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Cases of the Week 2010


This is our 100th Case! Number 10-26: Incidental Cardiac Mass
History: A 74-year old white male with previous history of CAD and CABG and chronic renal failure on hemodialysis, presented to our institution after a spontaneous fall while lawn mowing.

Number 10-27: Giant Systemic Venous Collateral
History: MRI evaluation of a double outlet right ventricle with a giant systemic venous collateral

Number 10-25: Constrictive Pericarditis Post Cardiac Transplant: Diagnostic Role of Cardiovascular MRI
History: A 56-year old male underwent heart transplantation (HTX) 8 years ago.

Number 10-24: Acute Pericarditis
History: A 58-year old man, free from any previous medical history, presented to the emergency department with retrosternal oppressive chest pain, varying with inspiration and posture, of rapid installation and evolution after prolonged direct exposure to cold airflow from an air-conditioner.

Number 10-23: Cardiac Lipoma
History: A 57 year old woman with a family history of premature coronary artery disease and a prolonged history of exertional chest pain underwent an exercise stress test and multislice CT coronarography which were negative for myocardial ischemia and obstructive coronary artery disease.

Number 10-22: Anomalous Right Coronary Artery Arising from the Main Pulmonary Artery
History: Multimodality imaging of an anomalous right coronary artery arising from the pulmonary arterial trunk

Number 10-21: Role of CMR in the diagnosis of ARVC
History: A 78 year old patient was admitted to the Accident and Emergency department with a syncope. The ECG showed a broad complex tachycardia (left bundle-branch morphology with superior axis) with a rate of 230 bpm. The patient received DC cardioversion under sedation, which resulted in sinus rhythm.

Number 10-20: Electrophysiologic and CMR features of ARVC
History: A 19-year old caucasian female with documented ventricular tachycardia was referred to electrophysiology service.

Number 10-19: Clinical Utility of Stress CMR to Guide Management
History: A 49-year old male patient with previous history of inferior infarction treated with angioplasty and stenting of the RCA, was admitted for new onset angina at rest.

Number 10-18: Aortic Coarctation Repair with associated Bicuspid Aortic Valve
History: 3D MRA demonstrating pre and post stenting of descending thoracic aorta coactation in addition to a bicuspid aortic valve with dilated aortic root.

Number 10-17: Clinical role of perfusion CMR *** CASE WINNER
History: **best case of the week in 2011. A patient with chest pain had echocardiography suspicious for HCM - CMR resolved the true diagnosis of multivessel CAD.

Number 10-16: Improvement in Image Quality in Atrial Fibrillation by using a Novel Prospective Reconstruction Method
History: Presentation of alternative techniques for improving image quality in patients with arrhythmia.

Number 10-15: T2* CMR to tailor chelation therapies
History: A 35 year old male with beta-thalassemia major, regularly transfused since the age of 30 months, started chelation treatment with subcutaneous desferrioxamine at the age of 4 years.

Number 10-14: Persistent Left SVC and AF Ablation
History: Electrical Activation of Atrial Fibrillation via persistent left SVC

Number 10-13: Cardiac Metastasis of the Renal Cell Carcinoma Diagnosed by CMR
History: A 59 year old male with history of pleuritic chest pain and pulmonary embolism presenting with painless hematuria

Number 10-12: Spiral Hypertrophic Cardiomyopathy
History: This is a case of HCM with asymmetrical hypertrophy which is distributed in a spiral or helical way from base to apex.

Number 10-11: Cardiac Sarcoidosis
History: A 32-year-old man presented with chest pain, fever, erythema nodosum of the lower extremities and swelling of both ankles. ECG showed ST-elevation in leads I and aVL and troponin was raised 40-fold.

Number 10-10: The Case of Three Ventricles
History: Large left ventricular basilar aneurysm with thrombus secondary to infarct

Number 10-09: Acute Pulmonary Edema in an Active Duty Officer in Iraq
History: A 27-year-old female active duty soldier with no significant past medical history was evacuated from Iraq for flash pulmonary edema.

Number 10-08: Perfusion Abnormalities in Cardiac Amyloidosis
History: A 68 year-old hypertensive male patient presented with typical chest pain. The ECG showed new characteristic ischemic changes and troponin dosage was positive. An urgent coronary angiogram revealed unobstructed epicardial coronary arteries. The echo showed a significant degree of septal wall thickening, out of proportion with his well-controlled blood pressure profile, suggesting possible hypertrophic cardiomyopathy.

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

Benefits include (1) Annual Meeting and Educational Workshops at a reduced fees (2) Free authorship in the open access journal Journal of Cardiovascular Magnetic Resonance (3) Scientific forum for: publications, presentations, equipment specifications (4) Exclusive online content ... More

Discrepancies between cardiovascular magnetic resonance and Doppler echocardiography in the measurement of transvalvular gradient in aortic stenosis: the effect of flow vorticity

Garcia J, Capoulade R, Le Ven F, Gaillard E, Kadem L, Pibarot P and Larose ?
Journal of Cardiovascular Magnetic Resonance 2013, 15:84 (20 September 2013)

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CMR Tissue Tracking: CP vs Restrictive CMP
Diagnostic concordance of echocardiography and cardiac magnetic resonance-based tissue tracking for differentiating constrictive pericarditis from restrictive cardiomyopathy.Circ Cardiovasc Imaging. 2014 Sep;7(5):819-27Amaki M et al. . On: 11/24/2014 By: jfernandes4125 ... Read more?

Multicenter Normal T1 Reference Values
Reference values for healthy human myocardium using a T1 mapping methodology: results from the International T1 Multicenter cardiovascular magnetic resonance study.Dabir D, Child N, Kalra A, Rogers T,.... On: 11/17/2014 By: jfernandes4125 ... Read more?

CMR Perfusion vs FFR
Diagnostic Accuracy of Myocardial Magnetic Resonance Perfusion to Diagnose Ischemic Stenosis With Fractional Flow Reserve as Reference: Systematic Review and Meta-AnalysisLi M et al. J Am Coll Cardiol.... On: 11/11/2014 By: jfernandes4125 ... Read more?

Susceptibility-weighted CMR
Susceptibility-weighted cardiovascular magnetic resonance in comparison to T2 and T2 star imaging for detection of intramyocardial hemorrhage following acute myocardial infarction at 3 TeslaKidambi A, Biglands JD, Higgins.... On: 11/03/2014 By: jfernandes4125 ... Read more?

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