title: Diagnosis of myocarditis: Current state and future perspectives.
abstract: Myocarditis, i.e. inflammation of the myocardium, is one of the leading causes of sudden cardiac death (SCD) and dilated cardiomyopathy (DCM) in young adults, and is an important cause of symptoms such as chest pain, dyspnea and palpitations. The pathophysiological process of disease progression leading to DCM involves an ongoing inflammation as a result of a viral-induced auto-immune response or a persisting viral infection. It is therefore crucial to detect the disease early in its course and prevent persisting inflammation that may lead to DCM and end-stage heart failure. Because of the highly variable clinical presentation, ranging from mild symptoms to severe heart failure, and the limited available diagnostic tools, the evaluation of patients with suspected myocarditis represents an important clinical dilemma in cardiology. New approaches for the diagnosis of myocarditis are needed in order to improve recognition, to help unravel its pathophysiology, and to develop new therapeutic strategies to treat the disease. In this review, we give a comprehensive overview of the current diagnostic strategies for patients with suspected myocarditis, and demonstrate several new techniques that may help to improve the diagnostic work-up.
authors.affiliation: Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), Amsterdam, The Netherlands. Electronic address: p.biesbroek@vumc.nl.
authors.forename: P Stefan
authors.initials: PS
authors.lastname: Biesbroek
authors.affiliation: Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), Amsterdam, The Netherlands.
authors.forename: Aernout M
authors.initials: AM
authors.lastname: Beek
authors.affiliation: Medical Center Alkmaar, Alkmaar, The Netherlands.
authors.forename: Tjeerd
authors.initials: T
authors.lastname: Germans
authors.affiliation: Department of Pathology and Cardiac Surgery, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), Amsterdam, The Netherlands.
authors.forename: Hans W M
authors.initials: HW
authors.lastname: Niessen
authors.affiliation: Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands; Institute for Cardiovascular Research of the Vrije Universiteit of Amsterdam (ICaR-VU), Amsterdam, The Netherlands.
authors.forename: Albert C
authors.initials: AC
authors.lastname: van Rossum
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D004699:Endocardium / Q000473:pathology*; D005544:Forecasting; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D009205:Myocarditis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology
chemical_list: D015415:Biomarkers
keywords: Biomarkers; Cardiac magnetic resonance; Diagnosis; Endomyocardial biopsy; Myocarditis