Acute myocarditis is an inflammatory disorder of the myocardium associated with cardiac dysfunction. The definition of myocarditis varies, but the Dallas criteria for myocarditis requires an inflam...

A delayed diagnosis of acute myocarditis: diagnostic value of cardiovascular magnetic resonance imaging.

This study analyzes morphologic and functional alterations detected by M-mode and 2-dimensional echocardiography in 41 patients with histologically proven myocarditis and different clinical presentations: congestive heart failure (63%), atrioventricular block (17%), chest pain (15%) and supraventricular arrhythmias (5%). Left ventricular dysfunction was common (69%), particularly in patients with congestive heart failure (88%), often without or with minor cavity dilatation. Patients with atrioventricular block or chest pain had usually preserved ventricular function. Right ventricular dysfunction was present in 23%. Additional findings included asynergic ventricular areas (64%), left ventricular "hypertrophy" sometimes reversible (20%), hyperrefractile myocardial areas (23%), ventricular thrombi (15%) and "restrictive" ventricular filling (7%). It is concluded that echocardiographic features of myocarditis are polymorphous and nonspecific. The echocardiographic pattern can simulate alternatively dilated, hypertrophic, restrictive or "right" ventricular cardiomyopathy, as well as coronary artery disease. In an appropriate clinical context, echocardiography can be helpful in the diagnosis of myocarditis and in the selection of patients for endomyocardial biopsy.

Echocardiographic findings in myocarditis.

Myocarditis is an uncommon cause of cardiac disease that can result in arrhythmia, congestive heart failure, and death. Myocardial injury in myocarditis is due in part to activated cellular and humoral immune components directed toward normal cardiac tissue. Although numerous therapies for myocarditis, including corticosteroids and immunosuppressive agents, have been applied in animal experiments and in human studies, none have demonstrated survival benefit over untreated controls. In many patients, myocarditis may spontaneously resolve. Information about myocarditis pathogenesis, manifestations, and treatment has been useful in disease management. Further research into the inflammatory nature of myocarditis may provide the basis for more favorable outcomes of intervention in this disease.

A delayed diagnosis of acute myocarditis: diagnostic value of cardiovascular magnetic resonance imaging.

References

Echocardiographic findings in myocarditis.

INFLAMMATORY HEART DISEASE: Pathogenesis, Clinical Manifestations, and Treatment of Myocarditis

Related Papers (5)

Role of cardiovascular magnetic resonance imaging (CMR) in the diagnosis of acute and chronic myocarditis

Cardiovascular imaging in clinical and experimental acute infectious myocarditis.

The Quest for New Approaches in Myocarditis and Inflammatory Cardiomyopathy

Fulminant myocarditis: The role of cardiac magnetic resonance imaging

Myocarditis and inflammatory cardiomyopathy: from diagnosis to treatment.