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Figure 1 Pre- and post-contrast images demonstrating hyperenhancement. The pre-contrast images are the diastolic frames of fast imaging with steady-state precession cine loops. In the post-contrast images, normal myocardium appears dark. There is a large area of septal hyperenhancement, with additional papillary muscle hyperenhancement and subendocardial hyperenhancement of the lateral wall. The patient is a 33-year-old female with two risk factors for sudden death. Eight years previously, echocardiography demonstrated marked asymmetric septal hypertrophy, but the ventricle is now thinning and dilating and left bundle branch block has developed. The total extent of hyperenhancement was 25% of the left ventricular (LV) mass. LA = left atrium; RA = right atrial; RV = right ventricle.
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