[Current problems in the diagnosis and treatment of patients with myocarditis]

Myocarditis as inflammatory cardiomyopathy is considered to be the primary group acquired cardiomyopathy. It is a disease of diverse etiology, which involves inflammation cardiomyocytes, interstitial tissue, vessels and sometimes the pericardium. The prevalence is not accurately known. Myocarditis is caused by many etiological factors: viruses, bacteria, protozoa and parasites. The presence of eosinophilic myocarditis is related to chemical compounds, including many drugs. This disease, although known for a long time still poses many problems in everyday medical practice. Clinical course of the disease and frequent process of transition dilated cardiomyopathy, tends to isolate the three phases of the disease: viral, autoimmune and dilated cardiomyopathy. These phases arise from the close link between viral infection and the accompanying immune response (especially contagious infection). In fact, the secondary immune response leads to activation of cytotoxic cells (CD8), which gives rise to antibodies directed against cardiomyocytes. Diagnosis of this disease is difficult and expensive, uses methods: direct (culture), molecular (PCR, hybridization) and imaging methods (echocardiography, MRI). Treatment of myocarditis depends on the phase and the etiology of the disease. In phase includes nonspecific viral antiviral agents, and avoidance of potentially harmful immunosuppression. The therapy is used among other immunoglobulins, statins, and patients in the phase dilated cardiomyopathy should be treated as idiopathic dilated cardiomyopathy and congestive heart failure. Myocarditis is one of the few units of cardiac disease for which there are no uniform standards of medical practice.