Files in this Data Supplement:

• Movie 1 - (Windows media) (3.5 MB) Echocardiogram parasternal long axis cine loop showing at least mild dilatation of the left ventricle.
• Movie 2 - (Windows media) (48 KB) Cardiovascular magnetic resonance left ventricular outflow tract cine loop showing a severely dilated left ventricle. The degree to which the heart is enlarged relative to the chest wall is noteworthy. Unlike the echocardiogram, regional wall thinning and dyskinesis were clearly documented in this long axis view. The apex of the heart is well visualised by cardiovascular magnetic resonance. The corresponding late gadolinium image shows enhancement in the area of dyskinesis. The enhancement is endocardium sparing with patchy enhancement of the septum. This distribution is not in keeping with ischaemic heart disease.
• Movie 3 - (Windows media) (3.0 MB) Echocardiogram mitral valve level short axis cine loop.
• Movie 4 - (Windows media) (2.1 MB) Cardiovascular magnetic resonance mitral level short axis cine loop. Late gadolinium enhancement was also seen in the left ventricular wall in this more basal segment. The enhancement of the tricuspid and mitral valve leaflets is normal.
• Movie 5 - (Windows media) (2.7 MB) Echocardiogram papillary muscle level short axis cine loop. There is regional wall thinning and wall motion abnormality.
• Movie 6 - (Windows media) (2.0 MB) Cardiovascular magnetic resonance papillary muscle level short axis cine loop showing lateral wall thinning and hypokinesis. The corresponding late gadolinium image seen in Figure 2 shows suggested full thickness scarring in this region. The scarring of the anterolateral papillary muscle is only detectable with late gadolinium enhancement.
• Movie 7 - (Windows media) (3.8 MB) Echocardiogram apical level short axis cine loop. In retrospect there may be mild regional wall motion abnormality.
• Movie 8 - (Windows media) (25 KB) Cardiovascular magnetic resonance apical level short axis cine loop demonstrating that the lateral regional wall motion abnormality extended down to apical level. The late gadolinium enhancement suggested degree of scarring would have been underestimated from cine imaging alone.