Differential diagnosis of suspected apical ballooning syndrome using contrast-enhanced magnetic resonance imaging
| Autor: | Holger Thiele, Gerhard Schuler, Dietmar Kivelitz, Ingo Eitel, Florian Behrendt, Matthias Gutberlet, Kathrin Schindler |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Gadolinium DTPA
Male Cardiac Catheterization medicine.medical_specialty Acute coronary syndrome Myocarditis Systole medicine.medical_treatment Myocardial Infarction Cardiomyopathy Contrast Media Coronary Angiography Diagnosis Differential Diastole Takotsubo Cardiomyopathy Internal medicine Humans Medicine Prospective Studies Myocardial infarction Acute Coronary Syndrome Aged Cardiac catheterization medicine.diagnostic_test business.industry Magnetic resonance imaging Prognosis medicine.disease Cardiology Female Radiology Myocardial infarction diagnosis Differential diagnosis Cardiology and Cardiovascular Medicine business Magnetic Resonance Angiography Follow-Up Studies |
| Zdroj: | European Heart Journal. 29:2651-2659 |
| ISSN: | 1522-9645 0195-668X |
| Popis: | Aims The apical ballooning syndrome (ABS) is a new diagnostic entity which is increasingly recognized. Precise magnetic resonance imaging (MRI) data are not yet available and there is little evidence for the differential diagnosis of ABS assessed by MRI. Methods and results Between January 2005 and January 2008, 6100 consecutive patients with diagnosis of acute coronary syndrome underwent left heart catheterization. In 59 patients (1.0%), coronary angiography revealed normal coronary arteries, but left ventriculography showed left ventricular dysfunction with apical ballooning. These 59 patients underwent cardiac MRI using a 1.5 T MRI scanner. In 13 patients (22.0%), MRI revealed diagnosis of myocardial infarction, in eight patients (13.6%) diagnosis of myocarditis. In all other 38 (64.4%) patients (36 female, age 73 ± 10 years) with suspected ABS, no delayed enhancement or signs of inflammation were detected. Follow-up MRI after 3 months showed a completely normalized left ventricular ejection in all patients with suspected ABS. Similarly, the end-diastolic volume and end-systolic volume improved at follow-up. Conclusion Cardiac MRI allows differentiating ABS from other rare causes with unobstructed coronary vessels such as myocarditis and coronary emboli with spontaneous lysis. Therefore, cardiac MRI can add valuable information in all patients with suspected ABS for further differential diagnosis. |
| Databáze: | OpenAIRE |
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