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Myocarditis
Open accessAbstract
Myocarditis is an underdiagnosed cause of acute heart failure, sudden death, and chronic dilated cardiomyopathy. In developed countries, viral infections commonly cause myocarditis; however, in the developing world, rheumatic carditis, Trypanosoma cruzi, and bacterial infections such as diphtheria still contribute to the global burden of the disease. The short-term prognosis of acute myocarditis is usually good, but varies widely by cause. Those patients who initially recover might develop recurrent dilated cardiomyopathy and heart failure, sometimes years later. Because myocarditis presents with non-specific symptoms including chest pain, dyspnoea, and palpitations, it often mimics more common disorders such as coronary artery disease. In some patients, cardiac MRI and endomyocardial biopsy can help identify myocarditis, predict risk of cardiovascular events, and guide treatment. Finding effective therapies has been challenging because the pathogenesis of chronic dilated cardiomyopathy after viral myocarditis is complex and determined by host and viral genetics as well as environmental factors. Findings from recent clinical trials suggest that some patients with chronic inflammatory cardiomyopathy have a progressive clinical course despite standard medical care and might improve with a short course of immunosuppression.
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“Giant cell myocarditis is a rare but rapidly progressing condition associated with a high risk of death or the necessity for heart transplantation.”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [186]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Eosinophilic myocarditis is characterized by a predominant infiltration of eosinophils in the myocardium”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [186]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“leading to advanced heart disorders such as heart failure, fibrosis, and thrombosis.”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [186]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“can show either diffuse STsegment elevations or ST-segment elevation in a coronary distribution.”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [186]
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“various conditions including infections, drugs, hypersensitivity, and autoimmune factors may be associated with the onset and progress of this disease.”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [186]
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“The ECG is abnormal in the majority of patients with myocarditis”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [186]
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Mayr, A., Klug, G., Feistritzer, H., Reinstadler, S. J., Reindl, M., Esterhammer, R., Feuchtner, G. M., Metzler, B., & Schocke, M. F. H. (2017) · International journal of cardiac imaging · doi:10.1007/s10554-017-1170-7 · Cited by 14
Huang, C., Zhang, Y., Qi, H., Xu, X., Yang, L., & Wang, J. (2020) · Bioscience Reports · doi:10.1042/bsr20194472 · Cited by 14
Papageorgiou, A., Heggermont, W., Rienks, M., Carai, P., Langouche, L., Verhesen, W., de Boer, R. A., & Heymans, S. R. B. (2015) · Cardiovascular Research · doi:10.1093/cvr/cvv157 · Cited by 14
Arrhythmia spectrum and outcome in children with myocarditis
Rasal, G., Deshpande, M. S., Mumtaz, Z. A., Phadke, M. S., Mahajan, A. U., Nathani, P., & Lokhandwala, Y. Y. (2021) · Annals of Pediatric Cardiology · doi:10.4103/apc.apc_207_20 · Cited by 14
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Beling, A., & Kespohl, M. (2018) · Frontiers in Immunology · doi:10.3389/fimmu.2018.02620 · Cited by 15
Liu, Q., Shang, Y., Tao, Z., Li, X., Shen, L., Zhang, H., Liu, Z., Rao, Z., Yu, X., Cao, Y., et al. (2024) · Journal of Virology · doi:10.1128/jvi.00805-24 · Cited by 13
Krumm, P., Brendel, J. M., Klingel, K., Müller, K., Kübler, J., Gräni, C., Gawaz, M., Nikolaou, K., & Greulich, S. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11175047 · Cited by 13
Sen, G., Scully, P. R., Gordon, P., & Sado, D. M. (2024) · Rheumatology · doi:10.1093/rheumatology/keae029 · Cited by 15
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Metadata
- Authors
- Sagar, S., Liu, P. P., & Cooper, L. T.
- Affiliations
- Mayo Clinic (US)
- University Health Network (CA)
- Corresponding author
- Cooper, Leslie T
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2012-02
- Volume
- 379
- Issue
- 9817
- Pages
- 738-747
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC5814111
- OpenAlex
- W4240413437
- Cited by
- 743
- References
- 104
- Citations by year
- 2026: 41 · 2025: 83 · 2024: 89 · 2023: 81 · 2022: 79 · 2021: 60 · 2020: 44 · 2019: 58 · 2018: 34 · 2017: 42 · 2016: 38 · 2015: 34 · 2014: 24 · 2013: 25 · 2012: 11
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R56HL056267, R01HL056267)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Pericarditis and Cardiac Tamponade
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- myocarditis, viral myocarditis, dilated cardiomyopathy, acute heart failure, sudden cardiac death, rheumatic carditis, Trypanosoma cruzi, diphtheria, cardiac MRI, endomyocardial biopsy, immunosuppression, prognosis, pathogenesis
- MeSH terms
- Acute Disease, Bacterial Infections, Humans, Myocarditis, Prognosis, Virus Diseases
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