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The aorto-left ventricular tunnel is an extracardiac communication that has a specific morphological feature. It is important to differentiate this entity from other diagnoses because the treatment options differ significantly and better outcomes are obtained with this entity.
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Antiphospholipid syndrome (APS) is a multisystem autoimmune disease characterized by acquired hypercoagulability, recurrent pregnancy loss, and elevated levels of antiphospholipid antibodies. The common cardiovascular manifestations include valvulopathy, coronary artery disease (CAD), myocardial dysfunction, cardiac thrombi, pulmonary thromboembolism, and pulmonary hypertension. Herein we present a case who presented with stroke with incidentally detected multiple cardiac lesions on echocardiography suspicious for mass. Cardiac magnetic resonance (CMR) was able to accurately characterize these lesions as cardiac thrombi, which were subsequently confirmed by endomyocardial biopsy. In this article, the case we discussed, highlights the importance of CMR in accurately characterizing the suspected mass lesion in echocardiography, thus arriving at an accurate diagnosis that changed patient management altogether.
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Saphenous vein graft (SVG) aneurysm after coronary artery bypass grafting (CABG) is a rare complication. A fistula between an SVG aneurysm and a cardiac chamber is even rarer. Herein, we report a middle-aged man who underwent CABG with five grafts 13 years prior presenting with multiple aneurysms in the venous graft with a fistula between the aneurysm and the right atrium. The computed tomographic angiogram findings and the subsequent treatment of the patient are addressed in the report.
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AIMS: Newer cardiac magnetic resonance techniques like native T1 mapping are being used increasingly as an adjunct to diagnose myocardial diseases with fibrosis. However, its full clinical utility has not been tested extensively, especially in the Indian population. The purpose of this study was to find native T1 values in healthy individuals without cardiac disease in our 3-Tesla MRI system and examine whether native myocardial T1 values can be used to differentiate between normal and diffuse myocardial disease groups. SUBJECTS AND METHODS: After approval from the institutional ethics committee, native T1 mapping was performed in 12 healthy individuals without cardiac disease who served as controls and in 26 patients with diffuse myocardial diseases (acute myocarditis (n = 5), hypertrophic cardiomyopathy (HCM) (n = 8), nonischemic dilated cardiomyopathy (DCM) (n = 7), restrictive cardiomyopathy (RCM) due to amyloidosis (n = 6)) in a 3-Tesla MRI system in short axis slices and four-chamber view using a modified Look-Locker inversion recovery sequence. The mean native T1 values and standard deviations were calculated for control and disease groups and compared. The ability of native myocardial T1 mapping to differentiate between normal and diffuse myocardial disease groups was assessed. One-way ANOVA with Tukey's Post-Hoc test was used to find significant difference in the multivariate analysis and Chi-Square test was used to find the significance in categorical data. RESULTS: The native T1 values for the healthy group in our 3-Tesla MRI system was 1186.47 ± 45.67 ms. The mean T1 values of the groups acute myocarditis (1418.68 ± 8.62 ms), HCM (1355.86 ± 44.67 ms), nonischemic DCM (1341.31 ± 41.48 ms), and RCM due to amyloidosis (1370.37 ± 90.14 ms) were significantly higher (P = 0.0005) than that of the healthy control group. CONCLUSION: Native myocardial T1 mapping is a promising tool for differentiating between healthy and diffuse myocardial disease groups.
