J-N Trochu, N Piriou, C Toquet, C Bressollette, F Valleix, T Le Tourneau, J-P Gueffet
La Revue de Médecine Interne 2012, 33 (10): 567-74
Myocarditis is an inflammatory disease of the myocardium associated with cardiac dysfunction. Etiologies of myocarditis are numerous - viral causes being the most frequent - as well as their clinical presentations which varies from isolated increase in cardiac enzymes during a viral pericarditis, fulminant myocarditis associated with cardiogenic shock to endomyocardial biopsy proven inflammation discovered during the etiologic diagnosis of a dilated cardiomyopathy. This article will discuss the importance of recognition of specific clinical scenarios of myocarditis and their echocardiographic presentations that are very useful for the etiologic diagnosis and to decide the medical strategy. Recent advances in the field of myocarditis concern improvement in understanding the pathophysiology, in the diagnostic approach with the use of noninvasive imaging (MRI) and molecular biology. However, specific treatment is still limited. Clinical trials with antiviral medications are not conclusive, and the medical strategies remain mainly based on the symptomatic treatment of heart failure.

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