Fig. 25.1
Single frontal radiograph (left) from an 11-week-old with dilated cardiomyopathy (DCM) shows massive cardiomegaly with perihilar pulmonary edema. Axial CT (right) shows massive dilatation of the left ventricle (A) and moderate dilatation of the left atrium (D). Notice the thinning of the left ventricular wall (B) and compression of the right ventricle (C)
25.2.1 Radiography Findings
Radiography findings typically include cardiomegaly, pulmonary edema, and pleural effusions.
25.2.2 Echocardiography Findings
Echocardiography is the diagnostic modality of choice, providing real-time evaluation of systolic hypokinesis and estimates of ejection fraction. It can be used to screen family members of patients with the genetic type. Color Doppler is used to evaluate for mitral regurgitation.
25.2.3 MRI Findings
Turbo spin (TS)/fast spin echo (FSE): Used to evaluate for myocardial edema seen with acute myocarditis
Steady-state free precession (SSFP) cine MR
Left ventricle end-diastolic volume >140 mL
Right ventricle end-diastolic volume >150 mL
Delayed gadolinium enhancement (typically involves the septum)
Presence indicates areas of fibrosis; mid-wall fibrosis is an independent risk predictor for all-cause mortality, hospitalization, and development of ventricular arrhythmias
Helps differentiate between DCM due to coronary artery disease and ischemic DCM from other etiologies, allowing for more directed therapeutic management
Ischemia causes subendocardial enhancement
Nonischemic causes demonstrate intramyocardial or subepicardial enhancement (Fig. 25.2)
Fig. 25.2
Three-dimensional (3D) color-coded image from a cardiac CTA in an 11-week-old with DCM shows massive dilatation of the left ventricle (salmon) with marked compression of the right ventricle (purple) . Functional analysis (right) shows an ejection fraction of 22 %, which is markedly decreased
25.2.4 Cardiac Catheterization
Direct measurement of pressures within the cardiac chambers and ejection fraction
Cardiac biopsy can be performed
25.2.5 Imaging Recommendations
Echocardiogram is used for screening, including screening family members of patients with familial type
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
