PMC7640612_01
Transthoracic echocardiogram (four chamber view) showing generalised thickening of ventricular walls and echo-bright myocardium of the interventricular septum (arrow). LA = left atrium; RA = right atrium; LV = left ventricle; RV = right ventricle.
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An echocardiogram showed normal sized left ventricle with moderate concentric hypertrophy and severe diastolic dysfunction (Fig. 1).
Cardiac magnetic resonance imaging scan (steady state free procession image) reveals diffuse thickening of the left ventricular wall (arrow). LV = left ventricle; RV = right ventricle.
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Cardiac magnetic resonance imaging (MRI) showed moderate generalised thickening of the left and right ventricular walls, moderate bi-atrial enlargement, preserved systolic function, severe diastolic dysfunction, and bilateral pleural effusions (Fig. 2).
Cardiac magnetic resonance imaging scan (late gadolinium enhancement image) shows subendocardial areas of late gadolinium enhancement in the left ventricle (LV) free wall suggestive of myocardial infiltration with amyloid. Further, diffuse late gadolinium enhancement areas can be seen in the right ventricle (RV) wall, too.
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Late post contrast images revealed multiple areas of diffuse circumferential gadolinium enhancement in both the left and right ventricular walls, highly indicative of amyloidosis (Fig. 3).