Myocarditis

Abstract

The symptoms and signs of myocarditis are non-specific. Thus, myocarditis is a differential diagnosis in many patients with heart complaints. As myocarditis may accompany common viral infections of the upper respiratory and gastrointestinal tracts, and mild ECG changes are not uncommon in such patients, the diagnosis needs to be considered in large patient cohorts. Establishing the correct diagnosis is of importance as the disease may lead to sudden cardiac death or dilated cardiomyopathy. As clinical tools such as history taking, physical examination, blood tests, the ECG, and the chest X-ray are not sufficient to ascertain the diagnosis of myocarditis, additional information from cardiac imaging techniques, or endomyocardial biopsy are necessary to confirm or exclude the disease. In daily clinical routine, however, the use of biopsy is limited to severely ill patients with reduced left ventricular function due to its invasiveness and potential complications. Thus, this chapter reviews how non-invasive cardiac imaging techniques can be used in clinical practice to diagnose myocarditis.