The Journal of the American College of Cardiology has issued a White Paper outlining the indications for cardiac MRI in patients with suspected myocarditis. Indications include: symptoms (CP, SOB, palpitations, etc), signs of myocardial injury (ventricular dysfunction, ECG changes, or elevated biomarkers), and suspected viral etiology (recent viral illness, previous myocarditis, no evidence of CAD) (article). Cardiac MRI is rapidly becoming the imaging test of choice in patients with suspected myocarditis.
Dyspnea ororthopnea or palpitations or effort intolerance/malaise or chest pain | Ventricular dysfunction or new or persisting ECG abnormalities orelevated troponin | History of recent systemic viral disease or previous myocarditis or absence of risk factors for coronary artery disease or age <35 yrs orsymptoms not explained by coronary stenosis on coronary angiogram orrecent negative ischemic stress test |
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