Cardiovascular

Myocarditis

Myocarditis is inflammation of the heart muscle that can present as an acute coronary syndrome mimic, new heart failure, ventricular arrhythmia or conduction disease; the immediate priorities are to assess instability, exclude time-critical alternatives, confirm myocardial inflammation and arrange cardiology follow-up.

Definition

Myocarditis is an inflammatory disorder of the myocardium supported by a compatible clinical presentation and evidence of myocardial injury or dysfunction, with cardiac MRI providing the principal non-invasive tissue assessment and endomyocardial biopsy reserved for selected severe or diagnostically consequential cases.

First principles

Myocarditis is a myocardial inflammatory syndrome

Myocarditis is inflammation of the myocardium and may overlap with pericarditis as myopericarditis. The trigger may be infectious, immune-mediated, toxic or drug-related, and the cause often remains unconfirmed. The current ESC framework uses a presentation- and risk-based approach rather than assuming that every case is viral.

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