Valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento ST y arterias coronarias normales

Background: Patients hospitalized with suspected ST-segment elevation myocardial infarction (STEMI) who have normal coronary arteries (CAs) on invasive coronary angiography (ICA) may have an AMI or another acute cardiac disease that mimics it. Aim: To evaluate the usefulness of cardiac magnetic re...

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Autores principales:	Díaz-Navarro,Rienzi, Silva González,Danilo, Henríquez-Roldán,Carlos
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2020
Materias:	Magnetic Resonance Imaging Myocarditis ST Elevation Myocardial Infarction Takotsubo Cardiomyopathy
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001001406
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spelling	oai:scielo:S0034-988720200010014062021-02-02Valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento ST y arterias coronarias normalesDíaz-Navarro,RienziSilva González,DaniloHenríquez-Roldán,Carlos Magnetic Resonance Imaging Myocarditis ST Elevation Myocardial Infarction Takotsubo Cardiomyopathy Background: Patients hospitalized with suspected ST-segment elevation myocardial infarction (STEMI) who have normal coronary arteries (CAs) on invasive coronary angiography (ICA) may have an AMI or another acute cardiac disease that mimics it. Aim: To evaluate the usefulness of cardiac magnetic resonance imaging (CMRI) for diagnosing conditions resembling AMI with normal CAs. Material and Methods: We studied 424 consecutive patients admitted with suspected STEMI who underwent ICA. Those with normal CAs underwent CMRI involving cine-CMRI sequences to evaluate segmental wall motion, T2-weighted short-tau inversion-recovery imaging to detect oedema and delayed contrast enhancement (DCE) after gadolinium administration to identify necrosis/fibrosis. Patients with previous myocardial infarction were excluded. Results: Twenty-six patients (6.1%) had normal CAs. Definitive diagnosis after CMRI was acute myocarditis in 11 patients (42.3%) whose DCE was localized in the subepicardium or intramyocardially but not in the endocardium, AMI in nine patients (34.6%) who had subendocardial or transmural DCE, and Takotsubo cardiomyopathy (TCM) in six patients (23.1%), whose CMRI showed regional contractility abnormalities of the left ventricle and myocardial oedema but not DCE. Conclusions: Cardiac magnetic resonance imaging allows a precise diagnosis of acute myocardial infarction in patients with angiographically normal coronary arteries.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.148 n.10 20202020-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001001406es10.4067/S0034-98872020001001406
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Magnetic Resonance Imaging Myocarditis ST Elevation Myocardial Infarction Takotsubo Cardiomyopathy
spellingShingle	Magnetic Resonance Imaging Myocarditis ST Elevation Myocardial Infarction Takotsubo Cardiomyopathy Díaz-Navarro,Rienzi Silva González,Danilo Henríquez-Roldán,Carlos Valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento ST y arterias coronarias normales
description	Background: Patients hospitalized with suspected ST-segment elevation myocardial infarction (STEMI) who have normal coronary arteries (CAs) on invasive coronary angiography (ICA) may have an AMI or another acute cardiac disease that mimics it. Aim: To evaluate the usefulness of cardiac magnetic resonance imaging (CMRI) for diagnosing conditions resembling AMI with normal CAs. Material and Methods: We studied 424 consecutive patients admitted with suspected STEMI who underwent ICA. Those with normal CAs underwent CMRI involving cine-CMRI sequences to evaluate segmental wall motion, T2-weighted short-tau inversion-recovery imaging to detect oedema and delayed contrast enhancement (DCE) after gadolinium administration to identify necrosis/fibrosis. Patients with previous myocardial infarction were excluded. Results: Twenty-six patients (6.1%) had normal CAs. Definitive diagnosis after CMRI was acute myocarditis in 11 patients (42.3%) whose DCE was localized in the subepicardium or intramyocardially but not in the endocardium, AMI in nine patients (34.6%) who had subendocardial or transmural DCE, and Takotsubo cardiomyopathy (TCM) in six patients (23.1%), whose CMRI showed regional contractility abnormalities of the left ventricle and myocardial oedema but not DCE. Conclusions: Cardiac magnetic resonance imaging allows a precise diagnosis of acute myocardial infarction in patients with angiographically normal coronary arteries.
author	Díaz-Navarro,Rienzi Silva González,Danilo Henríquez-Roldán,Carlos
author_facet	Díaz-Navarro,Rienzi Silva González,Danilo Henríquez-Roldán,Carlos
author_sort	Díaz-Navarro,Rienzi
title	Valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento ST y arterias coronarias normales
title_short	Valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento ST y arterias coronarias normales
title_full	Valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento ST y arterias coronarias normales
title_fullStr	Valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento ST y arterias coronarias normales
title_full_unstemmed	Valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento ST y arterias coronarias normales
title_sort	valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento st y arterias coronarias normales
publisher	Sociedad Médica de Santiago
publishDate	2020
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001001406
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Valor de la resonancia magnética cardíaca para el diagnóstico diferencial en pacientes con sospecha de infarto agudo de miocardio con elevación del segmento ST y arterias coronarias normales

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