Acute Myocarditis with Infarct-like Presentation in a Pediatric Population: Role of Cardiovascular Magnetic Resonance


Por: Martinez-Villar M, Gran F, Sabaté-Rotés A, Tello-Montoliu A, Castellote A, Figueras-Coll M, Ferrer Q and Roses-Noguer F

Publicada: 1 ene 2018
Resumen:
Chest pain is a typical symptom of acute myocarditis in adolescents. It may be indistinguishable from myocardial ischemia so it is called "infarct-like pattern." Cardiovascular magnetic resonance has an important role as a non-invasive diagnostic tool. The aim of our study is to provide a description of an acute myocarditis series with infarct-like pattern and to evaluate the cardiovascular magnetic resonance role in a pediatric population. We included all pediatric patients (0-16 years) admitted to our hospital (May 2007-May 2016) with clinical diagnosis of acute myocarditis and infarct-like presentation (chest pain, EKG alterations, and released cardiac biomarkers). Diagnosis was confirmed with cardiovascular magnetic resonance using Lake Louise criteria. Seven patients (five males, two females) with a median age of 14 years (12.5-15.2) were included. All patients showed ST-segment changes and released cardiac biomarkers. Three patients had left ventricular hypertrophy and two presented mild systolic left ventricular dysfunction. All patients had at least two positive Lake Louise criteria. Late gadolinium enhancement was positive in all of them. With a median follow-up of 23 months (8-47), all of them are alive, with no cardiac symptoms and normal ventricular function. Infarct-like pattern is a typical presentation of acute myocarditis in adolescents. CMR should be performed in this population and may be considered as a first-line diagnostic tool. Its high sensitivity in infarct-like acute myocarditis may allow us to avoid endomyocardial biopsy. Unlike what was described in adults, late gadolinium enhancement does not imply worse outcome in our series.

Filiaciones:
:
 Pediatric Cardiology Department, Hospital Universitario Materno-Infantil Vall d'Hebrón, Universidad Autónoma de Barcelona, Passeig Vall d'Hebrón, 119-129, 08035, Barcelona, Spain

 Pediatrics Department, Hospital Vega Baja, Orihuela, Alicante, Spain

Gran F:
 Pediatric Cardiology Department, Hospital Universitario Materno-Infantil Vall d'Hebrón, Universidad Autónoma de Barcelona, Passeig Vall d'Hebrón, 119-129, 08035, Barcelona, Spain.

Sabaté-Rotés A:
 Pediatric Cardiology Department, Hospital Universitario Materno-Infantil Vall d'Hebrón, Universidad Autónoma de Barcelona, Passeig Vall d'Hebrón, 119-129, 08035, Barcelona, Spain

Tello-Montoliu A:
 Cardiology Department. Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, Murcia, Spain

Castellote A:
 Pediatric Cardiology Department, Hospital Universitario Materno-Infantil Vall d'Hebrón, Universidad Autónoma de Barcelona, Passeig Vall d'Hebrón, 119-129, 08035, Barcelona, Spain

Figueras-Coll M:
 Pediatric Cardiology Department, Hospital Universitario Materno-Infantil Vall d'Hebrón, Universidad Autónoma de Barcelona, Passeig Vall d'Hebrón, 119-129, 08035, Barcelona, Spain

 Pediatrics Cardiology Department, Hospital Universitario de Girona Dr. Josep Trueta, Universidad de Girona, Girona, Spain

Ferrer Q:
 Pediatric Cardiology Department, Hospital Universitario Materno-Infantil Vall d'Hebrón, Universidad Autónoma de Barcelona, Passeig Vall d'Hebrón, 119-129, 08035, Barcelona, Spain

Roses-Noguer F:
 Pediatric Cardiology Department, Hospital Universitario Materno-Infantil Vall d'Hebrón, Universidad Autónoma de Barcelona, Passeig Vall d'Hebrón, 119-129, 08035, Barcelona, Spain

 Paediatric Cardiology Department, Royal Brompton and Harefield NHS Foundation Trust, London, UK
ISSN: 01720643





PEDIATR CARDIOL
Editorial
Springer Verlag, Estados Unidos America
Tipo de documento: Article
Volumen: 39 Número: 1
Páginas: 51-56
WOS Id: 000419883400008
ID de PubMed: 28986648

MÉTRICAS