ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ MRI TIM Ở BỆNH NHÂN VIÊM CƠ TIM CẤP NHẬP VIỆN

Abstract

Objective: To describe the clinical, paraclinical, and cardiac MRI characteristics of patients with acute myocarditis admitted to Cho Ray Hospital in 2021-2022, and to analyze the relationship between clinical–laboratory parameters and the extent of myocardial injury. Methods: A retrospective descriptive study was conducted on 218 patients aged ≥16 years diagnosed with acute myocarditis confirmed by cardiac MRI according to the 2018 Lake Louise criteria. Clinical features, laboratory results, ECG, echocardiography, and MRI findings were collected from hospital records between January 1, 2021 and December 31, 2022. Results: The mean age was 41.2 ± 16.9 years, and males accounted for 63.3%. The most common symptoms were fever (72%), chest pain (62%), and dyspnea (59%). Elevated Troponin I (95%) and CK-MB (91%) indicated significant myocardial injury. The mean ejection fraction (EF) was 44.1 ± 12.9%, with 28.4% of patients showing EF < 35%. Cardiac MRI revealed myocardial edema in 82.1%, positive LGE in 77.1%, and diffuse involvement (≥3 segments) in 48.2% of patients. Elevated cardiac enzymes, myocardial injury detected on cardiac magnetic resonance imaging, and reduced left ventricular ejection fraction are highly diagnostic indicators of myocarditis. Conclusion: Acute myocarditis at Cho Ray Hospital predominantly affected young adults, with nonspecific clinical manifestations. Cardiac MRI played a crucial role in diagnosis and risk stratification, allowing early detection of diffuse myocardial involvement and guiding timely management.