TY - JOUR T1 - An older man with a rare cause of heart failure JF - BMJ Case Reports DO - 10.1136/bcr-2013-202377 VL - 2013 SP - bcr2013202377 AU - Nilson Lopez-Ruiz AU - Kenny Mauricio Galvez AU - Juan Camilo Perez Y1 - 2013/12/04 UR - http://casereports.bmj.com/content/2013/bcr-2013-202377.abstract N2 - A previously healthy 74-year-old man presented with symptoms of heart failure over the last 10 months. Initial tests revealed raised levels of brain natriuretic peptide (617 pg/mL) and a low-voltage ECG. An echocardiogram showed symmetric left ventricular (LV) hypertrophy, systolic dysfunction (ejection fraction 35%; figure 1A, video 1), restrictive filling pattern and decreased global longitudinal strain (figure 1B). As the cardiomyopathy aetiology was unclear, he underwent further testing. A cardiac MRI demonstrated diffuse subendocardial delayed myocardial enhancement after gadolinium injection (figure 1C) and … ER -