Myocarditis and inflammatory cardiomyopathy: from diagnosis to treatment

Felicitas Escher1, Carsten Tschöepe2, Dirk Lassner3

  • 1Institute for Cardiac Diagnostics and Therapy (IKDT), Berlin, Germany; Department of Cardiology, Campus Virchow Klinikum, Charite - Universitaetsmedizin Berlin, Berlin, Germany. heinz-peter.schultheiss@charite.de.

Insights

Myocarditis, an inflammation of the heart muscle, and inflammatory cardiomyopathy, which includes cardiac dysfunction, have uncertain incidences. Myocarditis can lead to dilated cardiomyopathy and carries a variable prognosis.

Area of Science:

  • Cardiology
  • Pathology

Background:

  • Myocarditis is defined as myocardial inflammation meeting specific diagnostic criteria.
  • Inflammatory cardiomyopathy is diagnosed when myocarditis is associated with cardiac dysfunction.

Purpose of the Study:

  • To determine the actual incidences of myocarditis and inflammatory cardiomyopathy.
  • To review the prevalence and prognosis of myocarditis.

Main Methods:

  • Review of studies on sudden cardiac death in young people.
  • Analysis of biopsy-proven myocarditis in adult patients with unexplained nonischemic dilated cardiomyopathy.

Main Results:

  • Autopsy prevalence of myocarditis in sudden cardiac death cases ranges widely from 2-42%.
  • Biopsy-proven myocarditis is found in 9-16% of adults with unexplained nonischemic dilated cardiomyopathy.
  • Up to 30% of biopsy-proven myocarditis cases may progress to dilated cardiomyopathy with a poor prognosis.

Conclusions:

  • The exact incidence of myocarditis and inflammatory cardiomyopathy remains challenging to ascertain.
  • Prognosis in myocarditis is variable and depends on the underlying cause and potential progression to dilated cardiomyopathy.

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