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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Myocarditis with normal left ventricular function and troponin of 266

Carlos Ramos-Matos1, Michael Scholfield2, Joao Fontuoro3

  • 1Department of Internal Medicine, University of South Florida, Tampa, FL.

The American Journal of Emergency Medicine
|May 27, 2014
PubMed

Insights

This case report details a potential new form of acute myocarditis presenting with heart block and elevated troponin levels. A novel CT scan technique was used for diagnosis due to pacemaker interference with MRI.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Pathology

Background:

  • Acute myocarditis is an inflammatory condition of the heart muscle.
  • Diagnosis can be challenging, especially in patients with contraindications to standard imaging.
  • Cardiac biomarkers and electrocardiography are crucial in initial assessment.

Observation:

  • A patient presented with new onset atrioventricular block and markedly elevated troponin I levels (peak 266 ng/mL).
  • Left ventricular function was preserved.
  • Magnetic resonance imaging was not feasible due to a permanent pacemaker.

Findings:

  • A novel computed tomography technique with delayed enhancement was successfully employed for diagnosing myocarditis.
  • The imaging findings, combined with clinical presentation, suggest a potential new entity within acute myocarditis.

Implications:

  • This case highlights the utility of advanced CT imaging in diagnosing myocarditis when MRI is contraindicated.
  • The findings may expand the understanding of acute myocarditis presentations and diagnostic criteria.
  • Further research is warranted to define this potential new entity and its management.

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