Society for Cardiovascular Magnetic Resonance 2023 Cases of SCMR case series

Figures

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  Fig. 1. Case 1: Initial (A) 12-lead ECG and subsequent (B) on arrival to the hospital. Initial ECG tracing by EMS showing significant ST elevations in aVR and aVL with diffuse ST depression. ECG on arrival to the outside hospital emergency department showing residual ST elevation in V1, hyperacute T waves in V2 and V3, with ST segment flattening in V4-V6. ECG electrocardiogram, EMS emergency medical services

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  Fig. 2. Case 1: Posteroanterior chest x-ray. Normal chest x-ray without acute cardiopulmonary findings

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  Fig. 3. Case 1: Basal short-axis cine bSSFP image at end-diastole. There is mild hypertrophy of the basal inferior septum (1.3 cm), but no other areas of hypertrophy. bSSFP balanced steady-state free precession

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  Fig. 4. Case 1: Basal to mid short-axis T1 maps. Normal T1 values present without focal abnormalities

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  Fig. 5. Case 1: Mid short-axis T2 map. Normal T2 values present without focal abnormalities

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  Fig. 6. Case 1: Basal to apical (A-F) short-axis PSIR delayed enhancement images. There is subendocardial hyperenhancement in the mid and apical (B-F) LV inferior wall. PSIR phase-sensitive inversion recovery, LV left ventricular

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  Fig. 7. Case 1: Basal to apical short-axis (A-F) and four (G) and two (H) chamber FIDDLE images. There is punctate subendocardial enhancement in the LV mid-apical inferoseptum and inferior walls, as well as in the LV apex (arrows). FIDDLE flow-independent dark blood delayed enhancement, LV left ventricular

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  Fig. 8. Case 1: Coronary angiogram shows normal origin of the RCA and concern for anomalous origin of the LMCA (arrows). Otherwise, no obstructive coronary disease. RCA right coronary artery, LMCA left main coronary artery

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  Fig. 9. Case 1: CorCTA demonstrating anomalous LMCA arising from the right coronary sinus of valsalva (arrows) with high-risk features, including slit-like orifice, inter-arterial course, and likely intramural segment. CorCTA coronary computed tomography angiography, LMCA left main coronary artery

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  Fig. 10. Case 2: TTE apical three-chamber spectral Doppler (A) and parasternal long-axis color compare view (B). Moderate-to-severe multilevel LVOTO with a mildly hypoplastic aortic valve and moderately hypoplastic sinotubular junction. The aortic valve leaflets are thickened and doming, the sinotubular junction is moderately hypoplastic, and a linear echodensity is noted along the wall of the ascending aorta consistent with atherosclerosis. There is mild aortic regurgitation with a vena contracta measuring 2.8 mm. TTE transthoracic echocardiography, LVOTO left ventricular outflow tract obstruction, PG pressure gradient, VTI vertebral tortuosity index

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  Fig. 11. Case 2: Preoperative cardiac CT 3D reconstruction (A), aortic valve en face view (B), and off-axis coronal view (C). The RCA has a relatively focal, luminal narrowing just distal to its take off. The aortic valve leaflets are thick and abnormal, with calcified plaque in the proximal ascending aorta (yellow arrow). CT computed tomography, RCA right coronary artery, 3D three-dimensional

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  Fig. 12. Case 2: Serial 12-lead ECG (A and B). Submillimeter inferior ST elevation in lead III with Q wave and reciprocal ST segment depressions laterally (A) and hyperacute T waves in V2 and V3 (B) consistent evolution of inferior transmural MI. ECG electrocardiogram, MI myocardial infarction