High-Resolution, Contrast-Enhanced Cardiac Magnetic Resonance Detects an Intracardiac Thrombus in a Fontan Patient

World Journal for Pediatric & Congenital Heart Surgery
Catherine M AvitabileKevin K Whitehead

Abstract

A 28-year-old male with Fontan physiology presented with chest pain, elevated troponin, regional dyskinesis, and an apical echogenicity in the right-sided morphologically left ventricle (LV) on echocardiogram. Cardiac magnetic resonance (CMR) imaging was performed with a three-dimensional respiratory-navigated inversion recovery FLASH (low flip angle, spoiled gradient echo technique) sequence during slow gadolinium infusion. A hypointense lesion in the LV apex was consistent with thrombus. Gadolinium-delayed enhancement imaging demonstrated increased signal in the mid-inferior LV free wall. In this case, progressive decline in ventricular function was likely followed by an intracardiac thrombus and embolic myocardial infarction. The CMR was instrumental in characterizing the mass and identifying myocardial scar.

References

Nov 20, 2002·AJR. American Journal of Roentgenology·Jörg BarkhausenJörg F Debatin

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Citations

Jun 21, 2017·Journal of Thoracic Imaging·Giuseppe MuscogiuriArni Nutting

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