Myocarditis differential diagnosis: Difference between revisions
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Both diseases present with [[chest pain]], elevated [[cardiac biomarkers]], and focal [[left ventricular dysfunction]]. There are two studies that can be used to distinguish the two syndromes: | Both diseases present with [[chest pain]], elevated [[cardiac biomarkers]], and focal [[left ventricular dysfunction]]. There are two studies that can be used to distinguish the two syndromes: | ||
===Coronary Angiography=== | ===Coronary Angiography=== | ||
[[Coronary angiography]] can be performed to distinguish myocarditis from [[ST segment elevation myocardial infarction]]. | [[Coronary angiography]] can be performed to distinguish myocarditis from [[ST segment elevation myocardial infarction]]. [[ST segment elevation myocardial infarction]] is associated with either complete or subtotal occlusion of an epicardial [[coronary artery]] on coronary angiography. | ||
===Cardiac Magnetic Resonance Imaging=== | ===Cardiac Magnetic Resonance Imaging=== | ||
[[Cardiac magnetic resonance imaging]] is also useful in distinguishing between the two syndromes as well. On cardiac [[MRI]], myocarditis is associated with patchy, non-sentimental, hyperenhancement which is confined to the epicardial layer of the myocardium. In contrast, in [[ST segment elevation myocardial infarction]] there is confluent hyperenhancement extending from the [[endocardium]] in a distribution that mimics the distribution of the epicardial coronary arteries. | [[Cardiac magnetic resonance imaging]] is also useful in distinguishing between the two syndromes as well. On cardiac [[MRI]], myocarditis is associated with patchy, non-sentimental, hyperenhancement which is confined to the epicardial layer of the myocardium. In contrast, in [[ST segment elevation myocardial infarction]] there is confluent hyperenhancement extending from the [[endocardium]] in a distribution that mimics the distribution of the epicardial coronary arteries. | ||
Revision as of 13:18, 5 September 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Myocarditis presents with chest pain and ST segment elevation. Myocardiits must be distinguished from the life threatening condition of ST elevation myocardial infarction and pericarditis.
Differentiating Myocarditis from ST Segment Elevation Myocardial Infarction
Both diseases present with chest pain, elevated cardiac biomarkers, and focal left ventricular dysfunction. There are two studies that can be used to distinguish the two syndromes:
Coronary Angiography
Coronary angiography can be performed to distinguish myocarditis from ST segment elevation myocardial infarction. ST segment elevation myocardial infarction is associated with either complete or subtotal occlusion of an epicardial coronary artery on coronary angiography.
Cardiac Magnetic Resonance Imaging
Cardiac magnetic resonance imaging is also useful in distinguishing between the two syndromes as well. On cardiac MRI, myocarditis is associated with patchy, non-sentimental, hyperenhancement which is confined to the epicardial layer of the myocardium. In contrast, in ST segment elevation myocardial infarction there is confluent hyperenhancement extending from the endocardium in a distribution that mimics the distribution of the epicardial coronary arteries.