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Delayed enhancement on cardiac MRI in a patient with multiple myeloma without amyloidosis

¹ Cardiovascular Division, ² Hematology/Oncology Division, ³ Department of Pathology, ⁴ Department of Radiology, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee WI 53226, USA

Correspondence: Raymond Q Migrino, Medical College of Wisconsin-CVM, 9200 W Wisconsin Avenue, Milwaukee, WI 53226, USA. E-mail: rmigrino{at}mcw.edu

We report the first observation of diffuse subendocardial and myocardial delayed enhancement on cardiac MRI in a 50-year-old patient with recurrent multiple myeloma but without evidence of amyloidosis. She presented with advanced heart failure and severe restrictive cardiomyopathy. Myocardial biopsy revealed endomyocardial fibrosis. The case was associated with development of multiple arterial and venous thromboses and a fatal course. Because of the fatal outcome, the prognostic significance of delayed enhancement on MRI in multiple myeloma patients may need to be further investigated.