The Lake Louise criteria can be helpful for making the diagnosis of myocarditis based on changes seen on cardiac magnetic resonance (CMR).

Patient selection: clinically suspected myocarditis


Criteria - the presence of >= 2 of the following indicate myocardial inflammation:

(1) increase in regional or global myocardial signal intensity in T2-weighted images

(2) increase in global myocardial early gadolinium enhancement ratio (between myocardium and skeletal muscle) in gadolinium-enhanced T1-weighted images

(3) >= 1 focal lesion in a nonischemic regional distribution with late gadolinium enhancement (in inversion recovery-prepared gadolinium-enhanced T1-weighted images)


Additional support evidence of myocarditis:

(1) left ventricular dysfunction

(2) pericardial effusion


If the third criterion is present, then there is evidence of myocyte injury and/or scar caused by myocardial inflammation.


(If one of the criteria is present) OR (if no criteria are present AND onset of symptoms is very recent) then repeat the CMR in 1-2 weeks.

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