CMR at the Center of Myocarditis and Inflammatory Myopericardial Syndromes: A Case-Based Approach to Diagnosis, Management, and Follow-Up - Educational Grant from Bayer-CMR at the Center of Myocarditis and Inflammatory Myopericardial Syndromes: A Case-Based Approach to Diagnosis, Management, and Follow-Up

CMR at the Center of Myocarditis and Inflammatory Myopericardial Syndromes: A Case-Based Approach to Diagnosis, Management, and Follow-Up - Educational Grant from Bayer

Back to course

Video Transcription

Video Summary

The webinar reviewed the role of cardiac magnetic resonance (CMR) in diagnosing, managing and following inflammatory myopericardial syndromes. Speakers emphasized a risk-based approach: begin with clinical assessment, ECG, biomarkers and echocardiography; exclude coronary disease when appropriate; and use CMR early in stable patients. Endomyocardial biopsy remains important in high-risk or unstable cases and when identifying a specific cause could guide treatment.<br /><br />The updated Lake Louise criteria combine T1-based evidence of myocardial injury with T2-based evidence of edema. Mapping improves diagnostic sensitivity and can help monitor recovery, while late gadolinium enhancement (LGE), ventricular function and wall-motion abnormalities contribute to prognosis. CMR can also assess pericardial inflammation and effusion. Follow-up timing should be individualized, generally within six months, and may help guide return to work or exercise. Mapping requires good image quality and local reference values; arrhythmias and implanted devices can limit reliability.<br /><br />Case examples illustrated acute and chronic myocarditis, pericarditis, giant-cell and eosinophilic myocarditis, immune-checkpoint-inhibitor myocarditis, and recurrent inflammation associated with genetic cardiomyopathy. LGE extent and pattern—including anterior or septal involvement and transmural extension—may indicate higher risk. Recurrent episodes should prompt consideration of genetic testing. Overall, CMR is valuable but must be interpreted alongside clinical findings, with biopsy and specialist collaboration used when indicated.

Keywords

cardiac magnetic resonance

CMR

myopericardial syndromes

myocarditis

pericarditis

Lake Louise criteria

late gadolinium enhancement

myocardial mapping

endomyocardial biopsy

genetic cardiomyopathy