Chest Pain, Ischemia, Myocarditis
Conditions
Brief summary
A retrospective, observational study consisting of patients who presents with typical/atypical chest pain and have an ensuing negative ischemic evaluation
Detailed description
Multicenter, retrospective, observational study consisting of patients who presents with typical/atypical chest pain to the emergency department and have an ensuing negative ischemic evaluation. Planned to review the subsequent diagnostic process in these patients, including patients with CMRI (Cardiac Magnetic Resonance Imaging), PET (Positron Emission Tomography) imaging for evaluation of myocarditis with the goal of quantifying the number of patients who go on to have a proven diagnosis of myocarditis that can explain their presenting symptoms.
Interventions
DIAGNOSTIC_TESTImaging
To better understand the prevalance of further imaging for evaluation of myocarditis, all patients with negative workup will be included and see what number of patients undergo further CMRI, FGD-PET, or speckle tracking echocardiography. Patients will then be categorized as those with myocarditis with positive diagnosis, negative diagnosis or unknown.
Sponsors
Kansas City Heart Rhythm Institute
Texas Cardiac Arrhythmia Research Foundation
Montefiore Medical Center
Loma Linda University International Heart Institute
Kansas City Heart Rhythm Research Foundation
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age \>18 years 2. Patients with a presentation of typical or atypical chest pain (ICD-10 Code R07.89, R07. 9) 3. Patients with a negative ischemic workup: (including Coronary Artery Calcium Scoring/CTA, MPI, Nuclear Stress test, LHC/angiography showing anything greater than non-obstructive CAD)
Exclusion criteria
1. Patients with any evidence of positive ischemic workup as the cause of typical/atypical chest pain (as seen on Coronary Artery Calcium Scoring/CTA, MPI, Nuclear Stress test, LHC/angiography) 2. Previously documented history of Prinzmetal angina or coronary vasospasm 3. History of prior myocardial infarction 4. History of any prior CAD with severity greater than non-obstructive CAD in all 3 coronary arteries 5. History of LVEF\<40% 6. Previously documented history of pericarditis 7. Previously documented history of costochondritis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with unrecognized and underlying myocarditis | 1/2014 - 1/2022 | To quantify the number of patients with unrecognized and underlying myocarditis as a presentation of typical and atypical chest pain followed by a negative ischemic workup. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Morbidity/mortality | 1/2014 - 1/2022 | Assessment morbidity/mortality in this population |
| Diagnostic timing for imaging modalities | 1/2014 - 1/2022 | Identification of most appropriate diagnostic timing for imaging modalities such as CMRI, FDG PET, speckle tracking echocardiography to diagnose myocarditis after initial negative ischemic workup |
| Association of baseline characteristics or comorbidities with myocarditis | 1/2014 - 1/2022 | Identification of underlying baseline characteristics or comorbidities that have a greater association with myocarditis presenting as typical/atypical chest pain |
| Imaging parameters that provide best diagnostic accuracy | 1/2014 - 1/2022 | Identification of specific imaging parameters on CMRI or PET imaging (late gadolinium enhancement, global dissynchrony measurements, global longitudinal strain, FDG uptake, etc) provide best diagnostic accuracy |
| Imaging parameters that provide best outcome prediction for morbidity/mortality | 1/2014 - 1/2022 | Identification of specific imaging parameters on CMRI or PET imaging (late gadolinium enhancement, global dissynchrony measurements, global longitudinal strain, FDG uptake, etc) provide best outcome prediction for morbidity/mortality. |
| Comparison of specific imaging modalities | 1/2014 - 1/2022 | Comparison of specific imaging modalities (CMRI vs FDG-PET vs speckle tracking echocardiography) and their diagnostic accuracy for myocarditis |
Countries
United States
Contacts
Primary ContactDonita Atkins
Outcome results
None listed