Diagnosing acute myocarditis in the emergency department—advancing cardiac MRI with a focus on low-field MR applications

Acute myocarditis is an inflammatory condition of the myocardium, often triggered by viral infections, autoimmune diseases, or toxins. It can lead to arrhythmias, heart failure, and sudden cardiac death. Early and accurate diagnosis is crucial for timely management and preventing complications. It poses a significant diagnostic challenge in emergency departments (EDs) due to nonspecific symptoms, overlapping features with conditions like acute coronary syndrome, and limitations of conventional diagnostics. Cardiac magnetic resonance imaging (CMR) is the gold standard for noninvasive diagnosis, using the 2018 Modified Lake Louise Criteria (mLLC). However, high-field CMR (1.5–3T) faces barriers in EDs, such as longer scan times, higher cost, lack of accessibility, and contraindications in patients with implantable devices, severe kidney disease, or hemodynamic instability. Low-field MRI (