Introduction
Normal findings
Ischaemia-related diseases
Apical aneurysm and pseudoaneurysm
Aneurysms | Pseudoaneurysms | Congenital diverticula | |
---|---|---|---|
Layers | All layers of the ventricular myocardium | Organized hematoma and pericardium | All layers of the ventricular myocardium |
Cine | Akinetic dyskinetic segment | Akinetic or dyskinetic segment | Shows contraction during systole |
Myocardial late enhancement | Yes | No, only the border of the pseudoaneurysm will show enhancement | No |
Pericardial late enhancement | No or faint | Marked | No |
Apical diverticula
Apical ventricular remodelling
Apical hypertrophic cardiomyopathy
Factor assessed | Echocar-diographya | Multi-detector CT | MR imaging |
---|---|---|---|
LV volume | +++ | ++ | ++++ |
Ejection fraction | +++ | +++ | ++++ |
LV filling pressure | +++ | - | ++ |
Dynamic obstruction | +++ | + | +++ |
IschemialCFR | + | - | ++ |
Tissue characterisation | ++ | + | ++++ |
Tako-Tsubo cardiomyopathy
Primary cardiomyopathies (mostly confined to the heart) | Secondary cardiomyopathies (cardiac involvement is a part of systemic disease) |
---|---|
Genetic: | Infiltrative: |
Hypertrophic | Amyloidosis |
Arrhythmogenic | |
Non-compaction | |
Mixed: | Storage: |
Dilated | Hemochromatosis |
Restricted | |
Acquired: | Toxicity: |
Inflammatory | Drugs |
Tako-Tsubo | Chemical agents |
Perip artum | |
Endocrine: | |
Diabetes mellitus | |
Hyperthyroidism | |
Hypothyroidism | |
Hyperparathyroidism | |
Pheochromocytoma | |
Acromegaly | |
Autoimmune/collagen: | |
Systemic lupus erythematosis | |
Dermatomyositis | |
Rheumatoid arthritis | |
Scleroderma | |
Polyarteritis nodosa |
Tako-Tsubo | AMI | Myocarditis | |
---|---|---|---|
Hyperintensity distribution in T2-STIR | Transmural or diffuse | Transmural or subendocardial | Medium or subepicardic |
Location | Apical and mid ventricular segments without vascular distribution | Vascular distribution | Patchy, without vascular distribution |
Hyperintensity durability in T2-STTR | 2 weeks | More than 2 weeks |
Left ventricular non-compaction
Arrhythmogenic right ventricular dysplasia
Diagnostic criteria | |
---|---|
I. Global and/or regional dysfunction and structural alterations | • Major |
—Severe dilatation and reduction of right ventricular ejection fraction with no (or only mild) left and ventricular impairment | |
—Localized right ventricular aneurysms (akinetic or dyskinetic areas with diastolic bulging) | |
—Severe segmental dilatation of the right ventricle | |
• Minor | |
—Mild global right ventricular dilatation and/or ejection fraction reduction with normal left ventricle | |
—Mild segmental dilatation of the right ventricle | |
—Regional right ventricular hypokinesia | |
II. Tissue characterisation of walls | • Major |
—Fibrofatty replacement of myocardium at endomyocardial biopsy | |
III. Repolarisation abnormalities | • Minor |
—Inverted T waves in right precordial leads (V2 and V3) (people >12 years old; in absence of right bundle branch block) | |
IV. Depolarisation of conduction abnormalities | • Major |
—Epsilon waves or localised prolongation (>110 ms) of the QRS complex in right precordial leads (V1—V3) | |
• Minor | |
—Late potentials (signal-averaged ECG) | |
V. Arrhythmias | • Minor |
—Left bundle branch block type ventricular tachycardia (sustained or nonsustained; ECO, Holter, exercise testing) | |
—Frequent ventricular extrasystoles on Holter (>1,000/24 h) | |
VI. Family history | • Major |
—Familial disease confirmed at necropsy or surgery | |
• Minor | |
—Familial history of premature sudden death (at <35 years) due to suspected right ventricular cardiomyopathy | |
—Familial history (clinical diagnosis based on present criteria) |