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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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CLEAR FILTERS
DESCRIBING MYOCARDITIS IN THE ERA OF CARDIAC MRI
Session:
Painel 9 - Doença Valvular 7
Speaker:
Paulo Medeiros
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Paulo Medeiros; Juliana Martins; Isabel Durães Campos; Cátia Costa Oliveira; Carla Marques Pires; Rui Files Flores; Fernando Ribeiro Mané; Vitor Hugo Pereira; Jorge Marques
Abstract
<p><strong>Introduction:</strong> Acute myocarditis (AM) is challenging diagnosis, due to its non-specific symptoms that mimic conditions like acute myocardial infarction. Endomyocardial biopsy (EMB) is the gold standard for the diagnosis of definite AM. However, with the availability of cardiac magnetic resonance (CMR), EMB is used in a limited number of cases.</p> <p><strong>Methods</strong>: Single-center descriptive analysis of individuals hospitalized in our Cardiology department with diagnosis of AM between Nov/2016-Nov/2019. All patients had CMR-supported AM diagnosis (signal intensity increase in T2-weighted images; late gadolinium enhancement –LGE- with non-ischemic distribution).</p> <p><strong>Results</strong>: A total of 82 patients were included, 82% male (n=67) and 18% female (n=15). Mean age was 32.77yo (17-76) and mean hospital stay was 4.6 days. At admission, 26% of patients had no other complaints besides chest pain, while 30% reported gastrointestinal and 26% reported respiratory symptoms. Twenty-five patients were on antibiotics; the most commonly reported infection was acute tonsillitis (n=15). Pericarditis was diagnosed in 36% of patients. Mean troponin I peak was 15.8(0.14-95.4) ng/mL; mean NT-proBNP was 806(63-5712) pg/mL. Inflammatory markers were elevated in 97.6% of patients. ECG abnormalities were found in 68% patients, mostly ST-segment elevation (49%), PQ segment depression (20%) and T-wave inversion (12%). Regarding echocardiography, 78% of patients (n=64) had preserved LV function (LVEF>50%), while 12 had mild, 4 had moderate and 1 had severe dysfunction. For diagnostic workup, 30% of patients underwent coronary angiography, with no significant coronary disease found. EMB was performed in 1 patient (fulminant myocarditis and severe LV dysfunction). CMR revealed LV systolic dysfunction in 15.9%. LGE was more common in the lateral wall (n=38), followed by inferior (n=27) and anterior (n=11) walls. Tissue edema was described in 50% cases; pericardial effusion was found in 8.5%. About treatment, 87% of patients received NSAIDs, 38% beta-blockers, 33% ACEI/ARBs and 13% colchicine. One patient required immunomodulatory and inotropic drugs. No in-hospital deaths were registered. At mean follow-up of 10 months, 2 patients had recurrence of AM; 3 patients maintained LV dysfunction. One ICD was implanted, and 1 heart transplant was performed.</p> <p><strong>Conclusion</strong>: In our series, acute myocarditis was common in young male patients with few/no comorbidities, following gastrointestinal/respiratory symptoms. About 1/5 had some degree of LV systolic dysfunction. Most patients had a short and uncomplicated course.</p>
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