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Echocardiographic findings in myocarditis
B Pinamonti1, E Alberti, A Cigalotto
1Divisione di Cardiologia, Università degli Studi, Trieste, Italy.
Insights
Echocardiography reveals diverse cardiac changes in myocarditis patients, often mimicking other heart conditions. These findings are crucial for diagnosing myocarditis and guiding biopsy decisions.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Myocarditis presents with varied clinical symptoms.
- Accurate diagnosis is essential for appropriate patient management.
Purpose of the Study:
- To analyze echocardiographic findings in patients with confirmed myocarditis.
- To assess the utility of echocardiography in differentiating myocarditis from other cardiac diseases.
Main Methods:
- M-mode and 2-dimensional echocardiography were performed on 41 patients.
- Histological confirmation of myocarditis was established for all participants.
Main Results:
- Left ventricular dysfunction was observed in 69% of patients, particularly those with heart failure.
- Echocardiographic findings were polymorphous, simulating conditions like dilated or hypertrophic cardiomyopathy.
- Right ventricular dysfunction and other abnormalities like thrombi were also noted.
Conclusions:
- Echocardiography displays nonspecific and varied patterns in myocarditis.
- Echocardiography aids in diagnosing myocarditis and selecting patients for endomyocardial biopsy.
Abstract:
This study analyzes morphologic and functional alterations detected by M-mode and 2-dimensional echocardiography in 41 patients with histologically proven myocarditis and different clinical presentations: congestive heart failure (63%), atrioventricular block (17%), chest pain (15%) and supraventricular arrhythmias (5%). Left ventricular dysfunction was common (69%), particularly in patients with congestive heart failure (88%), often without or with minor cavity dilatation. Patients with atrioventricular block or chest pain had usually preserved ventricular function. Right ventricular dysfunction was present in 23%. Additional findings included asynergic ventricular areas (64%), left ventricular "hypertrophy" sometimes reversible (20%), hyperrefractile myocardial areas (23%), ventricular thrombi (15%) and "restrictive" ventricular filling (7%). It is concluded that echocardiographic features of myocarditis are polymorphous and nonspecific. The echocardiographic pattern can simulate alternatively dilated, hypertrophic, restrictive or "right" ventricular cardiomyopathy, as well as coronary artery disease. In an appropriate clinical context, echocardiography can be helpful in the diagnosis of myocarditis and in the selection of patients for endomyocardial biopsy.