LGE has been reported in all the phases, including early indeterminate [135]. LGE is subendocardial in 27%, transmural in 36%, mid myocardial in 14%, and subepicardial in 23% of patients [143]. Hence, the pattern is not specific, with contributions possibly from myocarditis and microvascular dysfunction. The diagnosis is therefore made in the context of appropriate epidemiological history [143]. EGE and myocardial edema similar to that of acute myocarditis can also be seen in all phases [135]. All these parameters correlated directly with disease severity [143]. MRI Heart Inotropic Stress There is no relevant literature to support the use of MRI heart inotropic stress for the evaluation of inflammatory myocardial disorders. Ischemia has already been excluded. MRI Heart Vasodilator Stress There is no relevant literature to support the use of MRI heart vasodilator stress for the evaluation of inflammatory myocardial disorders. Ischemia has already been excluded. Echocardiography Transesophageal There is no relevant literature to support the use of echocardiography transesophageal for the evaluation of inflammatory myocardial disorders. Echocardiography Transthoracic Resting Echocardiography shows global and regional functional abnormalities in acute myocarditis. Pericardial effusion may also be seen. Echocardiography is a first-line imaging modality in the evaluation of Chagas disease. It may present with hypokinetic dilated LV with diminished LVEF or biventricular dilation. Aneurysms, thrombus, and valvular disease (mitral and tricuspid regurgitation) may be seen [144]. Global longitudinal strain correlates with the amount of myocardial fibrosis in MRI [145]. Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list. The appendix includes the strength of evidence assessment and the final rating round tabulations for each recommendation.
Nonischemic Myocardial Disease with Clinical Manifestations Ischemic Cardiomyopathy Already Excluded . LGE has been reported in all the phases, including early indeterminate [135]. LGE is subendocardial in 27%, transmural in 36%, mid myocardial in 14%, and subepicardial in 23% of patients [143]. Hence, the pattern is not specific, with contributions possibly from myocarditis and microvascular dysfunction. The diagnosis is therefore made in the context of appropriate epidemiological history [143]. EGE and myocardial edema similar to that of acute myocarditis can also be seen in all phases [135]. All these parameters correlated directly with disease severity [143]. MRI Heart Inotropic Stress There is no relevant literature to support the use of MRI heart inotropic stress for the evaluation of inflammatory myocardial disorders. Ischemia has already been excluded. MRI Heart Vasodilator Stress There is no relevant literature to support the use of MRI heart vasodilator stress for the evaluation of inflammatory myocardial disorders. Ischemia has already been excluded. Echocardiography Transesophageal There is no relevant literature to support the use of echocardiography transesophageal for the evaluation of inflammatory myocardial disorders. Echocardiography Transthoracic Resting Echocardiography shows global and regional functional abnormalities in acute myocarditis. Pericardial effusion may also be seen. Echocardiography is a first-line imaging modality in the evaluation of Chagas disease. It may present with hypokinetic dilated LV with diminished LVEF or biventricular dilation. Aneurysms, thrombus, and valvular disease (mitral and tricuspid regurgitation) may be seen [144]. Global longitudinal strain correlates with the amount of myocardial fibrosis in MRI [145]. Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list. The appendix includes the strength of evidence assessment and the final rating round tabulations for each recommendation.