Mid-Wall LGE Prognosis — RACP Adult Medicine MCQ

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HardCardiologyMid-Wall LGE PrognosisRACP Adult Medicine

A 55-year-old man with known HFrEF (LVEF 22%). Cardiac MRI: extensive mid-wall LGE (non-ischaemic pattern). What does this indicate?

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Correct answer: D — Myocardial fibrosis – worse prognosis, higher SCD/VT risk

Mid-wall LGE in non-ischaemic DCM = fibrosis. Associated with higher SCD risk, worse remodelling, reduced CRT response. May influence ICD decision.

Reference: NHF/CSANZ – 2022; ESC – 2023