Nonischemic Cardiomyopathy - Mid-Wall LGE
Understanding Nonischemic Cardiomyopathy - Mid-Wall LGE found on Left ventricle Cardiac MRI imaging. Learn what this finding means and what steps to take next.
Radiographic Appearance
Cardiac MRI FindingMid-wall late gadolinium enhancement in the basal to mid interventricular septum with mild global hypokinesis (LVEF 45%).
Clinical Significance
Pattern favors nonischemic dilated cardiomyopathy rather than infarction; scar burden has prognostic value for arrhythmic risk.
What does the scan show?
Cardiac MRI with contrast demonstrates mid-wall LGE in the basal to mid septum and mild diffuse hypokinesis. No subendocardial or transmural scar is seen to suggest prior infarct. T2 mapping is normal.
Why it matters
Mid-wall LGE is typical of nonischemic dilated cardiomyopathy and correlates with higher risk of ventricular arrhythmias and heart failure events. Distinguishing ischemic vs. nonischemic etiology guides management and device therapy decisions.
Recommended next steps
- Optimize guideline-directed medical therapy for HFrEF and reassess LVEF after 3-6 months.
- Consider ambulatory rhythm monitoring; LGE extent can support ICD consideration if EF remains reduced.
- Evaluate secondary causes (viral, toxins, genetic); coronary disease already unlikely based on scar pattern.
Patient tips
- Take heart-failure medications consistently and track blood pressure/weight at home.
- Report palpitations, presyncope, or new swelling promptly; these can signal arrhythmia or decompensation.
Correlate with Lab Results
Doctors often check these blood tests when Nonischemic Cardiomyopathy - Mid-Wall LGE is found on imaging:
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