Interesting CMR Cases - Challenging Cardiomyopathies-Webinar

Video Transcription

Video Summary

The webinar opened a new SEMR “interesting cases” series focused on informal discussion of challenging pediatric cardiac imaging cases, moderated by Supriya Jain and Joe Pagano. Two expert commentators, Andy Powell and Lars Gross-Mortmann, joined to review four cases from around the world.<br /><br />Case 1: a 16-year-old basketball player with palpitations, presyncope, ECG T-wave inversion, mild LV hypertrophy, and extensive LGE on CMR that later regressed in thickness but not scar. The main debate was hypertrophic cardiomyopathy versus athlete’s heart versus ischemic or myocarditis-related injury. Experts felt the pattern was not classic for HCM and discussed cautious return-to-play decisions.<br /><br />Case 2: an 8-year-old boy with cardiac arrest, severe LV dysfunction, recurrent arrhythmias, and transmural/apical LGE after ablation. The group favored chronic infarction or prior myocarditis, though the trigger remained unclear.<br /><br />Case 3: a 16-year-old with monomorphic VT, RV dilation/dyskinesis, LV involvement, and a desmoplakin-family mutation, consistent with arrhythmogenic cardiomyopathy with biventricular/left-sided involvement.<br /><br />Case 4: a 15-year-old with massive right atrial enlargement, atrial fibrillation, tricuspid regurgitation, ascites, and no clear Ebstein anomaly, most consistent with giant right atrium. Reduction surgery was advised.<br /><br />The session closed with discussion of parametric mapping, emphasizing its value in specific scenarios but not as a standalone diagnostic tool.

Keywords

pediatric cardiac imaging

SEMR webinar

hypertrophic cardiomyopathy

arrhythmogenic cardiomyopathy

giant right atrium

cardiac MRI

late gadolinium enhancement

parametric mapping

return-to-play decisions