Cardiac Magnetic Resonance and Positron Emission Tomography in the Diagnosis and Follow-Up of Acute Rheumatic Fever - Case Report

Abstract

lactic dehydrogenase 297 U/ml, C-reactive protein 2.5 mg/L). A gallium-67 scintigraphy revealed increased concentration of the radiopharmaceutical in the cardiac area, with a diffuse pattern of uptake (Figure 1). Oral prednisone (1mg per kilogram per day) was started with good clinical response. MRI was conducted 72 hours after initiation of steroids, which showed LVEF of 44%, non-ischemic focal myocardial fibrosis with native T1 and extracellular volume, leading to the hypothesis of inflammatory cardiomyopathy (Figure 2). Seven days after prednisone, another TTE showed a significant improvement in LVEF, to 50%. Then, a fluorodeoxyglucose-(18F-FDG) PET-CT was performed, which confirmed myocardial uptake (Figure 3). Finally, the patient was discharged to finish corticosteroid therapy and referred for elective mitral and aortic valve replacement. is prevalent