Myocarditis
Infectious vs non-infectious
Acute myocarditis = acute inflammation of the heart muscle
Symptoms + normal or reduced — GLS & MRI
EF limitations — filling status, small hypertensive ventricles with high normal EF, WMA, prognosis, subclinical pathologies
GLS cut-off -15,3% to low normal for diagnosis of myocarditis
Elevated risk for CV-events -15% in normal EF. In reduced EF cut-off -10%,
Worse prognosis cut-off >-12% (3a)
Acute myocarditis is often affects the lateral segments (GLS -17%, lateral -13% vs. -20% and -21% in normal segments) — low-normal GLS as cut-off — „mirror“ to MRI & lateral involvement
Diffusely reduced Strain with anterolateral focus, GLS mildly reduced (20-year-old patient) in myocarditis with normal EF.
Layer-Specific Strain is possible (subepicardial inflammation vs ACS with subendocardial pathology)
Diffusely reduced Strain with anterolateral focus, GLS mildly reduced (20-year-old patient) in myocarditis with normal EF.
Layer-Specific Strain is possible (subepicardial inflammation vs ACS with subendocardial pathology)
Kostakou PM. Int J Cardiol 2018;259:116 / Hsiao JF. Int J Cardiovasc Imaging 2013;29:275
Initial regional (anterolateral) reduction
In the follow-up (6 months) no pathological changes and normalisation of strain
Initial regional (anterolateral) reduction
In the follow-up (6 months) no pathological changes and normalisation of strain
Myocarditis in COVID-19
Antero- und inferolateral reduction in COVID-19
GLS >-13,8% denotes poor prognosis in critical COVID-19 disease
Subclinical changes, especially lateral reduction, in the acute & the follow-up setting
RV FWS >-23% as a marker of poor prognosis in the acute setting
GLS >-13,8% denotes poor prognosis in critical COVID-19 disease
Subclinical changes, especially lateral reduction, in the acute & the follow-up setting
RV FWS >-23% as a marker of poor prognosis in the acute setting
Antero- & inferolateral reduction in acute COVID-19
Antero- & inferolateral reduction in acute COVID-19
