Stress cardiomyopathy MRI: Difference between revisions
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==References== | ==References== | ||
Revision as of 06:15, 28 August 2012
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Stress cardiomyopathy Microchapters |
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Diagnosis |
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Treatment |
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Unstable angina/non ST elevation myocardial infarction in Stress (Takotsubo) Cardiomyopathy |
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Case Studies |
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Stress cardiomyopathy MRI On the Web |
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American Roentgen Ray Society Images of Stress cardiomyopathy MRI |
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Risk calculators and risk factors for Stress cardiomyopathy MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Magnetic Resonance Imaging
The use of MRIs as a valuable diagnostic tool in differentiating cardiomyopathy from acute myocardial infarction and myocarditis cases. Cardiac magnetic resonance imaging is helpful in excluding a myocardial infarction due to the absence of delayed gadolinium hyperenhancement.
The Eitel study is the largest (n=256), (multi-center) cardiovascular MRI imaging series of stress cardiomyopathy [1]. Stress cardiomyopathy can be accurately diagnosed by identifying a typical pattern of LV dysfunction, myocardial edema, absence of significant necrosis/fibrosis, and markers of myocardial inflammation. There are four distinct patterns of regional ventricular ballooning: apical (82%), biventricular (34%), midventricular (17%), and basal (1%). Because patients with RV involvement tended to be older, hospitalized for longer, and have markers of heart failure, biventricular ballooning on MRI “may portend a longer and more severe course of disease compared with patients with isolated (LV) involvement.” Dysfunctions in the right ventricle are important to identify due to its effects on morbidity, treatment, and outcome. During follow up MRIs, patients exhibited normalization of LVEF (66%) and inflammatory markers in the absence of significant fibrosis in all patients.
MRI Examples
The MRIs below show a patients heart with apical ballooning and then later after resolution of the apical ballooning.
MRI during apical balllooning: {{#ev:youtube|23w6f71zTXI}} ____
MRI following resolution of apical ballooning: {{#ev:youtube|qE0YrlQ5d1o}}
References
- ↑ Eitel I, von Knobelsdorff-Brekenhoff F, Bernhardt P, et al. Clinical characteristics and CV magnetic resonance findings in stress (Takotsubo) cardiomyopathy. JAMA 2011; 306:277-286.