1/9 Tissue characterisation by #WhyCMR in a pt with bright signal in inferior and lateral LV wall on echo suspected of having had an MI but only mild CAD on coronary angio. @scmrorg @chiarabd @purviparwani @PushpaShivaram @AmroAlsaid @danilorenzatti @Kfarooqi @RayRcnita @BSCMR

2/9 Bright signal isodense with fat (epicardial and SC fat) in inferior / inferolateral subepicardial wall (at 3-5 o’clock-disappears with fat suppression sequences - far right) @JStojanovskaMD @DrJenniferCo_Vu @OKhaliqueMD @AScatteia @AKallifatidis @vineetao17 @DmmOsmany

3/9 Ectopic intracardiac fatty foci are not uncommon findings in both healthy & diseased patients.
#YesCCT & #whycmr can detect fat easily within the heart. @vineetao17 @Ahmed43101178 @JoaoLCavalcante @HeartDocSubha @mugander @Doc_Tiger @MasriAhmadMD

4/9 incidental frequency of cardiac adipose images is about 10% of the patients having #yescct.
However foci of ectopic cardiac adipose tissue are not usually reported even in pathological conditions, mostly if the exam is not specifically focused on the heart.

5/9 @RezaEmaminia @ShelbyKuttyMD @EylemLevelt @Sarah_Moharem @DrRyanPDaly @rladeiraslopes @DrFuisz @KimAtianzar @tiffchenMD @cshenoy3 @rooshaparikh @AChoiHeart @onco_cardiology @AkhilNarangMD @heartdockumar @ash71us

6/9 Non-pathological ectopic intramyocardial fat extending from the epicardiac adipose tissue is a relatively common incidental finding during a routine chest or cardiac CT (usu. more frequent in the RV than in the LV).

7/9 Following disease processes may need to be considered when ectopic fat deposits are seen
https://abs.twimg.com/emoji/v2/... draggable="false" alt="1️⃣" title="Tastenkappe Ziffer 1" aria-label="Emoji: Tastenkappe Ziffer 1">ARVC / ACM
https://abs.twimg.com/emoji/v2/... draggable="false" alt="2️⃣" title="Tastenkappe Ziffer 2" aria-label="Emoji: Tastenkappe Ziffer 2"> Postmyocardial Infarction Lipomatous Metaplasia (usu. subendocardial)
https://abs.twimg.com/emoji/v2/... draggable="false" alt="3️⃣" title="Tastenkappe Ziffer 3" aria-label="Emoji: Tastenkappe Ziffer 3"> Postmyocardial inflammation Lipomatous Metaplasia (usu. subepicardial)
https://abs.twimg.com/emoji/v2/... draggable="false" alt="4️⃣" title="Tastenkappe Ziffer 4" aria-label="Emoji: Tastenkappe Ziffer 4">DCM (usu. mid wall)

8/9 https://abs.twimg.com/emoji/v2/... draggable="false" alt="5️⃣" title="Tastenkappe Ziffer 5" aria-label="Emoji: Tastenkappe Ziffer 5"> Lipomatous Hypertrophy of the Interatrial Septum
https://abs.twimg.com/emoji/v2/... draggable="false" alt="6️⃣" title="Tastenkappe Ziffer 6" aria-label="Emoji: Tastenkappe Ziffer 6"> Tuberous sclerosis
https://abs.twimg.com/emoji/v2/... draggable="false" alt="7️⃣" title="Tastenkappe Ziffer 7" aria-label="Emoji: Tastenkappe Ziffer 7"> Lipoma & rarely liposarcoma
https://abs.twimg.com/emoji/v2/... draggable="false" alt="8️⃣" title="Tastenkappe Ziffer 8" aria-label="Emoji: Tastenkappe Ziffer 8"> others such as Muscular dystrophies, HCM, Fabrys, metabolic disorders

9/9 Now in case you were wondering how the #echofirst looked like @NMerke