INCIC cases ·
Watch the atrium on the 2-chamber cine: what is your diagnosis?
Cardiac MR, left ventricular 2-chamber cine. Look at the left atrium and its appendage.
Case by Julián Vega Adauy · jvega@incic.org
Cine2-chamberLeft atrium
What is your diagnosis?
Answer
Second-degree 2:1 atrioventricular block
2:1 AV blockConduction disorder
The 2-chamber cine shows the typical behaviour of 2:1 AV block: the left atrium and its appendage contract twice for every ventricular systole. One of every two atrial contractions is not conducted to the ventricle.
Teaching points
- Count the contractions. On cine, the ratio of atrial (and appendage) contractions to ventricular systoles tells the rhythm: here, two atrial for every ventricular.
- Cine is also an ECG. A conduction disorder can be recognised on MR before looking at the tracing.