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
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