inversion and a shift of the transition zone to V5 was found suggesting possible ARVC. Echo normal but with poor windows. |
| Number 07-16: Late Mediastinal malignancy treatment complications History: Increasing Breathlessness. Past medical history included a thymoma removal with subsequent mediastinal radiotherapy. Previous successful PCI to the LAD for radiation induced coronary artery disease. |
| Number 07-15: Sarcoidosis Masquerading as ARVD/C History: A 46 year old African American presenting with VT of LBBB morphology. |
| Number 07-14: ARVC with LV involvement History: A 59 year old with an 8 year history of asymptomatic ARVC diagnosed through family screening. A disease causing mutation in plakophilin was found. Type 1 diabetes since childhood. Recent echo showed a possible new LV apical aneurysm. Coronary angiography normal. |
| Number 07-13: Cine Artefact History: A 55 y.o. male admitted with new heart failure. No acute coronary syndrome. Past medical history includes type I Diabetes, hypertension, chronic renal insufficiency and anaemia of chronic disease. After stabilization, transthoracic echo showed an EF of 40%, no significant valvular disease. CMR was requested. |
| Number 07-12: Troponin +ve Chest pain, normal coronaries History: 6 months ago, a 48 year old body builder had troponin positive chest pain with inferior T wave inversion on ECG and normal coronary angiography. Echo had suggested possible inferior hypokinesia. Ongoing clinical uncertainty |
| Number 07-11: Valvular disease by CMR History: A 74 year old female with increasing breathlessness. Known rheumatic heart disease and LVH. |
| Number 07-10: Tumor or Thrombus? History: 61 year old male, known renal cell carcinoma with renal venous thrombosis. |
| Number 07-09: Tako-tsubo or Infarction History: ***Winner, case of the Year, 2007. |
| Number 07-08: Acquired VSD by CMR History: An 80 year old man with STEMI and cardiogenic shock. |
| Number 07-07: HCM with LVOT obstruction by CMR History: 62 year old man with HCM with obstruction referred for alcohol septal ablation (ASA) refractory symptoms of angina and dyspnea. This was a baseline study done prior to ASA., |
| Number 07-06: Microvascular Obstruction by CMR History: A 41 year-old man admitted with 3 hours of chest pain with initial thrombolysis (tenecteplase) and salvage angioplasty one hour later. |
| Number 07-05: Double chambered Right Ventricle History: 34-yr-old male, recurrent syncope and dyspnea |
| Number 07-04: Delayed enhancement-targeted biopsy History: A 53-yr-old male with 2 types of symptomatic VT. One VT with LBBB and superior axis suggested origin from RV inflow, likely from IVS. Rest ECG shows inverted T waves inferiorly and no epsilon wave. |
| Number 07-03: HCM with multi-level obstruction History: A 69 yr-old female, increasing breathlessness. |
| Number 07-02. Coarctation, MS and bicuspid AoV History: A 17-yr-old female, referred with hypertension. |
| Number 07-01: `Ringing bell' sinus of valsalva aneurysm History: A 42-yr-old male, recent onset breathlessness. |
Cases of the Week 2006
| Number 06-10: Myocarditis History: A 42 year-old male admitted with 3 days of chest pain and diarrhoea |
| Number 06-09: Isolated RV infarction History: A 61-year-old male, 24 hours of chest pain, CK raised, normal ECG. |
| Number 06-08: Great vessel pathology History: A 16 year old male, known coarctation + dysplastic aortic valve. |
| Number 06-07: Infective cardiomyopathy History: A 55 year old male presented with breathlessness and palpitations |
| Number 06-06: What course the RCA? History: A 56 year old female, atypical chest pain and collapse. |
| Number 06-05: Apical HCM by CMR and echo History: A 64 year old women presented with chest pain and palpitations. The ECG showed Extensive T wave inversion. Echocardiography (L) was reported as showing diastolic dysfunction and an akinetic apex. Cine CMR confirmed the clinical suspicion of apical hypertrophic cardiomyopathy (aHCM). |
| Number 06-04: Thrombus or tumor? History: An 84 year old women presented breathless. Earlier in the year, she had undergone coronary artery bypass from which she had made a full recovery. Echocardiography demonstrated a left atrial mass, of uncertain aetiology. |
| Number 06-03: Pericardial constriction History: A 59 year old presented with paroxysmal atrial fibrillation, breathlessness, ankle oedema and disturbed liver function tests. |
| Number 06-02: High Risk HCM History: A 33 year old man with HCM with a family history of sudden death. Seven years previously, a single Holter had shown 3 beats of NSVT. Cine CMR shows HCM with ASH, no SAM, no LVOTO (left or right), and normal systolic function. After gadolinium, there was very extensive late enhancement, (44% of LV myocardium, arrowed). The scan triggered re-evaluation of cardiac risk, and the patient was offered an ICD. |
| Number 06-01: Left Atrial Myxoma History: An 80 year old men presented with dyspnea. Echo showed a LA mass. Cine CMR (left) showed a large (7x7x4cm) tumor attached to the fossa ovalis, prolapsing through the mitral valve. Signal intensities: low T1 and high T2 (middle, top and bottom) were also compatible with myxoma, subsequently confirmed at surgery (right). The patient was discharged 6 days after surgery. |