| Journal: | lRevista médica de Chile |
| Database: | PERIÓDICA |
| System number: | 000449074 |
| ISSN: | 0034-9887 |
| Authors: | Díaz Navarro, Rienzi1 Pepe, Rodrigo Valenzuela2 Silva González, Danilo3 |
| Institutions: | 1Universidad de Valparaíso, Escuela de Medicina, Valparaíso. Chile 2Clínica Bupa Reñaca, Servicio de Imagenología, Viña del Mar. Chile 3Clínica Bupa Reñaca, Unidad de Cuidados Intensivos, Viña del Mar. Chile |
| Year: | 2021 |
| Season: | Oct |
| Volumen: | 149 |
| Number: | 10 |
| Pages: | 1399-1411 |
| Country: | Chile |
| Language: | Español |
| Document type: | Artículo |
| Approach: | Aplicado, descriptivo |
| English abstract | Acute myocarditis frequently mimics an acute myocardial infarction, and its diagnosis is a clinical challenge. Aim: To describe the characteristics of cardiac magnetic resonance imaging in patients with acute myocarditis hospitalized with a diagnosis of ST-segment elevation myocardial infarction. Patients and Methods: Twenty-four patients aged 33 ± 11 years (21 men) with a definitive diagnosis of acute myocarditis hospitalized with a presumptive diagnosis of ST-segment elevation myocardial infarction, in whom a coronary angiogram excluded significant atherosclerotic coronary lesions, were included. Cardiac magnetic resonance imaging with cine-resonance images was performed to assess global and regional ventricular function, and to study myocardial tissue characteristics. T2-STIR sequences were used for the assessment of oedema and late gadolinium enhancement for necrosis/fibrosis. Results: Patients had high levels of total CK, CK-MB, troponin I, brain natriuretic peptide and C-reactive protein. Cardiac magnetic resonance imaging revealed myocardial edema and late gadolinium enhancement was identified in all patients. The edema was transmural in 86% and subepicardial in 14%. Enhancement was subepicardial in 74% of patients and intramural in 26%. It was located in the inferior and lateral walls of the left ventricle in 93%, without affecting the endocardium. In all patients, two of three Lake Louise criteria were met, and an acute myocarditis was diagnosed. Conclusions: Cardiac magnetic resonance imaging is the diagnostic method of choice for diagnosing acute myocarditis when it mimics an acute myocardial infarction |
| Disciplines: | Medicina |
| Keyword: | Sistema cardiovascular, Diagnóstico, Miocarditis, Infarto agudo del miocardio, Diagnóstico diferencial, Resonancia magnética |
| Keyword: | Cardiovascular system, Diagnosis, Myocarditis, Acute myocardial infarction, Differential diagnosis, Magnetic resonance |
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