PREVALENCE OF MYOCARDITIS AND PERICARDITIS AMONG CHEST PAIN PATIENTS WITH A NORMAL ISCHEMIC EVALUATION

Title

PREVALENCE OF MYOCARDITIS AND PERICARDITIS AMONG CHEST PAIN PATIENTS WITH A NORMAL ISCHEMIC EVALUATION

Creator

Behbahani-Nejad O; Boland S; Raghavendran R; Mikolich B; Tondapu V; Mikolich J R

Publisher

Journal of the American College of Cardiology

Date

2019
2019-03

Description

Background Although stress-echo (SE), nuclear myocardial stress perfusion imaging (MPI) and coronary arteriography are used to detect atherosclerosis, they are not well suited for diagnosing inflammatory heart disease. Cardiac MRI (CMR) is uniquely capable of detecting myocardial and pericardial edema, a hallmark of inflammation. As the myocardium and pericardium are contiguous, myocarditis and pericarditis often coexist. This study assessed the prevalence of myocarditis and pericarditis in patients with chest pain and a negative ischemic evaluation, using CMR. Methods An institutional cardiac imaging database was queried for patients with chest pain who underwent CMR after a normal ischemic evaluation. CMR criteria for inflammation included myocardial/pericardial enhancement on T2 STIR, early gadolinium enhancement, increased T1 mapping relaxation time, increased T2 mapping relaxation time, and delayed gadolinium enhancement. At least 2 of these findings were required for a diagnosis of myocarditis or pericarditis. The prevalence of myocarditis/pericarditis was computed for patients with a negative SE, MPI or CMR stress study separately. Results There were 1,476 patients with chest pain and negative ischemic evaluation. Of 149 patients with a normal SE, 10 (6.8%) had evidence of myocarditis. Of these 10 patients, nine (90%) were female. These same 10 patients (100%) also had coexisting pericarditis (10% male, 90% female). Of 403 patients with a normal MPI, 29 (7.2%) had myocarditis. 22 of these 29 (75.9%) also had CMR findings of pericarditis. Of 924 patients with a normal CMR stress perfusion study, 63 (6.8%) had myocarditis on CMR. Of these 63 patients, 48 (76.2%) had CMR evidence of pericarditis as well. Conclusion This study suggests a 7% prevalence of underlying myocarditis in patients presenting with chest pain and a negative ischemic evaluation. Additionally, 78% of these patients had evidence of coexisting pericarditis. Females with normal stress-echo results are more likely to have a missed diagnoses of acute myocarditis and pericarditis. These data emphasize the value of CMR for diagnosing underlying myocarditis and pericarditis, after a negative ischemic evaluation.
--
Poster Contributions Poster Hall, Hall F Sunday, March 17, 2019, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: MR 3
Abstract Category: 29. Non Invasive Imaging: MR Presentation Number: 1227-338

Subject

Cardiovascular System & Cardiology

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Pages

1576–1576

Issue

9

Volume

73

ISSN

0735-1097

Citation

Behbahani-Nejad O; Boland S; Raghavendran R; Mikolich B; Tondapu V; Mikolich J R, “PREVALENCE OF MYOCARDITIS AND PERICARDITIS AMONG CHEST PAIN PATIENTS WITH A NORMAL ISCHEMIC EVALUATION,” NEOMED Bibliography Database, accessed July 30, 2021, https://neomed.omeka.net/items/show/6415.

Social Bookmarking