Myocarditis in patients with clinical presentation of myocardial infarction and normal coronary angiograms
Laure Sarda, MD*,
Patrice Colin, MD ,
Franck Boccara, MD ,
Doumit Daou, MD,
Rachida Lebtahi, MD*,
Marc Faraggi, MD, PhD*,
Charles Nguyen, MD*,
Ariel Cohen, MD, PhD,
Michel S. Slama, MD,
Philippe G. Steg, MD, PhD and
Dominique Le Guludec, MD, PhD*
* Nuclear Medicine Department, Bichat Hospital, Paris, France
Cardiology Department, Antoine Béclère Hospital, Clamart, France
Cardiology Department, St-Antoine Hospital, Paris, France
Cardiology Department, Bichat Hospital, Paris, France
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Figure 1 Scintigraphic pattern of diffuse myocarditis. The AMA planar images (A, HLR 2.1) and 111In-AMA/201Tl SPECT data (B, corresponding 111In-AMA and 201Tl slices) show diffuse AMA uptake throughout the whole LV myocardium, as well as normal 201Tl uptake. ANT = anterior; LAO = left anterior oblique.
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Figure 2 Scintigraphic pattern of focal myocarditis. The AMA planar images (A, HLR 2.4) and 111In-AMA/201Tl SPECT (B, corresponding AMA and 201Tl slices) show focal AMA uptake on the apex and the lateral LV wall, as well as a normal 201Tl scan. In this patient, coronary angiography and intracoronary contrast echocardiography performed during intense chest pain were normal, except for hypokinesia of the inferior and lateral walls. The chest pain persisted 6 h despite anti-ischemic therapy. Three months later, the ECG was normalized, and echocardiography showed mild global hypokinesia (LVEF 50%) without segmental wall motion abnormalities. ANT = anterior; LAO = left anterior oblique.
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