Subendocardial fat infiltration

Subendocardial fat infiltration is a finding that can be seen with thoracic and cardiac imaging. It forms a part of myocardial fat infiltration and can sometimes be seen in the setting of a long-gone myocardial infarction ¹ especially if seen in the distribution territory of a coronary artery and if associated with myocardial wall thinning.

Differential diagnosis

• a small amount of fat at the left ventricular apex represents physiologic fat
• arrhythmogenic right ventricular cardiomyopathy ²: 
  • fibrofatty replacement usually extends from the epicardium toward the endocardium
  • right ventricular free wall maintains normal thickness or is sometimes thickened