Role of cardiac magnetic resonance imaging in evaluating new-onset heart failure

In the United States of America, blacks have a higher prevalence of heart failure and become symptomatic at younger ages1-4. This is a result of higher prevalence of hypertension, obesity, diabetes, systolic dysfunction, and left ventricular hypertrophy. Cardiac amyloidosis is an unusual cause of heart failure in the young, with less than 3% occurring below 40 years, and 4.3% affect African Americans5. Delayed gadolinium-enhanced cardiac MRI has a sensitivity of 80% to detect amyloidosis and can obviate the need for a myocardial biopsy. This case highlights the significance of early echocardiographic evaluation in the work-up of new onset heart failure. Further evaluation by a gadolinium-enhanced cardiac MRI for infiltrative cardiomyopathy may have therapeutic and prognostic implications.