#whyCMR case: 78y/F, signs of ACS, normal coronary angiogram, CMR done. #SCMRAweSoMe @scmrorg @chiarabd @purviparwani @PushpaShivaram @AmroAlsaid @danilorenzatti @Kfarooqi @RayRcnita @JStojanovskaMD @DrJenniferCo_Vu @ydaryani @OKhaliqueMD @AScatteia @AKallifatidis @DmmOsmany
@JoaoLCavalcante @rajdoc2005 @HeartDocSubha @mugander @Doc_Tiger @MasriAhmadMD @pritixyz @EylemLevelt @Sarah_Moharem @DrRyanPDaly @rladeiraslopes @DrFuisz @KimAtianzar @tiffchenMD @cshenoy3 @rooshaparikh @AChoiHeart @onco_cardiology @AkhilNarangMD @heartdockumar @ash71us
#whyCMR LGE at +3SD threshold, none at +5 SD threshold @circlecvi @drkartikganga @avinash230791 @Ahmed43101178 ,
raised T1 and T2 mapping values

Role of #whyCMR in Takotsubo CM (TC):
reversible
transient LV dysfunction
most commonly basal hyperkinesis and mid-apical
LV ballooning and hypokinesia (a)
other phenotypes may be present (b-d)
diffuse edema/raised T2
https://www.birpublications.org/doi/abs/10.1259/bjr.20200514



LV ballooning and hypokinesia (a)


https://www.birpublications.org/doi/abs/10.1259/bjr.20200514
#whyCMR in TC:
absence of LGE (at +5SD threshold) , but recent studies suggest LGE may be present
T1 and ECV mapping detect diffuse ECM abnormalities- here ECV normal at basal LV, increased at apical LV
strain can help detect myocardial deformation abnormalities



More pertinent now as TC should also be considered in the differential diagnosis across the spectrum of myocardial injury in patients presenting with #COVID19. @JACCJournals
https://casereports.onlinejacc.org/content/2/9/1321
https://casereports.onlinejacc.org/content/2/9/1321
https://www.sciencedirect.com/science/article/pii/S2666084920306641
https://casereports.onlinejacc.org/content/2/9/1321
https://casereports.onlinejacc.org/content/2/9/1321
https://www.sciencedirect.com/science/article/pii/S2666084920306641