Outcomes of Myocarditis in Patients with Normal Left Ventricular Systolic Function on Admission

Barfuss, Spencer; Butts, Ryan J.; Knecht, Kenneth R.; Prada-Ruiz, Adriana C; Lal, Ashwin K.

doi:10.1007/s00246-019-02127-x

Cited by 11 publications

(10 citation statements)

References 8 publications

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“…A differential diagnosis between acute MI and myocarditis on the basis of laboratory findings may sometimes be difficult. Both diseases might be presented with increased levels of cardiac serum enzymes and inflammatory biomarkers [4,32,33]. However, a TnT level within normal limits does not exclude the diagnosis of myocarditis but may constitute a prognostic factor of a better outcome [27,34,35].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model

Wieczorkiewicz

Przybylak

Supel

et al. 2022

JCM

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Myocarditis may mimic myocardial infarction (MI) due to a similar clinical presentation, including chest pain, electrocardiography changes, and laboratory findings. The purpose of the study was to investigate the diagnostic value of clinical, laboratory, and electrocardiography characteristics of patients with acute coronary syndrome - like myocarditis and MI. We analysed 90 patients (≤45 years old) with an initial diagnosis of ST-segment elevation myocardial infarction; 40 patients (44.4%), through the use of cardiac magnetic resonance, were confirmed to have myocarditis, and 50 patients (55.6%) were diagnosed with MI. Patients with myocarditis were younger and had fewer cardiovascular risk factors than those with MI. The cutoff value distinguishing between myocarditis and MI was defined as the age of 36 years. The history of recent infections (82.5% vs. 6%) and C-reactive protein (CRP) levels on admission (Me 45.9 vs. 3.4) was more associated with myocarditis. Further, the QTc interval was inversely correlated with the echocardiographic ejection fraction in both groups but was significantly longer in patients with MI. Non-invasive diagnostics based on clinical features and laboratory findings are basic but still essential tools for differentiation between MI and myocarditis. The three-factor model including the criteria of age, abnormal CRP, and history of recent infections might become a valuable clinical indication.

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Section: Discussionmentioning

confidence: 99%

Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model

Wieczorkiewicz

Przybylak

Supel

et al. 2022

JCM

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“…Myocardial velocities measured using tissue doppler imaging of the mitral annulus during diastole fall progressively with age; in addition there is an increase in left ventricular diastolic stiffness that correlates with advancing age [33]. There is a steep increase in the prevalence of heart failure in older adults with normal left ventricular systolic function [34]. A significant reduction in early left ventricular filling may leave the left ventricle less distended and result in a failure of the Frank-Starling mechanism, together with an ageassociated reduction in left ventricular compliance, which can easily cause increases in left atrial and left ventricular end diastolic pressure and lead to pulmonary congestion and edema.…”

Section: Breathing: Cardiovascular Factors Should Be Paid Close Attention In Patients With Dyspneamentioning

confidence: 99%

Management of Very Old Patients in Intensive Care Units

Ding¹,

Lian²,

Wang³

2021

Aging and disease

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The global population is aging and the demand for critical care wards increasing. Aging is associated not only with physiological and cognitive vulnerability, but also with a decline in organ function. A new topic in geriatric care is how to appropriately use critical care resources and provide the best treatment plan for very old patients (VOPs). Our special geriatric intensive care unit has admitted nearly 500 VOPs. In this review, we share our VOP treatment strategy and summarize the key points as “ABCCDEFGHI bundles.” The aim is to help intensivists to provide more comprehensive therapy for VOPs in intensive care units.

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“…We suggest using a troponin I threshold of ≥10 ng/mL based on a multicenter study of patients with prepandemic pediatric myocarditis, who similarly to most patients with post‐COVID‐19 vaccine myocarditis, all had normal LV systolic function on admission. 11 Patients who experienced worse clinical outcomes (eg, use of heart failure medications, mechanical ventilation, death/transplant) had a double‐digit average troponin I level compared with those who did not (18.2 versus 6.4 ng/mL). 11 …”

mentioning

confidence: 99%

“…The prognostic utility of troponin in forecasting the clinical course of patients with myo‐pericardial inflammation is not clear. 11 , 12 , 13 In a small group of teenagers with myopericarditis who exhibited double‐digit troponin I elevation (in 1 case peaking as high as 134 ng/mL), all patients had normal LV systolic function throughout a 2‐month median follow‐up period and were treated with only NSAIDs. 13 Data from a more recent multicenter pediatric myocarditis analysis show that troponin I level correlated poorly with the degree of ventricular dysfunction (paradoxically lower with moderately severely reduced function) as well as the presence/absence of cardiac inflammation.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Myocarditis After COVID‐19 Vaccination in Pediatrics: A Proposed Pathway for Triage and Treatment

Sandeep

Fairchok

Hasbani

2022

JAHA

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Outcomes of Myocarditis in Patients with Normal Left Ventricular Systolic Function on Admission

Cited by 11 publications

References 8 publications

Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model

Symptomatic Young Adults with ST-Segment Elevation—Acute Coronary Syndrome or Myocarditis: The Three-Factor Diagnostic Model

Management of Very Old Patients in Intensive Care Units

Myocarditis After COVID‐19 Vaccination in Pediatrics: A Proposed Pathway for Triage and Treatment

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