78 year old male with history of dyspnea

 

 

Hx of bladder cancer and Merkel Cell Carcinoma of unknown primary origin involving a left inguinal node, with extracapsular extension. He is s/p node dissection and adjuvant radiation therapy.

Had an FDG avid mass adjacent to the jejunum. Biopsy confirmed metastatic MCC.

Hx of  polyneuropathy,

Heart Very eccentric MR from likely distal prolapse of the anterior leaflet tip based on the posterolateral MR jet direction.

LV size normal LA is dilated
Past MI s/p remote CABG
Cardiac MRI owed no radiographic evidence of myocarditis