case_images: PMC9714534_01
case_images: (A) Echocardiography at enrollment: (LVIDd/LVIDs: 2.1 cm/1.9 cm, FS 10%, LVEF 22%), (B) echocardiography at 14-day follow-up (LVIDd/LVIDs: 2.0 cm/1.5 cm, FS 27%, LVEF 55%), (C) CMR at 14-day follow-up (LVEDV: 10 ml, LVESV: 5 ml, LVEF 51%), (D) echocardiography at 4-year follow-up (LVIDd/LVIDs: 3.4 cm/2.0 cm, FS 40%, LVEF 73%), and (E) CMR at 4-year follow-up, displaying an ALS inferior of the left ventricle, determined to be an aneurysm (LVEDV: 40 ml, LVESV: 10 ml, LVEF 75%). CMR, cardiac magnetic resonance; ALS, aneurysm-like structure. LVIDd and LVIDs indicate left ventricular internal diameter end diastole and end systole, FS: fractional shortening, LVEF: left ventricular ejection fraction, LVEDV: left ventricular end diastolic volume, LVESV: left ventricular end systolic volume.
case_images: fped-10-953770-g002.jpg
case_images: PMC9714534_02_fped-10-953770-g002.jpg
case_images: F2
case_images: At the first echocardiography examination, in addition to left ventricular dilatation, an LVO was detected without any sign of a thrombus (Figure 2). At the following echocardiography examinations, the contractility was still low and no re-evaluation of the LVO was considered (Figure 2). At the second examination, at 4 years of age, 4Dflow was also added to the scan protocol to visualize the hemodynamical blood flow patterns within the heart (Figure 3 and Supplementary Video 2). The CMR images enabled clear views of the aneurysm-like structure, which in combination with echocardiography initially was determined to be an aneurysm with low contractility (Figure 2). With the added CMR 4Dflow measurements, the blood flow could be visualized in detail and the structure could be classified as a double-chambered left ventricle with sufficient contraction and emptying of the blood without an effect on the elliptical shape or function of the main left ventricle (Figure 3 and Supplementary Video 2).
case_images: PMC9714534_02
case_images: (A) Echocardiography at enrollment: (LVIDd/LVIDs: 2.1 cm/1.9 cm, FS 10%, LVEF 22%), (B) echocardiography at 14-day follow-up (LVIDd/LVIDs: 2.0 cm/1.5 cm, FS 27%, LVEF 55%), (C) CMR at 14-day follow-up (LVEDV: 10 ml, LVESV: 5 ml, LVEF 51%), (D) echocardiography at 4-year follow-up (LVIDd/LVIDs: 3.4 cm/2.0 cm, FS 40%, LVEF 73%), and (E) CMR at 4-year follow-up, displaying an ALS inferior of the left ventricle, determined to be an aneurysm (LVEDV: 40 ml, LVESV: 10 ml, LVEF 75%). CMR, cardiac magnetic resonance; ALS, aneurysm-like structure. LVIDd and LVIDs indicate left ventricular internal diameter end diastole and end systole, FS: fractional shortening, LVEF: left ventricular ejection fraction, LVEDV: left ventricular end diastolic volume, LVESV: left ventricular end systolic volume.
case_images: fped-10-953770-g002.jpg
case_images: PMC9714534_02_fped-10-953770-g002.jpg
case_images: F2
case_images: At the first echocardiography examination, in addition to left ventricular dilatation, an LVO was detected without any sign of a thrombus (Figure 2). At the following echocardiography examinations, the contractility was still low and no re-evaluation of the LVO was considered (Figure 2). At the second examination, at 4 years of age, 4Dflow was also added to the scan protocol to visualize the hemodynamical blood flow patterns within the heart (Figure 3 and Supplementary Video 2). The CMR images enabled clear views of the aneurysm-like structure, which in combination with echocardiography initially was determined to be an aneurysm with low contractility (Figure 2). With the added CMR 4Dflow measurements, the blood flow could be visualized in detail and the structure could be classified as a double-chambered left ventricle with sufficient contraction and emptying of the blood without an effect on the elliptical shape or function of the main left ventricle (Figure 3 and Supplementary Video 2).
case_images: CMR 4Dflow visualization of the heart and blood flow in the 4-year-old boy. The blood flow pattern was shown to be associated with a double-chambered left ventricle with good contraction and emptying of blood from the structure but without effect on the elliptical shape or function of the main left ventricle. The clinical decision-making was facilitated by this information, and with an almost complete emptying, there was no need for operation at this juncture. Hence, 4Dflow was of significant diagnostic value in this patient. CMR, cardiac magnetic resonance.
case_images: fped-10-953770-g003.jpg
case_images: PMC9714534_02_fped-10-953770-g003.jpg
case_images: F3
case_images: At the second examination, at 4 years of age, 4Dflow was also added to the scan protocol to visualize the hemodynamical blood flow patterns within the heart (Figure 3 and Supplementary Video 2). With the added CMR 4Dflow measurements, the blood flow could be visualized in detail and the structure could be classified as a double-chambered left ventricle with sufficient contraction and emptying of the blood without an effect on the elliptical shape or function of the main left ventricle (Figure 3 and Supplementary Video 2).
case_images: PMC9714534_03