Abstract
The symptoms and signs of myocarditis are non-specific. Thus, myocarditis is a differential diagnosis in many patients with heart complaints. As myocarditis may accompany common viral infections of the upper respiratory and gastrointestinal tracts and mild ECG changes are not uncommon in such patients, the diagnosis needs to be considered in large patient cohorts. Establishing the correct diagnosis is of importance as the disease may lead to sudden cardiac death or dilated cardiomyopathy.
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References
Magnani JW, Dec GW. Myocarditis: current trends in diagnosis and treatment. Circulation. 2006;113:876–890
Pinamonti B, Alberti E, Cigalotto A, et al Echocardiographic findings in myocarditis. Am J Cardiol. 1988;62:285–291
Felker GM, Boehmer JP, Hruban RH, et al Echocardiographic findings in fulminant and acute myocarditis. J Am Coll Cardiol. 2000;36:227–232
Martin ME, Moya–Mur JL, Casanova M, et al Role of noninvasive antimyosin imaging in infants and children with clinically suspected myocarditis. J Nucl Med. 2004;45:429–437
Narula J, Khaw BA, Dec GW, et al Diagnostic accuracy of antimyosin scintigraphy in suspected myocarditis. J Nucl Cardiol. 1996;3:371–381
O’Connell JB, Henkin RE, Robinson JA, Subramanian R, Scanlon PJ, Gunnar RM. Gallium–67 imaging in patients with dilated cardiomyopathy and biopsy–proven myocarditis. Circulation. 1984;70:58–62
le Polain de Waroux JB, Pouleur AC, Goffinet C, Pasquet A, Vanoverschelde JL, Gerber BL. Combined coronary and late–enhanced multidetector–computed tomography for delineation of the etiology of left ventricular dysfunction: comparison with coronary angiography and contrast–enhanced cardiac magnetic resonance imaging. Eur Heart J. 2008;29:2544–2551
Redheuil AB, Azarine A, Garrigoux P, Mousseaux E. Images in cardiovascular medicine. Correspondence between delayed enhancement patterns in multislice computed tomography and magnetic resonance imaging in a case of acute myocarditis. Circulation. 2006;114:e571–e572
Friedrich MG, Strohm O, Schulz–Menger J, Marciniak H, Luft FC, Dietz R. Contrast media–enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis. Circulation. 1998;97:1802–1809
Friedrich MG, Sechtem U, Schulz–Menger J, et al Cardiovascular magnetic resonance in myocarditis. J Am Coll Cardiol. 2009;53(suppl 17):1475–1487
Abdel–Aty H, Boyé P, Zagrosek A, Wassmuth R, et al The sensitivity and specificity of contrast–enhanced and T2–weighted cardiovascular magnetic resonance to detect acute myocarditis. J Am Coll Cardiol. 2005;45:1815–1822
Laissy JP, Messin B, Varenne O, et al MRI of acute myocarditis: a comprehensive approach based on various imaging sequences. Chest. 2002;122(suppl 5):1638–1648
Laissy JP, Hyafil F, Feldman LJ, et al Differentiating acute myocardial infarction from myocarditis: diagnostic value of early– and delayed–perfusion cardiac MR imaging. Radiology. 2005;237 (suppl 1):75–82
Gutberlet M, Spors B, Thoma T, et al Suspected chronic myocarditis at cardiac MR: diagnostic accuracy and association with immunohistologically detected inflammation and viral persistence. Radiology. 2008;246:401–409
Rieker O, Mohrs O, Oberholzer K, Kreitner KF, Thelen M. [Cardiac MRI in suspected myocarditis]. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 2002;174(suppl 12):1530–1536
Simonetti OP, Kim RJ, Fieno DS, et al An improved MRI technique for the visualization of myocardial infarction. Radiology. 2001;218: 215–223
Mahrholdt H, Goedecke C, Wagner A, et al Cardiovascular magnetic resonance assessment of human myocarditis: a comparison to histology and molecular pathology. Circulation. 2004;109: 1250–1258
Mahrholdt H, Wagner A, Deluigi C, et al Presentation, patterns of myocardial damage and clinical course of viral myocarditis. Circulation. 2006;114:1581–1590
DeCobelli CF, Pieroni M, Esposito A, et al Delayed gadolinium–enhanced cardiac magnetic resonance in patients with chronic myocarditis presenting with heart failure or recurrent arrhythmias. J Am Coll Cardiol. 2006;47:1649–1654
Roditi GH, Hartnell GG, Cohen MC. MRI changes in myocarditis – evaluation with spin echo, cine MR angiography and contrast–enhanced spin echo imaging. Clin Radiol. 2000;55:752–758
Hunold P, Schlosser T, Vogt FM, et al Myocardial late enhancement in contrast–enhanced cardiac MRI: distinction between infarction scar and noninfarction–related disease. AJR Am J Roentgenol. 2005;184:1420–1426
Ingkanisorn WP, Paterson I, Calvo KR, et al Cardiac magnetic resonance appearance of myocarditis caused by high dose IL–2: similarities to community–acquired myocarditis. J Cardiovasc Magn Res. 2006;8:353–360
Yilmaz A, Mahrholdt H, Athanasiadis A, et al Coronary vasospasm as the underlying cause for chest pain in patients with PVB19 myocarditis. Heart. 2008;94:1456–1463
Li G, Xiang B, Dai G, et al Tissue edema does not change gadolinium–diethylenetriamine pentaacetic acid (Gd–DTPA)–enhanced T1 relaxation times of viable myocardium. J Magn Reson Imaging. 2005;21:744–751
Zagrosek A, Abdel–Aty H, Boyé P, et al Cardiac magnetic resonance monitors reversible and irreversible myocardial injuries in myocarditis. J Am Coll Cardiol Imag. 2009;2(suppl 2): 131–138
Wagner A, Schulz–Menger J, Dietz R, Friedrich MG. Long–term follow–up of patients paragraph sign with acute myocarditis by magnetic paragraph sign resonance imaging. MAGMA. 2003;16:17–20
Zagrosek A, Wassmuth R, Abdel–Aty H, Rudolph A, Dietz R, Schulz–Menger J. Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study. J Cardiovasc Magn Reson. 2008;10:19
Mahrholdt H, Wagner A, Judd RM, et al Delayed enhancement cardiovascular magnetic resonance assessment of non–ischaemic cardiomyopathies. Eur Heart J. 2005;26:1461–1474
Baughman KL. Diagnosis of myocarditis: death of Dallas criteria. Circulation. 2006;113:593–595
Cooper LT, Baughman KL, Feldman AM, et al The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology. Eur Heart J. 2007;28:3076–3093
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Mahrholdt, H., Yilmaz, A., Sechtem, U. (2010). Myocarditis. In: Zamorano, J.L., Bax, J.J., Rademakers, F.E., Knuuti, J. (eds) The ESC Textbook of Cardiovascular Imaging. Springer, London. https://doi.org/10.1007/978-1-84882-421-8_28
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DOI: https://doi.org/10.1007/978-1-84882-421-8_28
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