E-page Original Images: Role of cardiovascular magnetic resonance in the diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia with left ventricular involvement

A 55-year-old female patient presented to Rapid Access Chest Pain Clinic with symptoms of chest pain on exertion. Her resting electrocardiogram showed precordial T wave inversion. A presumptive diagnosis of coronary artery disease led to an exercise stress test, which was non diagnostic with pseudo-normalisation of the T waves. Echocardiography revealed mild inferolateral hypokinesia of the left ventricle (LV) with normal ejection fraction (EF) and mild impairment of right ventricular (RV) systolic function. Nuclear myocardial perfusion scan suggested a small inferolateral infarct with some reversible ischemia. The patient was referred for cardiovascular magnetic resonance (CMR) imaging to assess ventricular function and the possibility of myocardial infarction and ischemia as the cause of her symptoms.