There is acute myocardial infarction the distribution of LAD, constitutes 40-50% of LV mass. It is dominant left circulation that is why the apex is involved as well. A dark zone of mesocardial non-enhancement in this distribution is suggestive for microvascular obstruction with underlying hemorrhage. Significant prolongation on native T2 mapping in this region is likely due to wall edema in keeping up with acute ischemia.  Severely decreased left ventricular systolic function with LVEF = 25% (contouring not included).

Diffuse pericardial enhancement seen in the setting of Dressler's syndrome.