CTICasesMyocardial Fat Infiltration in the Left Ventricle (Diagnosis Unclear)
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
A 19-year-old university student presented with an abnormal ECG showing T-wave inversion in inferior leads. Cardiac MRI showed normal ventricular function but persistent high signal in the inferior wall of the left ventricle with a striated appearance on cine, and dark signal on STIR, consistent with fat. CT confirmed fat density within the inferior wall. Coronary arteries were normal. The findings did not fully meet criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC) due to primary left ventricular involvement.
Key takeaways
This is a perplexing case of extensive fat infiltration within the inferior wall of the left ventricle in an asymptomatic, athletic young individual with an abnormal ECG. While it raises consideration for arrhythmogenic cardiomyopathy with left ventricular involvement, the exact diagnosis and significance remain unclear, prompting further workup. The presence of fat within the myocardium could also be a benign developmental or congenital lipomatous process.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Granulomatosis with Polyangiitis (GPA) Presenting as Mass-Like ConsolidationAutoimmune
- Relapsing PolychondritisAutoimmune
- Pulmonary Vein Stenosis Post-Ablation with CollateralsIatrogenic
- Sinus of Valsalva AneurysmCongenital
- Pulmonary Artery Compression of Right Middle Lobe Bronchus in Eisenmenger SyndromeVascular
- Pulmonary Amyloidosis with Hemorrhage into CystsMetabolic
- Lymphocytic Interstitial Pneumonia (LIP) in Sjögren SyndromeILD
- Isolated Cardiac Sarcoidosis with Ventricular TachycardiaAutoimmune
See all cases from March 11, 2015 →