Myocarditis differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
Myocarditis presents with [[chest pain]] and [[ST segment elevation]]. Myocardiits must be distinguished from the life threatening condition of [[ST elevation myocardial infarction | Myocarditis presents with [[chest pain]] and [[ST segment elevation]]. Myocardiits must be distinguished from [[pericarditis]] and the life threatening condition of [[ST elevation myocardial infarction]]. | ||
==Differentiating Myocarditis from ST Segment Elevation Myocardial Infarction== | ==Differentiating Myocarditis from ST Segment Elevation Myocardial Infarction== | ||
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===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. | ||
==Differentiating Myocarditis from Pericarditis== | |||
Both diseases present with [[chest pain]] and [[ST segment elevation]]. | |||
==References== | ==References== | ||
Revision as of 13:24, 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 pericarditis and the life threatening condition of ST elevation myocardial infarction.
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.
Differentiating Myocarditis from Pericarditis
Both diseases present with chest pain and ST segment elevation.