cardiac magnetic resonance imaging in alstrm syndrome background a case series of the cardiac magnetic resonance imaging findings in seven adult alstrm patientsmethods seven patients from the national specialist commissioning group centre for alstrm disease torbay england uk completed the cardiac magnetic resonance imaging protocol to assess cardiac structure and function in alstrm cardiomyopathyresults all patients had some degree of left and right ventricular dysfunction patchy mid wall gadolinium delayed enhancement was demonstrated suggesting an underlying fibrotic process some degree of cardiomyopathy was universal no evidence of myocardial infarction or fatty infiltration was demonstrated but coronary artery disease cannot be completely excluded repeat scanning after 18 months in one subject showed progression of fibrosis and decreased left ventricular functionconclusion adult alstrm cardiomyopathy appears to be a fibrotic process causing impairment of both ventricles serial cardiac magnetic resonance scanning has helped clarify the underlying disease progression and responses to treatment confirmation of significant mutations in the alms1 gene should lead to advice to screen the subject for cardiomyopathy and metabolic disorders