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__NOTOC__ | __NOTOC__ | ||
{{Myocarditis}} | {{Myocarditis}} | ||
{{CMG}} | {{CMG}} {{AE}} {{Homa}}[[Varun Kumar|Varun Kumar, M.B.B.S.]] | ||
==Overview== | ==Overview== | ||
[[Coronary angiography]] may be helpful in excluding either [[myocardial ischemia]] or [[MI|infarction]] as the cause of [[ST segment elevation]], elevated [[cardiac biomarkers]], or [[left ventricular dysfunction]]. | [[Coronary angiography]] may be helpful in excluding either [[myocardial ischemia]] or [[MI|infarction]] as the cause of [[ST segment elevation]], elevated [[cardiac biomarkers]], or [[left ventricular dysfunction]]. [[Nuclear]] [[imaging]] may be useful in [[diagnosis]] of [[cardiac sarcoidosis]]. | ||
==Other Imaging Findings== | ==Other Imaging Findings== | ||
===Coronary Angiography=== | ===Coronary Angiography=== | ||
*Since [[myocarditis]] presents similar to [[MI]] with [[ECG]] changes ([[ST segment elevation]]) and elevated [[cardiac enzymes]], coronary angiography may be valuable in excluding coronary disease as the cause of cardiac dysfunction. | *Since [[myocarditis]] presents similar to [[MI]] with [[ECG]] changes ([[ST segment elevation]]) and elevated [[cardiac enzymes]], [[coronary angiography]] may be valuable in excluding [[coronary disease]] as the cause of [[cardiac dysfunction]].<ref name="BrettStrugnell2011">{{cite journal|last1=Brett|first1=Nicholas J.|last2=Strugnell|first2=Wendy E.|last3=Slaughter|first3=Richard E.|title=Acute Myocarditis Demonstrated on CT Coronary Angiography With MRI Correlation|journal=Circulation: Cardiovascular Imaging|volume=4|issue=3|year=2011|issn=1941-9651|doi=10.1161/CIRCIMAGING.110.957779}}</ref><ref name="BousselGamondes2008">{{cite journal|last1=Boussel|first1=Loic|last2=Gamondes|first2=Delphine|last3=Staat|first3=Patrick|last4=Elicker|first4=Brett M.|last5=Revel|first5=Didier|last6=Douek|first6=Philippe|title=Acute Chest Pain With Normal Coronary Angiogram|journal=Journal of Computer Assisted Tomography|volume=32|issue=2|year=2008|pages=228–232|issn=0363-8715|doi=10.1097/RCT.0b013e3181452199}}</ref><ref name="ZhangHe2014">{{cite journal|last1=Zhang|first1=Jing|last2=He|first2=Shenghu|last3=Qi|first3=Xiang|last4=Li|first4=Yimin|title=Combined electrocardiography, coronary angiography and magnetic resonance imaging for the diagnosis of viral myocarditis: A case report|journal=Experimental and Therapeutic Medicine|volume=7|issue=6|year=2014|pages=1643–1646|issn=1792-0981|doi=10.3892/etm.2014.1671}}</ref> | ||
*[[Ventriculography]] may demonstrate decreased [[ejection fraction]]. | *[[Ventriculography]] may demonstrate decreased [[ejection fraction]]. | ||
*Elevated ventricular pressures may be noted in patients with [[systolic dysfunction|systolic]] or [[diastolic dysfunction]]. | *Elevated [[Ventricular pressure|ventricular pressures]] may be noted in [[patients]] with [[systolic dysfunction|systolic]] or [[diastolic dysfunction]]. | ||
=== | ===Nuclear imaging=== | ||
*[[Nuclear]] [[imaging]] may be useful in [[diagnosis]] of [[cardiac sarcoidosis]]. The [[nuclear]] [[imaging]] that can be used in detection of [[cardiac sarcoidosis]] include:<ref name="pmid6586327">{{cite journal| author=O'Connell JB, Henkin RE, Robinson JA, Subramanian R, Scanlon PJ, Gunnar RM| title=Gallium-67 imaging in patients with dilated cardiomyopathy and biopsy-proven myocarditis. | journal=Circulation | year= 1984 | volume= 70 | issue= 1 | pages= 58-62 | pmid=6586327 | doi= | pmc= | url= }} </ref><ref name="TellierPaycha1988">{{cite journal|last1=Tellier|first1=Philippe|last2=Paycha|first2=Frédéric|last3=Antony|first3=Isabelle|last4=Nitenberg|first4=Alain|last5=Valeyre|first5=France Dominique|last6=Foult|first6=Jean-Marc|last7=Battesti|first7=Jean-Paul|title=Reversibility by dipyridamole of thallium-201 myocardial scan defects in patients with sarcoidosis|journal=The American Journal of Medicine|volume=85|issue=2|year=1988|pages=189–193|issn=00029343|doi=10.1016/S0002-9343(88)80340-1}}</ref><ref name="FieldsOssorio1990">{{cite journal|last1=Fields|first1=Cheryl L.