Figure 6.

56-year-old female with a history of Anderson-Fabry disease. Clinical examination showed multiple angiokeratomas and hypertension. Transthoracic echocardiography was performed and demonstrated left ventricular global circumferential hypertrophic cardiomyopathy with slight elevation of the left ventricular ejection fraction. Cardiac MRI was performed with delayed enhancement using an SSFP sequence, 10 minutes following the administration of 20 ml of Gd-based contrast agent. (A) Short-axis view demonstrates mid wall and epicardial delayed enhancement of lateral wall in the mid segment of the heart (arrow). (B) The Four-chamber view demonstrates left ventricular hypertrophy and lateral wall delayed enhancement, which is mainly seen in the mid wall (arrow). In a small portion of the mid heart the enhancement is transmural (arrowhead).