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|Number 09-14 CARDIAC DAMAGE BY SCLERODERMA|
Number 09-14 CARDIAC DAMAGE BY SCLERODERMA
Case from: Sandra Graciela Rosales Uvera, Leticia Castellanos Caínas, Jorge Vázquez La Madrid, Martha Morelos Guzmán. National Institute of Medical Sciences and Nutrition "Salvador Zubirán", México city.
Cine CMR: Overall low normal LVEF but with regional wall motion abnormalities.
Post contrast CMR: Extensive subendocardial late gadolinium enhancement in the LV and RV, in parts transmural (eg LV apex)
MSCT coronary angiography demonstrated normal coronaries (as shown below) and an apical aneurysm on ventriculography.
MSCT: RCA prox and mid course up to the Crux
MSCT: left main and LAD/LCx bifurcation
MSCT 3D reconstruction
Conclusion: CMR is a reliable and sensitive technique to diagnose heart involvement in SSc providing additional information by visualising myocardial fibrosis and inflammation. Unfortunately, T2-weighted images to detect inflammation were not available in this case. Further study is needed to determine whether cardiac MRI abnormalities have an impact on prognosis and treatment strategy.
4. Bezante GP, Rollando D, Sessarego M, Panico N, Setti M, Filaci G, Molinari G, Balbi M, Cutolo M, Barsotti A, Indiveri F, Ghio M. Cardiac magnetic resonance imaging detects subclinical right ventricular impairment in systemic sclerosis. J Rheumatol 2007;34:2431-7.
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