Season 4 Case 20
Case 20
History: chest pain. Anything to help you figure out a possible etiology for this patient’s chest pain?

Answer:
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The heart is the key here. Notice the low density appearance within the myocardium, or more specifically, in the subendocardial region of the left ventricle.
Answer: Subendocardial fat deposition consistent with prior myocardial infarct (ie fatty replacement of post-infarct scarring)
Reference: http://www.ajronline.org/doi/full/10.2214/AJR.08.1608 or http://pubs.rsna.org/doi/full/10.1148/rg.306105519