Myocarditis masquerading as ischemic heart disease: the diagnostic utility of antimyosin imaging.
The diagnosis of myocarditis presents a diagnostic challenge due to its varied clinical presentation. In addition, criteria for myocarditis are varied. At present, the confirmation of myocarditis depends on an endomyocardial biopsy demonstrating myocardial inflammation and necrosis. Unfortunately, this invasive procedure is associated with some degree of risk and has significant limitations. This report discusses the case presentations of two patients with chest pain, electrocardiographic changes and elevated creatine kinase levels suggestive of myocardial infarction, who were subsequently found to have findings compatible with myocarditis based on indium-111 antimyosin antibody scanning. This noninvasive test therefore appears to have value in the differentiation of myocardial ischemia from myocarditis.
Lambert
K
K
Department of Medicine, Northwestern University Medical School, Chicago, Ill. 60611.
Isaac
D
D
Hendel
R
R
D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D004699:Endocardium / Q000473:pathology; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D009205:Myocarditis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D009218:Myosins / Q000276:immunology*; D016719:Radioimmunodetection
D007205:Indium Radioisotopes; D009218:Myosins