Cardiac Imaging in Myocarditis: Current Evidence and Future Directions
Camila Urzua Fresno, Felipe Sánchez Tijmes, Kirsten E. Shaw, Flora Huang, Paaladinesh Thavendiranathan, Sharmila Khullar, Michael A. Seidman, Kate Hanneman
Abstract
Myocarditis is defined as a non-ischemic inflammatory disease of the myocardium. It remains a challenge to diagnose given non-specific symptoms and lack of specific blood biomarkers. Cardiac imaging plays an important role in the evaluation of myocarditis with unique strengths and limitations of different imaging modalities, including cardiac magnetic resonance imaging, echocardiography, cardiac computed tomography, and positron emission tomography. The purpose of this review is to discuss the strengths and limitations of various cardiac imaging techniques in the evaluation of myocarditis, review imaging findings in specific causes of myocarditis including COVID-19 and after vaccination, evaluate the role of imaging in differentiating myocarditis from potential mimics and differential considerations, identify current gaps in knowledge, and propose future directions.