Cardiovascular magnetic resonance in myocardial infarction with non-obstructive coronary arteries patients: A review

Table 1 Cardiovascular magnetic resonance diagnostic criteria for acute myocarditis

	Original Lake Louise Criteria	2018 Lake Louise Criteria update
Main criteria	2 out of 3	2 out of 2
	T2-weighted imaging: Regional high T2 signal intensity or global T2 signal intensity ratio ≥ 2.0 in T2 weighted images	T2-based imaging: Regional high T2 signal intensity or global T2 signal intensity ratio ≥ 2.0 in T2 weighted images or regional or global increase of myocardial T2 relaxation time
	Early gadolinium enhancement signal intensity ratio myocardium/skeletal muscle of ≥ 4.0	T1-based imaging: regional or global increase of native myocardial T1 relaxation time or extracellular volume or areas with high signal intensity in a nonischemic distribution pattern in gadolinium enhancement images
	Late gadolinium enhancement: areas with high signal intensity in a nonischemic distribution pattern
Supportive criteria (not necessary nor sufficient for diagnosis)	Pericardial effusion	Pericardial effusion or High signal intensity of the pericardium in late gadolinium enhancement, T1- or T2-mapping
	Left ventricular wall motion abnormality	Systolic left ventricular wall motion abnormality

Adapted from Ferreira et al[29].

Table 2 International Takotsubo Diagnostic Criteria (InterTAK Diagnostic Criteria)[8]

No.	International Takotsubo Diagnostic Criteria
1	Transient left ventricular dysfunction (hypokinesia, akinesia, dyskinesia), manifests as apical ballooning or mid-ventricular, basal or focal wall motion abnormality, which usually extend beyond a single epicardial vascular distribution. Right ventricular involvement can be present
2	A mental, physical or mixed cause can precede the event of Takotsubo syndrome but this is not necessary
3	Takotsubo syndrome can be caused by neurological conditions (e.g. subarachnoid hemorrhage, stroke/transient ischemic attack, or seizures) as well as pheochromocytoma
4	Electrocardiogram changes (elevation or depression of the ST-segment, inversion of the T-wave and prolongation of the QTc); however, there are unusual cases without electrocardiogram changes
5	Elevation of cardiac biomarkers (troponin and creatine kinase)
6	Significant coronary artery disease could also be present in Takotsubo syndrome
7	Exclusion of acute myocarditis, in this case cardiovascular magnetic resonance is recommended
8	The pathology is common in postmenopausal women are predominantly affected