Iron overload cardiomyopathy can result from secondary iron overload primarily associated with transfusion dependent anemias such as thalassemia, which can progress to dilated cardiomyopathy with chamber dilatation and impaired systolic function. 

Cardiac MRI with T2* can quantify myocardial and hepatic iron content with resulting T2* (ms) and R2* (Hz) values and corresponding tissue iron levels in mg/g dry weight. The severity of myocardial iron overload and therefore the T2* value can predict the risk of developing heart failure with a threshold value of 20 ms with T2* values <10 ms being the highest risk.