Acute Myocarditis Riskier Than Unexplained Chest Pain

METHODOLOGY

• The accurate differentiation of AM from unexplained chest pain is a significant clinical challenge.
• Researchers conducted a retrospective analysis of data from a Swedish registry to compare the short- and long-term outcomes of AM with those of unexplained chest pain.
• They included patients older than 16 years who were hospitalised between 1998 and 2018 and had a diagnosis of either AM (n = 3792; median age, 37 years; 79.9% men) or unexplained chest pain (n = 109,934; median age, 59 years; 51.4% men).
• The primary outcome was all-cause mortality at 30 days and at a long-term follow-up (median follow-up duration, 7.8 years).
• Further assessments included the risk for myocardial infarction (MI), development of heart failure, significant bleeding, and stroke.

TAKEAWAY

• Patients with AM were younger (P < .001) and had fewer comorbidities than those with unexplained chest pain. Chest pain was the most common presenting symptom in patients with AM (82.9%) and those with unexplained chest pain (93.4%).
• Although rare overall, cardiac shock and resuscitated cardiac arrest occurred more frequently in the AM group than in the unexplained chest pain group.
• Mortality at 30 days (adjusted odds ratio [aOR], 3.75; P < .001) and the risk of developing heart failure during hospitalisation (aOR, 5.4; P < .001) were significantly higher in patients with AM than in those with unexplained chest pain.
• Long-term risks for mortality, heart failure, and MI were higher in patients with AM than in those with unexplained chest pain (P < .001 for all).

IN PRACTICE

The study findings challenge the common perception of AM as a benign condition and emphasise the need for structured follow-up for these patients over both the short term and long term.

 

 

https://www.medscape.com/viewarticle/acute-myocarditis-riskier-than-unexplained-chest-pain-2025a10008pe