Figure 4

Thickened myocardium. ( A) HCM with asymmetrical septal hypertrophy ( a, arrow) and a confluent LGE pattern matching the hypertrophy ( b, arrow). Dynamic LVOT obstruction with SAM ( c: diastole, d: systole with a SAM) and circumferential sub-endocardial ischemia in hypertrophied areas as a consequence of microvascular dysfunction are among classical features ( e top: stress-induced perfusion defects, e bottom: normalization at rest). ( B) Amyloidosis with a typical circumferential diffuse enhancement (‘zebra’ pattern). ( C) Anderson-Fabry disease with concentric LV hypertrophy ( a) and patchy LGE affecting the inferolateral wall ( b, arrow).