Diagnostic use of the endomyocardial biopsy: a consensus statement
Gaetano Thiene1, Patrick Bruneval, John Veinot
1Department of Cardiological, Thoracic and Vascular Sciences, University of Padua, Via A. Gabelli, 61, 35121 Padua, Italy. gaetano.thiene@unipd.it
Virchows Archiv : an International Journal of Pathology
|June 11, 2013
Summary
Endomyocardial biopsy is crucial for diagnosing heart conditions like myocarditis and rejection. Molecular techniques and expert collaboration enhance diagnostic accuracy for better patient treatment.
Area of Science:
- Cardiovascular Pathology
- Clinical Cardiology
- Diagnostic Pathology
Background:
- Endomyocardial biopsy (EMB) is essential for diagnosing specific cardiac conditions.
- A consensus document was developed to guide the use of EMB in clinical practice.
Purpose of the Study:
- To define the role of EMB in diagnosing and treating heart failure, arrhythmias, and cardiac masses.
- To provide guidance on the optimal application of EMB in clinical settings.
Main Methods:
- A task force from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology convened.
- A consensus document was drafted outlining indications and methodologies for EMB.
Main Results:
- EMB is the gold standard for diagnosing myocarditis, cardiac allograft rejection, and infiltrative/storage myocardial disorders.
- Molecular techniques are mandatory for etiological and pathogenetic insights, complementing histology and immunohistochemistry.
- EMB should be performed in specialized cardiac pathology referral centers.
Conclusions:
- Optimal utilization of EMB necessitates clinicopathologic correlation.
- Collaboration with referral centers ensures access to comprehensive pathological investigations, including molecular techniques.
Related Concept Videos
01:27Myocarditis II: Clinical Features and Diagnostic Tests
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
01:25Cardiomyopathy I: Introduction and Classification
Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
01:18Endocarditis III: Medical Management
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
01:25Endocarditis I: Introduction
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...