Document Detail


Myocarditis in patients with clinical presentation of myocardial infarction and normal coronary angiograms.
MedLine Citation:
PMID:  11693753     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to assess the diagnosis of myocarditis in patients presenting with acute myocardial infarction (MI) and normal coronary angiograms. BACKGROUND: Most often in these patients, the etiologic diagnosis remains unclear once they are found to have normal coronary arteries. The diagnosis of myocarditis mimicking MI is clinically relevant, because numerous arguments suggest a relation between myocarditis and dilated cardiomyopathy. Myocardial indium-111 (111In)-antimyosin antibody (AMA)/rest thallium-201 (201Tl) imaging allows noninvasive detection of myocarditis. METHODS: Forty-five patients admitted to three intensive care units for suspicion of acute MI, with normal coronary angiograms, were investigated. Indium-111-AMA planar images and then a dual-isotope rest AMA/201Tl tomographic study were performed. Six-month echocardiographic follow-up was obtained in 80% of the patients with initial left ventricular (LV) wall motion abnormalities. RESULTS: In eight patients, AMA and 201Tl scintigraphy were negative. In two patients, a matched 201Tl defect and focal AMA uptake suggested acute MI (due to prolonged vasospasm or spontaneously reperfused coronary occlusion). In 17 patients, diffuse AMA uptake over the whole LV suggested diffuse myocarditis. In 18 patients, focal AMA uptake with a normal 201Tl scan suggested diffuse but heterogeneous, or focal myocarditis. Complete functional recovery was observed in 81% of the patients with a pattern of myocarditis. CONCLUSIONS: Among 45 patients presenting with acute MI and normal coronary angiograms, 38% had diffuse myocarditis and 40% had a scintigraphic pattern of heterogeneous or focal myocarditis. Short-term follow-up showed complete LV functional recovery in 81% of these patients.
Authors:
L Sarda; P Colin; F Boccara; D Daou; R Lebtahi; M Faraggi; C Nguyen; A Cohen; M S Slama; P G Steg; D Le Guludec
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  37     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-11-05     Completed Date:  2001-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  786-92     Citation Subset:  AIM; IM    
Affiliation:
Nuclear Medicine Department, Bichat Hospital, Paris, France. dominique.leguludec@bch.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Monoclonal / immunology
Coronary Angiography
Electrocardiography
Female
Humans
Indium Radioisotopes / diagnostic use
Male
Middle Aged
Myocardial Infarction / diagnosis*,  physiopathology,  radiography
Myocarditis / diagnosis*,  physiopathology,  radionuclide imaging,  ultrasonography
Organometallic Compounds / immunology
Prospective Studies
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Indium Radioisotopes; 0/Organometallic Compounds; 138660-99-8/imciromab pentetate

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