Discussion
There is no ‘gold standard’ non-invasive test to diagnose myocarditis. It is a clinico-histopathological diagnosis.1 Clinical manifestations include: heart failure, chest pain (from either pericarditis or angina from coronary artery spasm/inf lammation), sudden cardiac death and arrhythmias (sinus tachycardia, ectopics, ventricular tachycardia, heart blocks). Examination may reveal raised JVP, pulmonary crackles, a gallop rhythm or a pericardial rub.
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References
- Lieberman EB, Hutchins GM, Herskowitz A, et al. Clinicopathologic description of myocarditis. J Am Coll Cardiol 1991; 18: 1617–26.
- Smith SC, Ladenson JH, Mason JW, et al. Elevations of cardiac troponin I associated with myocarditis. Circulation 1997; 95: 162–8.
- Cooper LT. Myocarditis. NEJM 2009; 360: 1526–38.
- Keeling PJ, Lukaszyk A, Poloniecki J, et al. A prospective case-control study of antibodies to coxsackie B virus in idiopathic dilated cardiomyopathy. J Am Coll Cardiol 1994; 23: 593–8.
- Abdel-Aty H, Boye P, Zagrosek A, et al. Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: comparison of different approaches. J Am Coll Cardiol 2005; 45: 1815–22.
- Cooper LT, Baughman KL, Feldman AM, et al. The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology. Circulation 2007: 116: 2216–33.
- Kim JS, Judson MA, Donnino R, et al. Cardiac sarcoidosis. Am Heart J 2009; 157: 9–21.
- Frustaci A, Cuoco L, Chimenti C, et al. Celiac disease associated with autoimmune myocarditis. Circulation. 2002; 105: 2611–18.
- Cooper LT Jr, Berry GJ, Shabetai R. Idiopathic giant-cell myocarditisnatural history and treatment. Multicentre Giant Cell Myocarditis Study Group Investigators. NEJM 1997; 336: 1860–66.
- Kuhl U, Pauschinger M, Schwimmerbeck PL, et al. Interferon-beta treatment eliminates cardiotrophic viruses and improves left ventricular function in patients with myocardial persistence of viral genomes and left ventricular dysfunction. Circulation 2003: 107: 2793–8.
- Goldberg LR, Sulk J, Patton KK, et al. Predictors of adverse outcome in biopsy proven myocarditis (abstract) . J Am Coll Cardiol 1999; 33: A850.
- Cappola TP, Felker GM, Kao WH, et al. Pulmonary hypertension and risk of death in cardiomyopathy: patients with myocarditis are at higher risk. Circulation 2002; 105:1663–68.
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