Multiple Choice Question of the Week : CMR-07 : [Answer]

             
      



Woman, 67 years, worsening dyspnea from 1 year before. Which is the possible diagnosis?

A – Myocarditis
B – Ischemic Myocardial injury
C – Cardiac amyloidosis
D – HCM

Correct answer is C) : Cardiac amyloidosis

Symmetric hypertrophy, reduced EF with hypokinesia more evident in the basal segments, atrial dilation, thickening of the atrial septum  and pericardial effusion, suggest the presence of cardiac amyloidosis. The diagnosis is reinforced by the LGE sequences. There are different LGE patterns (from the most extensive to those with spots) but they all have in common the difficult annullation of the myocardial signal. The T1 mapping sequence shows elevated T1 values (1.200 ms).

The final diagnosis was AL amyloidosis.

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