Document Detail

Characterization of patients with acute chest pain using cardiac magnetic resonance imaging.
MedLine Citation:
PMID:  18516488     Owner:  NLM     Status:  MEDLINE    
AIMS: The purpose of this study was to evaluate whether CMRI provides characteristic findings in patients with acute chest pain suffering from ST-elevation-myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), acute myocarditis or Tako-tsubo cardiomyopathy. PATIENTS AND METHODS: 230 consecutive patients with acute chest pain underwent cardiac catheterization followed by CMRI within median 5 days. Patients were classified to suffer from STEMI (n = 102), NSTEMI (n = 89), acute myocarditis (n = 27), or Tako-tsubo cardiomyopathy (n = 12) on the synopsis of all clinical data. Wall motion abnormalities, late enhancement (LE), persistent microvascular obstruction as well ventricular volumes and functions were assessed by CMRI. RESULTS: Right and left ventricular volumes were significantly different between the groups and values were highest in patients with acute myocarditis. Wall motion abnormalities were observed in 100% of STEMI, 75% of NSTEMI, 67% of acute myocarditis and 100% of Tako-tsubo patients. There was a characteristic pattern of abnormal wall motion focused on midventricular-apical segments in patients with Tako-tsubo cardiomyopathy, depending on the culprit vessel in patients with STEMI/NSTEMI and with a random distribution in patients with acute myocarditis. LE was mainly subendocardial or transmural in patients with STEMI (93.2%) or NSTEMI (62.9%). LE was diffuse, intramural or subepicardial in patients with acute myocarditis. No LE was observed in patients with Tako-tsubo cardiomyopathy. Persistent microvascular obstruction was only visualized in patients with STEMI (33%) or NSTEMI (6%). CONCLUSIONS: Cardiac magnetic resonance imaging provides characteristic patterns of LE, persistent microvascular obstruction and wall motion abnormalities that allow a differentiation between patients with acute chest pain from coronary and non-coronary origin.
Vinzenz Hombach; Nico Merkle; Hans A Kestler; Jan Torzewski; Matthias Kochs; Nikolaus Marx; Thorsten Nusser; Christof Burgstahler; Volker Rasche; Peter Bernhardt; Markus Kunze; Jochen Wöhrle
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-05-30
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  97     ISSN:  1861-0692     ISO Abbreviation:  -     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-22     Completed Date:  2008-12-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  760-7     Citation Subset:  IM    
Department of Internal Medicine II, University of Ulm, Ulm, Germany.
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MeSH Terms
Acute Coronary Syndrome / diagnosis*
Chest Pain / diagnosis*
Magnetic Resonance Imaging / methods*
Middle Aged
Myocarditis / diagnosis*
Reproducibility of Results
Sensitivity and Specificity
Takotsubo Cardiomyopathy / diagnosis*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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