[Controversial issues and working practice in myocarditis: from scientific data to clinical grounds]
Marco Anzini1, Michele Moretti, Marco Merlo
1Dipartimento Cardiovascolare, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Trieste, Italy.
Giornale Italiano Di Cardiologia (2006)
|July 24, 2013
Summary
Myocarditis, often viral, can cause heart damage and arrhythmias. Early, multiparametric diagnosis and personalized treatment are crucial for managing this heart condition.
Area of Science:
- Cardiology
- Infectious Diseases
- Immunology
Context:
- Myocarditis, inflammation of the heart muscle, has diverse causes including infections, systemic diseases, drugs, and toxins.
- Cardiotropic viruses are common triggers, often leading to silent progression, but can cause persistent myocyte damage, dilated cardiomyopathy, or arrhythmias.
- While 40-50% of patients experience spontaneous improvement in left ventricular function, others face progressive dysfunction.
Purpose:
- To review the multiparametric diagnostic work-up and prognostic assessment of myocarditis.
- To analyze controversial aspects of myocarditis diagnosis and therapy, including the roles of cardiac magnetic resonance imaging and endomyocardial biopsy.
- To provide evidence-based instructions for personalized myocarditis management, potentially including specific immunoactive treatments.
Summary:
- A comprehensive diagnostic approach for myocarditis involves biomarkers (troponin I, brain natriuretic peptide), advanced echocardiography, cardiac magnetic resonance, and endomyocardial biopsy with histopathologic, immunohistochemical, and virological analyses.
- Personalized management strategies are essential, considering the potential need for specific immunoactive treatments.
- Unresolved issues in myocarditis diagnosis and therapy necessitate further investigation and clinical consensus.
Impact:
- Facilitates evidence-based, personalized management of myocarditis.
- Aims to resolve diagnostic and therapeutic controversies in myocarditis.
- Improves clinical practice by providing clear instructions for myocarditis assessment and treatment.
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