Tissue characterization by cardiovascular magnetic resonance aids in the evaluation of a patient with ventricular tachycardia
| Autor: | Omar Cheema, Mohammed Attar, William A. Zoghbi, Sherif F. Nagueh, Dipan J. Shah, Nadim Nasir |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Heart Ventricles Magnetic Resonance Imaging Cine Ventricular tachycardia Left ventricular hypertrophy Coronary artery disease Diagnosis Differential Internal medicine Diabetes mellitus medicine Humans Ventricular Function cardiovascular diseases Cardiac catheterization Aged medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine medicine.disease Ventricular flutter medicine.anatomical_structure Ventricle cardiovascular system Cardiology Tachycardia Ventricular Radiology business |
| Zdroj: | Methodist DeBakey cardiovascular journal. 7(2) |
| ISSN: | 1947-6094 |
| Popis: | VII (2) 2011 | MDCVJ Preoperative Clinical Course A 70-year-old white man with hypertension, diabetes mellitus, and hyperlipidemia was admitted to our hospital for dizziness and documented runs of nonsustained ventricular tachycardia (Figure 1). Serum electrolytes were within normal limits. Transthoracic echocardiography was technically challenging but revealed concentric left ventricular hypertrophy and normal systolic function with no detectable regional wall motion abnormalities. Cardiac catheterization was performed to evaluate for an ischemic etiology of the ventricular tachycardia (Figure 2), and this demonstrates no obstructive coronary artery disease. Programmed electrical stimulation (PES) was subsequently performed to evaluate for inducible ventricular arrhythmias. PES revealed inducible ventricular flutter and polymorphic ventricular tachycardia with triple extra stimuli. At this point there was a dilemma as to whether or not an automated defibrillator would be beneficial. Induction of ventricular flutter and polymorphic ventricular tachycardia in normal hearts or hearts without significant scar (as compared to post MI) are nonspecific findings and typically do not warrant implantation of an automated defibrillator. Given this patient’s challenging findings at echocardiography and his presenting symptoms, we questioned the presence of significant left ventricle scar. This prompted the performance of a cardiac magnetic resonance (CMR) scan to evaluate for substrate for ventricular arrhythmias (i.e., myocardial scar or fatty infiltration). CMR was performed using a 1.5 T Siemens Sonata scanner (Erlangen, Germany) and revealed asymmetric septal hypertrophy (anteroseptum 1.8 cm; inferolateral wall 1.1 cm). Systolic function was preserved with no regional dysfunction. Delayed contrastTISSuE CHARACTERIZATION BY CARDIOVASCuLAR MAGNETIC RESONANCE AIDS IN THE EVALuATION OF A PATIENT WITH VENTRICuLAR TACHYCARDIA Omar Cheema, M.D.ab; Nadim Nasir Jr., M.D.a; Mohammed Attar, M.D.a; Sherif Nagueh, M.D.a; William A. Zoghbi, M.D.a; Dipan J. Shah, M.D.a Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, Texas and The University of Texas Medical Branch, Galveston, Texas O. Cheema, M.D. |
| Databáze: | OpenAIRE |
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