N Engl J Med. 2009 Apr 9;360(15):1526-38. doi: 10.1056/NEJMra0800028.


Myocarditis may present with a wide range of symptoms, ranging from mild dyspnea or chest pain that resolves without specific therapy to cardiogenic shock and death. Dilated cardiomyopathy with chronic heart failure is the major long-term sequela of myocarditis. Most often, myocarditis results from common viral infections; less commonly, specific forms of myocarditis may result from other pathogens, toxic or hypersensitivity drug reactions, giant-cell myocarditis, or sarcoidosis. The prognosis and treatment of myocarditis vary according to the cause, and clinical and hemodynamic data usually provide guidance to decide when to refer a patient to a specialist for endomyocardial biopsy. The aim of this review is to provide a practical and current approach to the evaluation and treatment of suspected myocarditis.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Arrhythmias, Cardiac / drug therapy
  • Arrhythmias, Cardiac / etiology
  • Cardiomyopathy, Dilated / complications
  • Diagnosis, Differential
  • Echocardiography
  • Electrocardiography
  • Humans
  • Magnetic Resonance Imaging
  • Myocarditis* / complications
  • Myocarditis* / diagnosis
  • Myocarditis* / therapy
  • Myocarditis* / virology
  • Myocardium / pathology*
  • Prognosis