|last2=Ossorio|first2=Miguel A.|last3=Roy|first3=Thomas M.|last4=Denny|first4=D Martin|last5=Varga|first5=Daniel W.|title=Thallium-201 Scintigraphy in the Diagnosis and Management of Myocardial Sarcoidosis|journal=Southern Medical Journal|volume=83|issue=3|year=1990|pages=339–342|issn=0038-4348|doi=10.1097/00007611-199003000-00022}}</ref><ref name="GuludecMenad1994">{{cite journal|last1=Guludec|first1=Dominique Le|last2=Menad|first2=Fatiha|last3=Faraggi|first3=Marc|last4=Weinmann|first4=Pierre|last5=Battesti|first5=Jean-Paul|last6=Valeyre|first6=Dominique|title=Myocardial Sarcoidosis|journal=Chest|volume=106|issue=6|year=1994|pages=1675–1682|issn=00123692|doi=10.1378/chest.106.6.1675}}</ref><ref name="OhiraTsujino2011">{{cite journal|last1=Ohira|first1=Hiroshi|last2=Tsujino|first2=Ichizo|last3=Yoshinaga|first3=Keiichiro|title=18F-Fluoro-2-deoxyglucose positron emission tomography in cardiac sarcoidosis|journal=European Journal of Nuclear Medicine and Molecular Imaging|volume=38|issue=9|year=2011|pages=1773–1783|issn=1619-7070|doi=10.1007/s00259-011-1832-y}}</ref><ref name="ArdehaliQasim2004">{{cite journal|last1=Ardehali|first1=Hossein|last2=Qasim|first2=Atif|last3=Cappola|first3=Thomas|last4=Howard|first4=David|last5=Hruban|first5=Ralph|last6=Hare|first6=Joshua M|last7=Baughman|first7=Kenneth L|last8=Kasper|first8=Edward K|title=Endomyocardial biopsy plays a role in diagnosing patients with unexplained cardiomyopathy|journal=American Heart Journal|volume=147|issue=5|year=2004|pages=919–923|issn=00028703|doi=10.1016/j.ahj.2003.09.020}}</ref><ref name="DecPalacios1990">{{cite journal|last1=Dec|first1=G.William|last2=Palacios|first2=Igor|last3=Yasuda|first3=Tsunehiro|last4=Fallon|first4=John T.|last5=Khaw|first5=Ban An|last6=Strauss|first6=H.William|last7=Haber|first7=Edgar|title=Antimyosin antibody cardiac imaging: Its role in the diagnois of myocarditis|journal=Journal of the American College of Cardiology|volume=16|issue=1|year=1990|pages=97–104|issn=07351097|doi=10.1016/0735-1097(90)90463-Y}}</ref> | |||
**[[Myosin|Antimyosin antibody]] [[imaging]] | |||
** Tallium 201 [[scintigraphy]] | |||
**[[Technetium-99m|Technetium 99m]] [[scintigraphy]] | |||
**[[Gallium|Gallium-67]] [[scintigraphy]] | |||
** 18 [[fluorodeoxyglucose]] [[positron emission tomography]] ([[PET scan|PET]]) | |||
* '''Note:''' The only recommendation for using [[nuclear]] [[imaging]] in the [[diagnosis]] of myocarditis is [[cardiac sarcoidosis]]. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Medicine]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category: | [[Category:Up-To-Date]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category: | [[Category:Intensive care medicine]] | ||
Latest revision as of 22:51, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]Varun Kumar, M.B.B.S.
Overview
Coronary angiography may be helpful in excluding either myocardial ischemia or infarction as the cause of ST segment elevation, elevated cardiac biomarkers, or left ventricular dysfunction. Nuclear imaging may be useful in diagnosis of cardiac sarcoidosis.
