Cardiovascular magnetic resonance (CMR) plays a growing role in therapeutic decision-making as it allows differentiation of etiologies and provides prognostic information.
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Cardiac cine imaging of the myocardium, dynamic first pass myocardial perfusion imaging, and delayed myocardial enhancement imaging are presented in a patient with macrovascular obstruction.
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This 70-year-old woman presented to the emergency room with acute onset of severe chest pain. No prior history of trauma. The pain started after a quarrel with her 45-year old daughter. The electrocardiogram did not reveal evidence of ischemic ST segment deviations. Creatinine kinase was of borderline value (10 U/L), but cardiac troponin T was elevated (2.15 µg/L). Coronary artery disease was ruled out by emergency coronary angiography. However, left ventricular angiography demonstrated apical ballooning with a reduced left ventricular ejection fraction.
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A 59 year-old man presents with long QT-syndrome and recurrent collapse. Neurologic assessment failed to reveal any abnormalities or pathologic findings. Ultrasound screening of the supraaortic arteries (including specifically the internal carotid and vertebral arteries) was unremarkable.
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