Case of the week 07-14 .ppt

Case of the week 07-14: * Clinical:. A 59 year old with an 8 year history of asymptomatic ARVC diagnosed by 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. Cine CMR: RV moderate impairment with multiple wall motion abnormalities micro aneuysms . Discreet areas of LV thinning apex, mid antero-lateral wall Tissue characterisation – intrinsic contrast: Fatty infiltration of the RV side of the septum, parts of the moderator band and RV trabeculae, also the lateral wall of the LV T1W TSE, nulling with fat sat . Tissue characterisation – extrinsic contrast: LGE matching the fatty infiltration possibly explained by the shorter T1 of fat but additional RV free wall LGE and in the LV not explained by the fat. Interpretation: LV involvement is probably more common than initially recognised in ARVC. Scanner: Siemens avanto. Authors: Antonis Pantazis, Perry Elliott The Heart Hospital, London, UK References: Sen-Chowdhry S et al. Circulation 2007;115:1710-20; Sen-chowdhry S et al. JACC 2006;48:2132-40 *