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Figure 10 CMR of an Elderly Patient With Acute Anterior Infarction and Invasive Exclusion of Relevant Coronary Artery Stenosis
(A) The CMR images taken at admission of an elderly woman who presented with acute anterior infarction and invasive exclusion of relevant coronary artery stenosis. (Left panel) Diastolic (upper) and systolic (lower) frames of a breath-hold cine study, showing typical extensive mid-ventricular and apical dyskinesia ("ballooning"). (Right upper panel) T2-weighted image showing diffuse intraventricular high signal intensity due to slow flowing blood as well as an increased signal intensity of the mid-ventricular and apical myocardium, presumably reflecting myocardial edema. (Right lower panel) Late gadolinium enhancement study showing no subendocardial high signal intensity but some diffuse late enhancement of the dysfunctional segments. The final diagnosis in this patient was acute stress-induced cardiomyopathy (see Online Video 8). (B) Follow-up study of the same patient after 4 weeks. (Left panel) Diastolic (upper) and systolic (lower) frames of a breath-hold cine study, showing normalization of systolic function. (Right upper panel) T2-weighted image showing homogeneous signal intensity. (Right lower panel) Late gadolinium enhancement study showing persisting diffuse late enhancement of the dysfunctional segments (see Online Video 9).
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