A case report of a myocardial ischaemic attack: a novel hyperenhancement pattern on cardiac magnetic resonance in focal ischaemic injury.
Hedwig M J M NiesTom VromenCasper MihlSebastiaan C A M BekkersSaman RasoulRobert J HoltackersMartijn W SmuldersPublished in: European heart journal. Case reports (2023)
This case with an acute myocardial infarction showed intracoronary thrombi and emboli on ICA and CCTA. Interestingly, DE-CMR showed two different patterns of hyperenhancement in the same territories of the coronary thrombi. This observation may challenge the concept that these non-endocardial areas of hyperenhancement on DE-CMR are always of non-ischaemic aetiology. It is hypothesized that occlusion of smaller distal branches of the coronary arteries may result in mid-wall or epicardial fibrosis as opposed to subendocardial fibrosis commonly found in patients with a large epicardial coronary occlusion. Clinicians should be aware of these atypical patterns to be able to initiate adequate medical therapy.
Keyphrases
- coronary artery disease
- coronary artery
- acute myocardial infarction
- magnetic resonance
- left ventricular
- aortic stenosis
- percutaneous coronary intervention
- palliative care
- minimally invasive
- heart failure
- cardiac resynchronization therapy
- st elevation myocardial infarction
- stem cells
- bone marrow
- liver fibrosis
- aortic valve
- transcatheter aortic valve replacement
- contrast enhanced
- blood flow
- replacement therapy
- smoking cessation