Left Ventricle Fat Post MI

Goldfarb et al  “We also found that fat deposition was predominately mid myocardial or mid epicardial, whereas results of prior autopsy and CT studies suggest that fat deposition almost always affects the subendocardium (28). MR imaging is unique for the study of fat deposition owing to its sensitivity to the off-resonance properties of fat, allowing fat-water separation imaging and the viewing of MI in all stages by using LGE imaging. ”

ISCHEMIC CARDIOMYOPATHY
41 year old male presents with chest pain.
Axial CT with contrast at the level of the enlarged left atrium (LA) (a) reveals a dilated LV, with subendocardial fatty infiltration of the LV myocardium in the septum (white arrowhead), and apex red arrowhead). There is thinning of the myocardium in the septum and apex.
Image B is more inferior and taken at the level of the dilated RA and normal sized RV showing similar subendocardial fatty infiltration of the LV myocardium in the septum (white arrowhead), and apex red arrowhead). There is thinning of the myocardium in the septum and apex. The transverse dimension of the LV was 7.2 cms which is significantly dilated
These findings are consistent with myocardial infarction with and ischemic cardiomyopathy.
Ashley Davidoff MD
86943c03L  has LCA aneurysm
FAT IN LATERAL WALL – OBTUSE MARGINAL TERRIRTORY 81 year old Female
HEAVY CALCIFICATION OF THE CIRCUMFLEX ARTERY 81 year old Female
FAT AND CALCIUM IN THE HEART
56 year old male with history of coronary artery disease. Axial CT through the heart shows apical curvilinear fat (yellow arrowheads, ( a and b) associated with apical myocardial dystrophic calcification (green arrowheads c and d) both indicating prior apical MI. In addition there mitral annular calcification (red arrowhead, b) and multifocal fatty deposits in the RV (white arrowheads, a and b) usually depicting age related degenerative changes,
Ashley Davidoff MD

Links and References

Goldfarb et al   Myocardial Fat Deposition after Left Ventricular Myocardial Infarction: Assessment by Using MR Water-Fat Separation Imaging RadiologyVol. 253, No. 1