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Non-viable LAD infarct

Non-viable LAD infarct
March 16, 2021
  • Case details
  • Legends
  • Diagnosis and Discussion

Case details

Non-viable LAD infarct

Legends

 

1.Fig 1. 4CH SSFP: Dilated left ventricle and left atrium, with myocardial thinning in apex.

2.Fig 2. Rest perfusion SA image: Rest perfusion deficit (arrows) in anteroseptal and inferoseptal mid-ventricle.

3.Fig 3,4,5. 2 CH, 4CH and 3CH PSIR: Transmural LGE (late gadolinium enhancement) involving mid-ventricular interventricular septum and anterior wall and apex, with myocardial wall thinning and aneurysmal dilatation of apex.

 

 

Fig 6,7. SA PSIR: Transmural LGE (late gadolinium enhancement) involving mid-ventricular interventricular septum, mid-ventricular anterior wall and apex, with myocardial wall thinning.

 

Fig 8. Calculation of LV function shows dilated left ventricle with reduced ejection fraction: LVEF: 31% and LVEDV: 268 ml

Diagnosis and Discussion

DIAGNOSIS:

Non-viable left ventricular apical and mid interventricular septal myocardium with transmural delayed gadolinium enhancement, and extending to involve basal septum, with wall thinning and aneurysmal dilatation of apex.

DISCUSSION:

Differentiation of viable and non-viable myocardium

Complications of non-viable (infarcted) myocardium:

1.Ventricular free wall rupture.

2.Ventricular septal rupture.

3.Mitral valve regurgitation.

4.post-myocardial infarction pericarditis.

5.Left ventricular aneurysm.

REFERENCES:

  1. Elfigih IA, Henein MY. Non-invasive imaging in detecting myocardial viability: Myocardial function versus perfusion. IJC Heart & Vasculature. 2014 Dec 1;5:51-6.
  2. Montrief T, Davis WT, Koyfman A, Long B. Mechanical, inflammatory, and embolic complications of myocardial infarction: An emergency medicine review. The American journal of emergency medicine. 2019 Jun 1;37(6):1175-83.

Case contributed by:

Dr. Deepali Saxena,
DNB, Fellowship Cardiothoracic Imaging (USA)
Lead Cardiothoracic Imaging
Manipal Hospitals Radiology Group.
Unit coordinator, Whitefield
Dr. Vivek Jirankali,
MD
Senior resident and cross-sectional fellow
Manipal Hospitals Radiology Group.

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Lead Neurology Imaging – Manipal Hospitals Radiology Group

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