IMAGES IN CARDIOLOGY
Ebstein Anomaly by Cardiac Magnetic Resonance Imaging
Ikuko Nakamura, MD*,
Norihiko Kotooka, MD*,
Yoshiaki Komori, MS and
Koichi Node, MD*
* Department of Cardiovascular and Renal Medicine, Saga University, Saga, Japan
Siemens-Asahi Medical Technologies, Ltd., Tokyo, Japan
Manuscript received December 9, 2008;
accepted January 6, 2009.
We described a case of Ebstein anomaly in a 69-year-old woman with progressive dyspnea on exertion. Her electrocardiogram revealed type B Wolf-Parkinson-White syndrome. The patient underwent cardiac magnetic resonance imaging (CMR). Cine images showed thick pericardial fat on the free wall of the right ventricle, small circumferential pericardial effusion, a huge right atrium, and apical displacement of the tricuspid valve leaflets. The atrialized ventricular wall was thinner than the distal functional right ventricular wall (A, Online Videos 1 and 2), and late gadolinium enhancement (LGE) was observed in the atrialized ventricular wall (B).
It has been reported that the atrialized ventricular wall is thin and fibrotic, and LGE is a technique for detecting fibrosis in the myocardium (1). We suggest that CMR using LGE can visualize areas of fibrosis in the thin atrialized ventricular wall in patients with Ebstein anomaly.
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References
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1. McCrohon JA, Moon JC, Prasad SK, et al. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance Circulation 2003;108:54-59.[Abstract/Free Full Text]
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