Diagnostic criteria for myocarditis on cardiac magnetic resonance imaging: an educational review

Abstract

Acute myocarditis represents one of the most mysterious acute cardiovascular diseases due to the great diversity of its clinical presentation, ranging from simple symptoms such as flu-like syndrome to lethal conditions such as cardiogenic shock or sudden cardiac death. The diagnosis will be suspicious in the presence of chest pain in a subject with risk factors, and guided mainly by the ECG, biological markers, trans-thoracic echocardiography, and the cardiac MRI. In this sense, and returning to the pathophysiological bases of this condition, the positive diagnosis will rely mainly on the detection of tissue abnormalities secondary to the myocardial inflammatory storm. Cardiac MRI represents a diagnostic pillar, given the information it can provide, both in analyzing the morphology, and the myocardial function but also tissue abnormalities that represent the main element of the diagnostic criteria of Lake Louisse.

Mechanisms of Myocardial Edema Development in CVD Pathophysiology

“…Currently, the etiology of myocardial edema, its relationship with the excitationcontraction coupling, as well as the regulation of fluid flow between the capillary and cardiomyocytes generating pressure > 100 mmHg every second [5], and the lymphatic system is not completely understood. Myocardial edema can be observed in coronary heart disease due to hypoxia [6], myocardial infarction [7,8], myocarditis [9], and various types of cardiomyopathies [1], which account for more than 70% of all deaths from cardiovascular diseases in the world [1,10]. In addition, the edema is found in such chronic conditions Biomedicines 2024, 12, 465 2 of 17 as arterial and pulmonary hypertension, as well as during the usage of cardiopulmonary bypass, cardioplegic arrest [11], and sepsis [1].…”