El rol de la resonancia magnética cardíaca en el diagnóstico diferencial entre miocarditis aguda e infarto agudo de miocardio con elevación del segmento ST



Título del documento: El rol de la resonancia magnética cardíaca en el diagnóstico diferencial entre miocarditis aguda e infarto agudo de miocardio con elevación del segmento ST
Revue: lRevista médica de Chile
Base de datos: PERIÓDICA
Número de sistema: 000449074
ISSN: 0034-9887
Autores: 1
2
3
Instituciones: 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
Año:
Periodo: Oct
Volumen: 149
Número: 10
Paginación: 1399-1411
País: Chile
Idioma: Español
Tipo de documento: Artículo
Enfoque: Aplicado, descriptivo
Resumen en inglés 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
Disciplinas: Medicina
Palabras clave: Sistema cardiovascular,
Diagnóstico,
Miocarditis,
Infarto agudo del miocardio,
Diagnóstico diferencial,
Resonancia magnética
Keyword: Cardiovascular system,
Diagnosis,
Myocarditis,
Acute myocardial infarction,
Differential diagnosis,
Magnetic resonance
Texte intégral: Texto completo (Ver HTML) Texto completo (Ver PDF)