title: [Endomyocardial biopsy should be performed in selected patients with suspected myocarditis].
abstract: Endomyocardial biopsy (EMB) is the gold standard for the diagnosis of myocarditis. Patients with clinical presentation consistent with myocarditis and acute heart failure should undergo EMB, in particular to exclude giant-cell myocarditis or necrotizing eosinophilic myocarditis that are life-threatening conditions. The indication for EMB is debatable in case of suspected myocarditis with infarct-like presentation and preserved left ventricular ejection fraction. In fact, in this group of patients the prognosis is fairly good, and the clinical advantage to reach a histological diagnosis by means of an invasive procedure with potential complications such as EMB is limited. In this article we discuss the indication for EMB in the light of current guidelines based on existing consensus documents.
authors.affiliation: Cardiologia 2 - Insufficienza Cardiaca e Trapianto.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ammirati
authors.affiliation: Cardiologia 2 - Insufficienza Cardiaca e Trapianto.
authors.forename: Manlio
authors.initials: M
authors.lastname: Cipriani
authors.affiliation: Servizio di Anatomia Patologica.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Bonacina
authors.affiliation: Cardiologia 2 - Insufficienza Cardiaca e Trapianto.
authors.forename: Andrea
authors.initials: A
authors.lastname: Garascia
authors.affiliation: Unità di Cure Intensive Cardiologiche, Dipartimento Cardiotoracovascolare "A. De Gasperis", A.O. Ospedale Niguarda Ca' Granda, Milano.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Oliva
mesh_terms: D001706:Biopsy / Q000379:methods*; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D009205:Myocarditis / Q000175:diagnosis* / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D018579:Patient Selection; D011379:Prognosis; D016277:Ventricular Function, Left