Case Session 01: Ischemic Heart Disease and Acute Chest Pain (2018)-Chronic Intramyocardial Hemorrhage Detected by T1 and T2 star Mapping after Reperfusion of ST-Segment-Elevation Myocardial Infarction: A Case Report

Chronic Intramyocardial Hemorrhage Detected by T1 and T2 star Mapping after Reperfusion of ST-Segment-Elevation Myocardial Infarction: A Case Report

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Video Summary

A 63-year-old man with ST-elevation myocardial infarction underwent urgent LAD stenting after acute thrombus was found. Reperfusion occurred four hours after symptom onset, but slow flow developed. Cardiac MRI at six months showed severe anterior wall hypokinesis. T2 mapping and late gadolinium enhancement suggested chronic intramyocardial hemorrhage or residual iron deposition in the septal infarct core, while elevated T1 in the anterior infarct area indicated fibrosis. The case highlights how T1 and T2 mapping can help distinguish chronic hemorrhage/iron from fibrosis after myocardial infarction, though the finding may represent persistent iron rather than active hemorrhage.

Keywords

ST-elevation myocardial infarction

LAD stenting

cardiac MRI

T1 and T2 mapping

myocardial hemorrhage