Fig. 5

Example of a clinically “silent” myocardial infarction. Native mapping and contrast enhanced CMR from a subject with no history of cardiac disease. Arrows indicate a typically ischemic, subendocardial scar on the late gadolinium enhancement (LGE) image (a) in the inferior wall. There was no regional increase in native myocardial T1 (b), but a decrease in post-contrast T1 (c) with subsequent increase in extracellular volume fraction (ECV) (d). The constellation of an ischemic scar without increased native T1 or T2 values was interpreted as a previous, clinically “silent” myocardial infarction in heretofore-unknown coronary artery disease