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A case of chronic myocarditis
Hiroaki Kawano1, Keita Iyama1, Kuniko Abe2
1Department of Cardiovascular Medicine, Nagasaki University Hospital, Nagasaki, Japan.
Diagnosing chronic myocarditis can be challenging. Endomyocardial biopsy, especially with immunohistochemistry, is crucial for accurate pathological diagnosis and differentiating it from inflammatory cardiomyopathy.
Area of Science:
- Cardiology
- Pathology
Background:
- Chronic myocarditis presents diagnostic challenges with conventional clinical modalities.
- Distinguishing between chronic myocarditis and inflammatory dilated cardiomyopathy can be difficult.
Observation:
- A 43-year-old man presented with heart failure and a hypokinetic left ventricle.
- Standard diagnostics including FDG-PET/CT and coronary angiography were inconclusive.
- Endomyocardial biopsy revealed diffuse inflammatory cell infiltration, myocyte damage, and fibrosis.
Findings:
- Immunohistochemical staining of the biopsy specimen showed a predominance of T lymphocytes and macrophages over B cells.
- The pathological findings were critical in differentiating chronic myocarditis from inflammatory dilated cardiomyopathy.
Implications:
- Endomyocardial biopsy is a highly valuable diagnostic tool for chronic myocarditis.
- Immunohistochemistry is essential for precise pathological diagnosis in challenging cases.
- Accurate diagnosis impacts patient management and treatment strategies for heart conditions.
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