Myocardial infarction showing non-ischaemic late gadolinium enhancement pattern in the mid-septum: a case report.

Pub Date : 2024-09-25 eCollection Date: 2024-10-01 DOI:10.1093/ehjcr/ytae535
Luigi Tassetti, Ludovica Massa, Gianluca Pontone
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Abstract

Background: Cardiac magnetic resonance (CMR) is gaining an important role in the setting of acute coronary syndromes: it gives prognostic information based on oedema and late gadolinium enhancement (LGE) extension in acute myocardial infarction, and has a diagnostic value in myocardial infarction with nonobstructive coronary arteries (MINOCA) thanks to its capability to distinguish, based on different LGE patterns, ischaemic and non-ischaemic myocardial injuries.

Case summary: We describe a case of acute myocardial infarction involving a recurrent apical branch showing an atypical intramyocardial LGE pattern in the medium inferior septum.

Discussion: An intramyocardial LGE pattern might be determined by an ischaemic injury involving the interventricular septum. The knowledge of this misleading LGE pattern is important to adequately interpret CMR findings in this clinical setting.

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在中隔显示非缺血性晚期钆增强模式的心肌梗死:病例报告。
背景:心脏磁共振(CMR)在急性冠状动脉综合征中发挥着越来越重要的作用:它能根据急性心肌梗死的水肿和晚期钆增强(LGE)扩展提供预后信息,并能根据不同的 LGE 模式区分缺血性和非缺血性心肌损伤,因此在冠状动脉非阻塞性心肌梗死(MINOCA)中具有诊断价值。病例摘要:我们描述了一例急性心肌梗死病例,该病例涉及一个复发性心尖支,在中下间隔显示出非典型的心内LGE模式:心内 LGE 模式可能由涉及室间隔的缺血性损伤决定。了解这种误导性 LGE 模式对于在这种临床情况下充分解释 CMR 结果非常重要。
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