Myocarditis echocardiography

Echocardiography in patients with myocarditis allows for serial assessment of left ventricular dysfunction and can be used to distinguish fulminant (non-dilated hypocontractile left ventricle with thick interventricular septum) from acute myocarditis (dilated hypocontractile left ventricle with normal interventricular septum).

Cardiac function may be monitored via serial echocardiograms. In general, left ventricular function improves in fulminant myocarditis over a course of approximately 6 months. Echocardiographic findings in myocarditis include:^[1][2][3][4]

• Wall motion abnormalities
• Systolic dysfunction
• Diastolic dysfunction
• Changes in image texture on echocardiogram, i.e. increase in brightness, heterogeneity, and contrast
• Pericardial effusion may be noted in few patients
• Functional regurgitation through the AV valves may be noted due to ventricular dilation

Fulminant myocarditis appears as a non-dilated, thickened and hypocontractile left ventricle with increased septal thickness while, acute myocarditis is associated with marked left ventricular dilation, normal septal thickness, and decreased ventricular function.^[1]

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