Which imaging or test suggests myocarditis?

Which imaging or test suggests myocarditis?

• A. Cardiac MRI showing myocardial edema.
• B. Coronary angiography showing a blocked artery.
• C. Lipid panel showing high cholesterol.
• D. Chest x-ray with clear lungs.

Answer: (B)

Cardiac MRI findings of myocardial edema best suggest myocarditis. Inflammation increases water content in the heart muscle, which MRI detects as edema on T2-weighted images. Cardiac MRI also often shows late gadolinium enhancement in a non-ischemic pattern (typically subepicardial or mid-wall), not confined to a single coronary artery territory. This combination helps distinguish myocarditis from ischemic injury due to a blocked artery, where enhancement follows a vascular distribution. The other tests don’t fit as well: a blocked coronary artery on angiography points to infarction from CAD rather than myocarditis; a lipid panel assesses cholesterol risk but doesn’t visualize inflammation of the myocardium; a chest X-ray with clear lungs is non-specific and not diagnostic for myocarditis.

Cardiac MRI findings of myocardial edema best suggest myocarditis. Inflammation increases water content in the heart muscle, which MRI detects as edema on T2-weighted images. Cardiac MRI also often shows late gadolinium enhancement in a non-ischemic pattern (typically subepicardial or mid-wall), not confined to a single coronary artery territory. This combination helps distinguish myocarditis from ischemic injury due to a blocked artery, where enhancement follows a vascular distribution.

The other tests don’t fit as well: a blocked coronary artery on angiography points to infarction from CAD rather than myocarditis; a lipid panel assesses cholesterol risk but doesn’t visualize inflammation of the myocardium; a chest X-ray with clear lungs is non-specific and not diagnostic for myocarditis.