Daniel Rodríguez Sánchez

Cardiac magnetic resonance (CMR) is a non-invasive imaging technique that plays a crucial role in the diagnosis, risk stratification, and management of a broad spectrum of cardiovascular diseases. Its high spatial resolution and ability to provide multiparametric tissue characterization make it uniquely suited for evaluating both structural and functional cardiac abnormalities. This review provides a comprehensive and clinically oriented overview of CMR applications in adult cardiology, structured into six main areas: (1) myocardial scarring in ischemic and non-ischemic cardiomyopathies, (2) infiltrative myocardial diseases, (3) adult congenital heart disease, (4) valvular heart disease, (5) pulmonary hypertension and right ventricular morpho-functional evaluation, and (6) cardio-oncology. In addition, technical considerations are also discussed. Finally, recommendations from recent guidelines issued by main international societies are integrated to support clinical decision-making.

We present a 72-year-old man who was referred to our hospital due to chest pain. The patient complained of dyspnoea during moderate exertion (New York Heart Association functional Class II/IV). The results of a 12-lead electrocardiogram showed no significant alterations. Troponins were slightly elevated at first and normalized in serial analysis. Chest radiography showed mediastinal widening (Panel 1). The 64-slice computed tomography revealed a large, solid, multinodular mass in the diaphragm (Panel 2). Furthermore, the CT showed pericardial infiltration and moderate pleuro-pericardial effusion without signs of tamponade (Panel 3). Magnetic resonance showed parietal invasion of the right atrium (Panel 4). A histological examination revealed proliferation of malignant neoplastic cells (Panel 5). Additionally, rhabdomyosarcoma was positive for desmin and miogenin. These findings are consistent with pleomorphic rhabdomyosarcoma in the diaphragmatic region. (Panels 6 and 7).