Figure 4.

Case Report 1

A 63-year-old man presented with a history of nonsustained ventricular tachycardia and paroxysmal atrial fibrillation treated with atrial ablation. CMR was performed for further evaluation. Cine images at end-diastole in 4-chamber (A) (Video 1) and 2-chamber long-axis views (B) (Video 2) show excessive trabeculation with biventricular dilation with an EF of 48%. Scattered areas of late gadolinium enhancement were present with a nonischemic pattern (C and D). Genetic testing showed a MYH7 allelic variant. Stress perfusion cardiac magnetic resonance (not shown) showed diffuse perfusion abnormalities in multiple myocardial segments. Although excessive trabeculation is present, the presentation of ventricular dilatation, low EF, and nonischemic myocardial scar and genetic abnormality is the same as in dilated cardiomyopathy. Patient treatment is based on the symptoms and the prognostic risks of arrhythmia, stroke, and contractile impairment. CMR = cardiac magnetic resonance; EF = ejection fraction.