title: Infectious Diseases of the Heart: Pathophysiology, Clinical and Imaging Overview.
abstract: Myriad infectious organisms can infect the endocardium, myocardium, and pericardium, including bacteria, fungi, parasites, and viruses. Significant cardiac infections are rare in the general population but are associated with high morbidity and mortality as well as increased risk in certain populations, such as the elderly, those undergoing cardiac instrumentation, and intravenous drug abusers. Diagnostic imaging of cardiac infections plays an important role despite its variable sensitivity and specificity, which are due in part to the nonspecific manifestations of the central inflammatory process of infection and the time of onset with respect to the time of imaging. The primary imaging modality remains echocardiography. However, cardiac computed tomography and magnetic resonance (MR) imaging have emerged as the modalities of choice wherever available, especially for diagnosis of complex infectious complications including abscesses, infected prosthetic material, central lines and instruments, and the cryptic manifestations of viral and parasitic diseases. MR imaging can provide functional, morphologic, and prognostic value in a single examination by allowing characterization of inflammatory changes from the acute to chronic stages, including edema and the patterns and extent of delayed gadolinium enhancement. We review the heterogeneous and diverse group of cardiac infections based on their site of primary cardiac involvement with emphasis on their cross-sectional imaging manifestations. Online supplemental material is available for this article. (©)RSNA, 2016.
authors.affiliation: From the Division of Medical Imaging, Sutter Medical Group, 1500 Expo Pkwy, Sacramento, CA 95815 (H.M.); Department of Radiology (C.S.R., A.J.B.), Division of Cardiology (J.A.M.), and Department of Pathology (R.L.R.), University of Texas Health Science Center at San Antonio, San Antonio, Tex; Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colo (D.V.); Department of Radiology, University of Texas Health Science Center at Houston, Houston, Tex (D.O.); and Department of Radiology, Saint Luke's Health System, Kansas City, Mo (S.M.).
authors.forename: Horacio
authors.initials: H
authors.lastname: Murillo
authors.affiliation: From the Division of Medical Imaging, Sutter Medical Group, 1500 Expo Pkwy, Sacramento, CA 95815 (H.M.); Department of Radiology (C.S.R., A.J.B.), Division of Cardiology (J.A.M.), and Department of Pathology (R.L.R.), University of Texas Health Science Center at San Antonio, San Antonio, Tex; Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colo (D.V.); Department of Radiology, University of Texas Health Science Center at Houston, Houston, Tex (D.O.); and Department of Radiology, Saint Luke's Health System, Kansas City, Mo (S.M.).
authors.forename: Carlos Santiago
authors.initials: CS
authors.lastname: Restrepo
authors.affiliation: From the Division of Medical Imaging, Sutter Medical Group, 1500 Expo Pkwy, Sacramento, CA 95815 (H.M.); Department of Radiology (C.S.R., A.J.B.), Division of Cardiology (J.A.M.), and Department of Pathology (R.L.R.), University of Texas Health Science Center at San Antonio, San Antonio, Tex; Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colo (D.V.); Department of Radiology, University of Texas Health Science Center at Houston, Houston, Tex (D.O.); and Department of Radiology, Saint Luke's Health System, Kansas City, Mo (S.M.).
authors.forename: Juan Alejandro
authors.initials: JA
authors.lastname: Marmol-Velez
authors.affiliation: From the Division of Medical Imaging, Sutter Medical Group, 1500 Expo Pkwy, Sacramento, CA 95815 (H.M.); Department of Radiology (C.S.R., A.J.B.), Division of Cardiology (J.A.M.), and Department of Pathology (R.L.R.), University of Texas Health Science Center at San Antonio, San Antonio, Tex; Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colo (D.V.); Department of Radiology, University of Texas Health Science Center at Houston, Houston, Tex (D.O.); and Department of Radiology, Saint Luke's Health System, Kansas City, Mo (S.M.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Vargas
authors.affiliation: From the Division of Medical Imaging, Sutter Medical Group, 1500 Expo Pkwy, Sacramento, CA 95815 (H.M.); Department of Radiology (C.S.R., A.J.B.), Division of Cardiology (J.A.M.), and Department of Pathology (R.L.R.), University of Texas Health Science Center at San Antonio, San Antonio, Tex; Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colo (D.V.); Department of Radiology, University of Texas Health Science Center at Houston, Houston, Tex (D.O.); and Department of Radiology, Saint Luke's Health System, Kansas City, Mo (S.M.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Ocazionez
authors.affiliation: From the Division of Medical Imaging, Sutter Medical Group, 1500 Expo Pkwy, Sacramento, CA 95815 (H.M.); Department of Radiology (C.S.R., A.J.B.), Division of Cardiology (J.A.M.), and Department of Pathology (R.L.R.), University of Texas Health Science Center at San Antonio, San Antonio, Tex; Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colo (D.V.); Department of Radiology, University of Texas Health Science Center at Houston, Houston, Tex (D.O.); and Department of Radiology, Saint Luke's Health System, Kansas City, Mo (S.M.).
authors.forename: Santiago
authors.initials: S
authors.lastname: Martinez-Jimenez
authors.affiliation: From the Division of Medical Imaging, Sutter Medical Group, 1500 Expo Pkwy, Sacramento, CA 95815 (H.M.); Department of Radiology (C.S.R., A.J.B.), Division of Cardiology (J.A.M.), and Department of Pathology (R.L.R.), University of Texas Health Science Center at San Antonio, San Antonio, Tex; Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colo (D.V.); Department of Radiology, University of Texas Health Science Center at Houston, Houston, Tex (D.O.); and Department of Radiology, Saint Luke's Health System, Kansas City, Mo (S.M.).
authors.forename: Robert Lee
authors.initials: RL
authors.lastname: Reddick
authors.affiliation: From the Division of Medical Imaging, Sutter Medical Group, 1500 Expo Pkwy, Sacramento, CA 95815 (H.M.); Department of Radiology (C.S.R., A.J.B.), Division of Cardiology (J.A.M.), and Department of Pathology (R.L.R.), University of Texas Health Science Center at San Antonio, San Antonio, Tex; Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colo (D.V.); Department of Radiology, University of Texas Health Science Center at Houston, Houston, Tex (D.O.); and Department of Radiology, Saint Luke's Health System, Kansas City, Mo (S.M.).
authors.forename: Ameya Jagdish
authors.initials: AJ
authors.lastname: Baxi
mesh_terms: D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000503:physiopathology*; D006801:Humans; D007239:Infections / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000503:physiopathology*