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Differential diagnosis of left ventricular hypertrophy: usefulness of multimodality imaging and tissue characterization with cardiac magnetic resonance
Author(s) -
Izgi Cemil,
Vassiliou Vassilis,
Baksi A. John,
Prasad Sanjay K.
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13367
Subject(s) - magnetic resonance imaging , cardiac magnetic resonance , left ventricular hypertrophy , medicine , multimodality , differential diagnosis , cardiology , cardiac magnetic resonance imaging , characterization (materials science) , radiology , nuclear magnetic resonance , pathology , materials science , computer science , physics , nanotechnology , blood pressure , world wide web
Differential diagnosis of asymmetrical left ventricular hypertrophy may be challenging, particularly in patients with history of hypertension. A middle‐aged man underwent an echocardiographic examination during workup for hypertension, which unexpectedly showed significant asymmetrical septal hypertrophy and raised suspicion for hypertrophic cardiomyopathy. Cardiovascular magnetic resonance confirmed the asymmetrical hypertrophy. No myocardial late gadolinium contrast enhancement was seen. However, precontrast T1 mapping revealed a low native myocardial T1 value. This was highly suggestive of Anderson‐Fabry disease, which was subsequently proved with very low alpha galactosidase enzyme levels and mutation analysis. The case illustrates clinical usefulness of multimodality imaging and the novel tissue characterization techniques for assessment of left ventricular hypertrophy.