TY - JOUR
T1 - when to consider cardiac mri in the evaluation of the competitive athlete after sars-CoV-2 infection
AU - Phelan, Dermot
AU - Kim, Jonathan H.
AU - Drezner, Jonathan A.
AU - Elliott, Michael D.
AU - Martinez, Matthew W.
AU - Chung, Eugene H.
AU - Krishan, Sheela
AU - Levine, Benjamin D.
AU - Baggish, Aaron L.
N1 - Funding Information:
The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
PY - 2022
Y1 - 2022
N2 - CMR is a powerful diagnostic tool for the evaluation of myocarditis when clinically indicated. CMR is the only non-invasive imaging modality that can accurately measure myocardial function and provide tissue characterisation capable of detecting manifestations of myocarditis including necrosis/fibrosis/scar (using late gadolinium enhancement) and oedema/hyperaemia/capillary leak (using parametric mapping-derived T1 and T2 relaxation times).7 The European Society of Cardiology and the American Heart Association recommend a diagnostic algorithm for myocarditis predicated on both a clinical presentation suggestive of disease and concomitant abnormal diagnostic testing including data derived from CMR.8 9 Symptoms suggestive of myocarditis include acute/new-onset chest pain, dyspnoea, palpitations and syncope. Diagnostic criteria include ECG or rhythm abnormalities, elevated troponin, structural or functional abnormalities on cardiac imaging and abnormal tissue characterisation on CMR. Clinically suspected myocarditis is defined by the presence of ≥1 clinical symptom and ≥1 diagnostic criterion, or, in the absence of symptoms, ≥2 diagnostic criteria.8 Importantly, CMR-derived tissue characterisation abnormalities, in the absence of symptoms or other diagnostic abnormalities, do not fulfil the contemporary definition of clinical myocarditis.
AB - CMR is a powerful diagnostic tool for the evaluation of myocarditis when clinically indicated. CMR is the only non-invasive imaging modality that can accurately measure myocardial function and provide tissue characterisation capable of detecting manifestations of myocarditis including necrosis/fibrosis/scar (using late gadolinium enhancement) and oedema/hyperaemia/capillary leak (using parametric mapping-derived T1 and T2 relaxation times).7 The European Society of Cardiology and the American Heart Association recommend a diagnostic algorithm for myocarditis predicated on both a clinical presentation suggestive of disease and concomitant abnormal diagnostic testing including data derived from CMR.8 9 Symptoms suggestive of myocarditis include acute/new-onset chest pain, dyspnoea, palpitations and syncope. Diagnostic criteria include ECG or rhythm abnormalities, elevated troponin, structural or functional abnormalities on cardiac imaging and abnormal tissue characterisation on CMR. Clinically suspected myocarditis is defined by the presence of ≥1 clinical symptom and ≥1 diagnostic criterion, or, in the absence of symptoms, ≥2 diagnostic criteria.8 Importantly, CMR-derived tissue characterisation abnormalities, in the absence of symptoms or other diagnostic abnormalities, do not fulfil the contemporary definition of clinical myocarditis.
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U2 - 10.1136/bjsports-2021-104750
DO - 10.1136/bjsports-2021-104750
M3 - Editorial
C2 - 35086807
AN - SCOPUS:85128000794
SN - 0306-3674
VL - 56
SP - 425
EP - 426
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
IS - 8
ER -