EuroPCR2025-images-A65922MM-Calcified breast in the heart: which imaging modality is diagnostic? Invasive or non-invasive?

What is the diagnosis?
Invasive coronary angiography at first session was diagnostic in this case
LV diverticulum was the main differential diagnosis of this case
Calcified pseudoaneurysm of apical segments with LV clot was the best differential diagnosis of this case
Correct! The correct answer is "Calcified pseudoaneurysm of apical segments with LV clot was the best differential diagnosis of this case"
 
In coronary angiography: a significant stenosis in the LAD was observed from ostial part and bridging-like collaterals between the proximal and distal parts of LAD. The LAD was nearly totally occluded, with poor antegrade run-off and a bizarre recanalisation pattern, featuring dense collaterals that resembled an elongated nest
 
In LGE sequences of CMR, there was near transmural fibrosis in anterior and anteroseptal wall, and subendocardial in lateral wall, from mid to apical segments. LV clot in apical segments was observed.
 
Computed tomography angiography (CCTA) identified calcified subendocardial borders, apical pseudoaneurysm, and a large thrombus in the LAD territory.
 
The patient was treated medically with GDMT and anticoagulation (Apixaban) due to the LV clot, with frequent follow-up plans. Multimodal imaging is crucial to avoid missing such complex conditions as the calcified pseudoaneurysm resulting from old SCAD of LAD, which was finally diagnosed by combination of invasive and non-invasive imaging modalities.
 
Good try! The correct answer is "Calcified pseudoaneurysm of apical segments with LV clot was the best differential diagnosis of this case".
 
In coronary angiography: a significant stenosis in the LAD was observed from ostial part and bridging-like collaterals between the proximal and distal parts of LAD. The LAD was nearly totally occluded, with poor antegrade run-off and a bizarre recanalisation pattern, featuring dense collaterals that resembled an elongated nest.
 
In LGE sequences of CMR, there was near transmural fibrosis in anterior and anteroseptal wall, and subendocardial in lateral wall, from mid to apical segments. LV clot in apical segments was observed.
 
Computed tomography angiography (CCTA) identified calcified subendocardial borders, apical pseudoaneurysm, and a large thrombus in the LAD territory.
 
The patient was treated medically with GDMT and anticoagulation (Apixaban) due to the LV clot, with frequent follow-up plans. Multimodal imaging is crucial to avoid missing such complex conditions as the calcified pseudoaneurysm resulting from old SCAD of LAD, which was finally diagnosed by combination of invasive and non-invasive imaging modalities.
 
 
 
{"name":"EuroPCR2025-images-A65922MM-Calcified breast in the heart: which imaging modality is diagnostic? Invasive or non-invasive?", "url":"https://www.poll-maker.com/Q07VOQFBI","txt":"What is the diagnosis?, Correct! The correct answer is \"Calcified pseudoaneurysm of apical segments with LV clot was the best differential diagnosis of this case\"   In coronary angiography: a significant stenosis in the LAD was observed from ostial part and bridging-like collaterals between the proximal and distal parts of LAD. The LAD was nearly totally occluded, with poor antegrade run-off and a bizarre recanalisation pattern, featuring dense collaterals that resembled an elongated nest   In LGE sequences of CMR, there was near transmural fibrosis in anterior and anteroseptal wall, and subendocardial in lateral wall, from mid to apical segments. LV clot in apical segments was observed.   Computed tomography angiography (CCTA) identified calcified subendocardial borders, apical pseudoaneurysm, and a large thrombus in the LAD territory.   The patient was treated medically with GDMT and anticoagulation (Apixaban) due to the LV clot, with frequent follow-up plans. Multimodal imaging is crucial to avoid missing such complex conditions as the calcified pseudoaneurysm resulting from old SCAD of LAD, which was finally diagnosed by combination of invasive and non-invasive imaging modalities., Good try! The correct answer is \"Calcified pseudoaneurysm of apical segments with LV clot was the best differential diagnosis of this case\".   In coronary angiography: a significant stenosis in the LAD was observed from ostial part and bridging-like collaterals between the proximal and distal parts of LAD. The LAD was nearly totally occluded, with poor antegrade run-off and a bizarre recanalisation pattern, featuring dense collaterals that resembled an elongated nest.   In LGE sequences of CMR, there was near transmural fibrosis in anterior and anteroseptal wall, and subendocardial in lateral wall, from mid to apical segments. LV clot in apical segments was observed.   Computed tomography angiography (CCTA) identified calcified subendocardial borders, apical pseudoaneurysm, and a large thrombus in the LAD territory.   The patient was treated medically with GDMT and anticoagulation (Apixaban) due to the LV clot, with frequent follow-up plans. Multimodal imaging is crucial to avoid missing such complex conditions as the calcified pseudoaneurysm resulting from old SCAD of LAD, which was finally diagnosed by combination of invasive and non-invasive imaging modalities.","img":"https://www.poll-maker.com/3012/images/ogquiz.png"}
Tools: Poll Maker | Quiz Maker | Super Surveys