51. Infectious Diseases of the Heart: Pathophysiology, Clinical and Imaging Overview
- Author
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Horacio Murillo, Robert L. Reddick, Daniel Vargas, Juan Marmol-Velez, Ameya Baxi, Daniel Ocazionez, Santiago Martinez-Jimenez, and Carlos S. Restrepo
- Subjects
Diagnostic Imaging ,Pathology ,medicine.medical_specialty ,Heart Diseases ,Population ,030204 cardiovascular system & hematology ,Infections ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,03 medical and health sciences ,High morbidity ,0302 clinical medicine ,Edema ,Medical imaging ,medicine ,Pericardium ,Humans ,Radiology, Nuclear Medicine and imaging ,education ,Endocardium ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Pathophysiology ,medicine.anatomical_structure ,cardiovascular system ,medicine.symptom ,business - Abstract
Myriad infectious organisms can infect the endocardium, myocardium, and pericardium, including bacteria, fungi, parasites, and viruses. Significant cardiac infections are rare in the general population but are associated with high morbidity and mortality as well as increased risk in certain populations, such as the elderly, those undergoing cardiac instrumentation, and intravenous drug abusers. Diagnostic imaging of cardiac infections plays an important role despite its variable sensitivity and specificity, which are due in part to the nonspecific manifestations of the central inflammatory process of infection and the time of onset with respect to the time of imaging. The primary imaging modality remains echocardiography. However, cardiac computed tomography and magnetic resonance (MR) imaging have emerged as the modalities of choice wherever available, especially for diagnosis of complex infectious complications including abscesses, infected prosthetic material, central lines and instruments, and the cryptic manifestations of viral and parasitic diseases. MR imaging can provide functional, morphologic, and prognostic value in a single examination by allowing characterization of inflammatory changes from the acute to chronic stages, including edema and the patterns and extent of delayed gadolinium enhancement. We review the heterogeneous and diverse group of cardiac infections based on their site of primary cardiac involvement with emphasis on their cross-sectional imaging manifestations. Online supplemental material is available for this article. (©)RSNA, 2016.
- Published
- 2016