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"Where is the Heart?" When Cardiac Magnetic Resonance Imaging Helps if Echocardiography is Inconclusive

Alessandro Caretta1,2, Laura Anna Leo1, Vera Lucia Paiocchi1

  • 1Fondazione Cardiocentro Ticino, Lugano, Switzerland.

Journal of Cardiovascular Echography
|August 9, 2019
PubMed

Insights

Cardiovascular magnetic resonance (CMR) offers superior cardiac assessment. In a complex case, CMR precisely quantified mitral regurgitation and identified an incidental hiatus hernia, demonstrating its comprehensive diagnostic value.

Area of Science:

  • Cardiovascular Imaging
  • Diagnostic Radiology
  • Cardiac Surgery Support

Background:

  • Cardiovascular magnetic resonance (CMR) is the gold standard for cardiac structure and function assessment.
  • Echocardiography can be limited in visualizing cardiac structures, particularly for complex valvular pathologies.
  • A 64-year-old male required evaluation for mitral regurgitation prior to coronary revascularization.

Observation:

  • Transthoracic and transesophageal echocardiography provided inconclusive results for mitral regurgitation mechanism due to poor visualization.
  • Cardiovascular magnetic resonance (CMR) was employed to accurately quantify the mitral regurgitation.
  • CMR incidentally identified a giant hiatus hernia with gastric herniation into the thorax.

Findings:

  • CMR successfully quantified the severity of mitral regurgitation, clarifying the valvular disease.
  • The examination revealed significant extracardiac findings, specifically a giant hiatus hernia.
  • The combination of cardiac and extracardiac findings provided a comprehensive patient overview.

Implications:

  • CMR enhances the diagnostic accuracy for valvular heart disease when echocardiography is limited.
  • This case highlights the utility of CMR in detecting incidental extracardiac abnormalities.
  • Comprehensive imaging with CMR can improve surgical planning and patient management by revealing unexpected pathology.

Keywords:
Cardiac magnetic resonanceextracardiac findingshiatus herniamitral regurgitation quantification

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