The management of myocarditis

Eur Heart J. 2011 Nov;32(21):2616-25. doi: 10.1093/eurheartj/ehr165. Epub 2011 Jun 23.


Despite considerable advances in our understanding of myocarditis pathogenesis, the clinical management of myocarditis has changed relatively little in the last few years. This review aims to help bridge the widening gap between recent mechanistic insights, which are largely derived from animal models, and their potential impact on disease burden. We illustrate the pathogenetic mechanisms that are prime targets for novel therapeutic interventions. Pathway and pathogen-specific molecular diagnostic tests have expanded the role for endomyocardial biopsy. State of the art cardiac magnetic resonance imaging can now provide non-invasive tissue characterization and localize inflammatory infiltrates but imaging techniques are misleading if infectious agents are involved. We emphasize the gaps in our current clinical knowledge, particularly with respect to aetiology-based therapy, and suggest opportunities for high impact, translational investigations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Echocardiography
  • Electrocardiography
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / virology
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Interferon-beta / therapeutic use
  • Magnetic Resonance Angiography
  • Male
  • Myocarditis / diagnosis
  • Myocarditis / drug therapy*
  • Myocarditis / virology
  • Virus Diseases / diagnosis
  • Virus Diseases / therapy*


  • Anti-Inflammatory Agents
  • Antiviral Agents
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Immunosuppressive Agents
  • Interferon-beta