Myocardial edema refers to an increased water content of the myocardium particularly within the extracellular interstitium 1.
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Clinical presentation
Myocardial edema often reflects an acute or subacute cardiac event, most often either ischemic or inflammatory and thus can be associated with chest pain or signs of cardiac insufficiency.
Pathology
Myocardial edema develops as a result of a dysbalance between the microvascular fluid filtration and the removal via a network of lymphatic capillaries from the myocardial interstitium 1,2 and is considered a marker of myocardial injury 6.
Etiology
Myocardial edema is present in a large number of cardiac pathologies acute or chronic 1-5:
reperfusion injury
arterial hypertension
cardiopulmonary bypass
-
cardiac transplantation 1,2
preservation/reperfusion
transplant rejection
Radiographic features
MRI
Myocardial edema can be seen in T2-weighted images if focal, if diffuse it can be assessed with myocardial mapping techniques.
Signal characteristics
T2/STIR: hyperintensity
T2-mapping: increased T2 [ms]
T1-mapping: increased T1 [ms]
ECV: increased
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