Presentation
Chest pain and intermittent shortness of breath for one week with subsequent hospital admission about 6 weeks ago with the diagnosis of an anterior wall STEMI with echographically moderately reduced left ventricular ejection fraction to 35-40%. No PCI at the time.
Patient Data
enlarged left ventricle with a severely reduced ejection fraction of 19%.
akinesia of the anterior and anteroseptal segments and the apex
-
transmural: basal and midventricular anteroseptal and apical inferior, septal and anterior
subendocardial: basal and midventricular anterolateral
microvascular obstruction: (marked hypointense) of all anteroseptal segments also visible in the short axis
focal myocardial edema in the basal anteroseptal wall
increased T1 time in the anterior septum (1240 ms vs 1080 ms in remote myocardium)
For the evaluation of the coronary arteries, a percutaneous coronary intervention was planned.
Case Discussion
Imaging features of myocardial infarction with extensive transmural late gadolinium enhancement severely reduced left ventricular function and a no-reflow-zone, (indicating microvascular obstruction) of the anteroseptal wall, probably as a result of prolonged myocardial injury/ischemia.
Due to the possibility that the extent of the scar is smaller than the late enhancement, mild myocardial edema in the anteroseptal wall (indicating myocardial area at risk) the patient's condition and the fact that the infarction can be attributed to one coronary territory a percutaneous coronary intervention was planned.
Unable to process the form. Check for errors and try again.