, Volume 17, Issue 2, pp 328-332
Date: 24 Sep 2009

Cardiomyopathy of uncertain etiology: Complementary role of multimodality imaging with cardiac MRI and 18FDG PET

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A 59-year-old female with longstanding history of tachyarrhythmias was admitted for syncope and recurrent ventricular tachycardia. She had a past medical history of hyperlipidemia, hypothyroidism, atrial fibrillation, and wide complex tachycardia that had been attributed to Wolf-Parkinson-White syndrome. Her medications included atenolol, propafenone, synthroid, and lipitor. Her 12-lead ECG was notable for sinus rhythm with marked 1st degree heart block, right bundle branch block, and left anterior fascicular block (Figure 1). The echocardiogram on admission demonstrated a moderately dilated left ventricle with normal wall thickness. There was global left ventricular hypokinesis with an estimated ejection fraction (LVEF) of 20%. There was mild right ventricular dilatation with mild global reduction in right ventricular systolic function.Figure 1

12 lead ECG notable for Sinus rhythm (black arrow indicates p wave) with marked 1st degree heart block, right bundle branch block and left ante