Onlineartikel 02.11.2015

Acute Myocarditis

deutsche Version

CMR provides unsurpassed methods for exact quantification of cardiac function and volumes as well as tissue characterization for the identification of myocardial edema and necrosis.


Patient history


24-year-old male with new onset chest pain for 12 hours, ubiquitous changes of the ST-segment and elevated troponin levels five days after suffering from severe gastroenteritis. Immediately performed invasive coronary angiography did not demonstrate any obstructive coronary disease. CMR was carried out the day after admission to the hospital.


MR examination


Standard CMR using cine SSFP for assessment of global and regional LV- and RV-function, T2-weighted imaging and contrast enhanced images for tissue characterization.
Breath hold was about 8-12 seconds. Spatial resolution was between 1.5 x 1.5 and 2.0 x 2.0 mm.


MR images and interpretation



Cine SSFP (see video 1 and 2) demonstrates slightly depressed global LV-function with subtle, hypokinesia of the apical lateral wall. T2-weighted images (Figure 1) and late gadolinium enhancement (Figure 2 and 3) show diffuse, epicardially pronounced edema and myocardial necrosis (white arrows).


Akute Myokarditis Bild1

Figure 1

Credit:
DGK 2015


Akute Myokarditis Bild2

Figure 2

Credit:
DGK 2015


Akute Myokarditis Bild3

Figure 3

Credit:
DGK 2015


Diagnosis


Acute myocarditis