Right ventricular endomyocardial biopsy: clinicopathologic correlates in 64 consecutive patients

Endomyocardial biopsy is a safe, reliable, and reproducible technique to confirm or establish the diagnosis of the pathology that affects cardiac function in conditions previously classified as cardiomyopathies of unknown cause. The first 64 consecutive patients to undergo endomyocardial biopsy were reviewed to determine its utility in various clinical settings. Furthermore a review of literature relating to endomyocardial biopsy is presented. On the basis of these findings, we conclude that endomyocardial biopsy is indicated in the clinical setting of dilated cardiomyopathy, for evaluating underlying myocarditis. In patients with dysrhythmias or clinical myocarditis, endomyocardial biopsy may disclose myocarditis or changes consistent with congestive cardiomyopathy. In patients with systemic disease endomyocardial biopsy is instructive to prove or to exclude myocardial involvement. In patients with angina-like chest pain but with normal coronary angiograms or exercise tests, endomyocardial biopsy may prove underlying heart disease.