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Troponin positive chest pain with unobstructed coronary arteries: definitive differential diagnosis using cardiac MRI

Troponin positive chest pain with unobstructed coronary arteries: definitive differential diagnosis using cardiac MRI
Troponin positive chest pain with unobstructed coronary arteries: definitive differential diagnosis using cardiac MRI
Objective: The purpose of this study was to assess the outcome of cardiac MRI (CMRI)with late gadolinium enhancement (LGE) at outpatient follow-up in a consecutive
series of patients with troponin-positive chest pain but unobstructed coronary arteries at the index admission.

Methods: The study comprised 91 consecutive patients who presented to our institution with cardiac chest pain, elevated troponin I and unobstructed coronary
arteries on coronary angiography. All patients underwent an outpatient CMRI with LGE imaging in order to establish a definitive diagnosis.

Results: The average time from coronary angiography to LGE-CMRI was 2 months.73% of patients had no abnormality on their LGE-CMRI, 16% of patients had patchy late enhancement consistent with myocarditis and 11% had focal subendocardial or full thickness late enhancement consistent with myocardial infarction. There were no
deaths in this cohort during a mean follow-up of 21 months.

Conclusion: LGE-CMRI is a useful tool for establishing whether such patients have definitive evidence of non-ST-segment elevation myocardial infarction (NSTEMI), and
can make an important contribution to the long-term management strategy of these patients as an inappropriate diagnosis of NSTEMI carries important medical, social and
financial implications.
0007-1285
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Harden, S.
9a770018-262b-4e6e-8739-364a8e445622
Abid, N.
88de79c9-6f70-47ff-90db-769b62ec38c7
Peebles, C.
8eb51995-0f07-46f7-9ca2-f97301fefc3d
Nicholas, Z.
266e88f3-01a5-4251-8353-29d7aee0ab84
Jones, T.
bf04d9bf-15e9-416a-a4cb-e8d418068b81
McKenzie, D.
72e76c5e-1d96-48f6-be85-d758e97bdf28
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Harden, S.
9a770018-262b-4e6e-8739-364a8e445622
Abid, N.
88de79c9-6f70-47ff-90db-769b62ec38c7
Peebles, C.
8eb51995-0f07-46f7-9ca2-f97301fefc3d
Nicholas, Z.
266e88f3-01a5-4251-8353-29d7aee0ab84
Jones, T.
bf04d9bf-15e9-416a-a4cb-e8d418068b81
McKenzie, D.
72e76c5e-1d96-48f6-be85-d758e97bdf28
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4

Mahmoudi, Michael, Harden, S., Abid, N., Peebles, C., Nicholas, Z., Jones, T., McKenzie, D. and Curzen, N. (2012) Troponin positive chest pain with unobstructed coronary arteries: definitive differential diagnosis using cardiac MRI. British Journal of Radiology. (doi:10.1259/bjr/90663866). (PMID:22457316)

Record type: Article

Abstract

Objective: The purpose of this study was to assess the outcome of cardiac MRI (CMRI)with late gadolinium enhancement (LGE) at outpatient follow-up in a consecutive
series of patients with troponin-positive chest pain but unobstructed coronary arteries at the index admission.

Methods: The study comprised 91 consecutive patients who presented to our institution with cardiac chest pain, elevated troponin I and unobstructed coronary
arteries on coronary angiography. All patients underwent an outpatient CMRI with LGE imaging in order to establish a definitive diagnosis.

Results: The average time from coronary angiography to LGE-CMRI was 2 months.73% of patients had no abnormality on their LGE-CMRI, 16% of patients had patchy late enhancement consistent with myocarditis and 11% had focal subendocardial or full thickness late enhancement consistent with myocardial infarction. There were no
deaths in this cohort during a mean follow-up of 21 months.

Conclusion: LGE-CMRI is a useful tool for establishing whether such patients have definitive evidence of non-ST-segment elevation myocardial infarction (NSTEMI), and
can make an important contribution to the long-term management strategy of these patients as an inappropriate diagnosis of NSTEMI carries important medical, social and
financial implications.

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More information

e-pub ahead of print date: 28 March 2012
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 340829
URI: http://eprints.soton.ac.uk/id/eprint/340829
ISSN: 0007-1285
PURE UUID: cb435704-cea7-45a0-ac44-73316ec29a78
ORCID for Michael Mahmoudi: ORCID iD orcid.org/0000-0003-1293-8461
ORCID for N. Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 04 Jul 2012 09:30
Last modified: 15 Mar 2024 03:54

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Contributors

Author: S. Harden
Author: N. Abid
Author: C. Peebles
Author: Z. Nicholas
Author: T. Jones
Author: D. McKenzie
Author: N. Curzen ORCID iD

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