Other Imaging Findings
Coronary Angiography
- Since myocarditis presents similar to MI with ECG changes (ST segment elevation) and elevated cardiac enzymes, coronary angiography may be valuable in excluding coronary disease as the cause of cardiac dysfunction.[1][2][3]
- Ventriculography may demonstrate decreased ejection fraction.
- Elevated ventricular pressures may be noted in patients with systolic or diastolic dysfunction.
Nuclear imaging
- Nuclear imaging may be useful in diagnosis of cardiac sarcoidosis. The nuclear imaging that can be used in detection of cardiac sarcoidosis include:[4][5][6][7][8][9][10]
- Note: The only recommendation for using nuclear imaging in the diagnosis of myocarditis is cardiac sarcoidosis.
References
- ↑ Brett, Nicholas J.; Strugnell, Wendy E.; Slaughter, Richard E. (2011). "Acute Myocarditis Demonstrated on CT Coronary Angiography With MRI Correlation". Circulation: Cardiovascular Imaging. 4 (3). doi:10.1161/CIRCIMAGING.110.957779. ISSN 1941-9651.
- ↑ Boussel, Loic; Gamondes, Delphine; Staat, Patrick; Elicker, Brett M.; Revel, Didier; Douek, Philippe (2008). "Acute Chest Pain With Normal Coronary Angiogram". Journal of Computer Assisted Tomography. 32 (2): 228–232. doi:10.1097/RCT.0b013e3181452199. ISSN 0363-8715.
- ↑ Zhang, Jing; He, Shenghu; Qi, Xiang; Li, Yimin (2014). "Combined electrocardiography, coronary angiography and magnetic resonance imaging for the diagnosis of viral myocarditis: A case report". Experimental and Therapeutic Medicine. 7 (6): 1643–1646. doi:10.3892/etm.2014.1671. ISSN 1792-0981.
- ↑ O'Connell JB, Henkin RE, Robinson JA, Subramanian R, Scanlon PJ, Gunnar RM (1984). "Gallium-67 imaging in patients with dilated cardiomyopathy and biopsy-proven myocarditis". Circulation. 70 (1): 58–62. PMID 6586327.
- ↑ Tellier, Philippe; Paycha, Frédéric; Antony, Isabelle; Nitenberg, Alain; Valeyre, France Dominique; Foult, Jean-Marc; Battesti, Jean-Paul (1988). "Reversibility by dipyridamole of thallium-201 myocardial scan defects in patients with sarcoidosis". The American Journal of Medicine. 85 (2): 189–193. doi:10.1016/S0002-9343(88)80340-1. ISSN 0002-9343.
- ↑ Fields, Cheryl L.; Ossorio, Miguel A.; Roy, Thomas M.; Denny, D Martin; Varga, Daniel W. (1990). "Thallium-201 Scintigraphy in the Diagnosis and Management of Myocardial Sarcoidosis". Southern Medical Journal. 83 (3): 339–342. doi:10.1097/00007611-199003000-00022. ISSN 0038-4348.
- ↑ Guludec, Dominique Le; Menad, Fatiha; Faraggi, Marc; Weinmann, Pierre; Battesti, Jean-Paul; Valeyre, Dominique (1994). "Myocardial Sarcoidosis". Chest. 106 (6): 1675–1682. doi:10.1378/chest.106.6.1675. ISSN 0012-3692.
- ↑ Ohira, Hiroshi; Tsujino, Ichizo; Yoshinaga, Keiichiro (2011). "18F-Fluoro-2-deoxyglucose positron emission tomography in cardiac sarcoidosis". European Journal of Nuclear Medicine and Molecular Imaging. 38 (9): 1773–1783. doi:10.1007/s00259-011-1832-y. ISSN 1619-7070.
- ↑ Ardehali, Hossein; Qasim, Atif; Cappola, Thomas; Howard, David; Hruban, Ralph; Hare, Joshua M; Baughman, Kenneth L; Kasper, Edward K (2004). "Endomyocardial biopsy plays a role in diagnosing patients with unexplained cardiomyopathy". American Heart Journal. 147 (5): 919–923. doi:10.1016/j.ahj.2003.09.020. ISSN 0002-8703.
- ↑ Dec, G.William; Palacios, Igor; Yasuda, Tsunehiro; Fallon, John T.; Khaw, Ban An; Strauss, H.William; Haber, Edgar (1990). "Antimyosin antibody cardiac imaging: Its role in the diagnois of myocarditis". Journal of the American College of Cardiology. 16 (1): 97–104. doi:10.1016/0735-1097(90)90463-Y. ISSN 0735-1097.