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Abnormal Delayed Myocardial Hyperenhancement on Cardiac MRI: Unusual Presentation of an Uncommon Diagnosis
Chete Eze-Nliam, MD; Mandip Gakhal, MD
Background A 29-year-old male with history of ulcerative colitis and an
ex-cigarette smoker, presented with progressive fatigue for several months and shortness of breath on exertion with palpitations. A 12-lead electrocardiogram was performed which demonstrated complete heart block. A transvenous pacer was placed. Electrolytes were within normal limits. Lyme titers were negative. A computed tomography (CT) study of the chest with intravenous contrast was obtained (Figure 1). A cardiac magnetic resonance imaging (MRI) examination utilizing intravenous diagnosis (Figure 2).
QUESTION:
WHAT IS THE MOST LIKELY DIAGNOSIS
CASE REPORT
1. 2. 3. 4.
Right ventricular infarct Right ventricular dysplasia Cardiac sarcoidosis Pulmonary arterial embolism
FIGURE 1
CT chest with intravenous contrast.
FIGURE 2
Delayed gadolinium enhanced MRI of the chest.