Skip to main content
SpringerLink
Log in
Book cover

Cardiac Pathology pp 133–146Cite as

Myocarditis/Inflammatory Cardiomyopathy

  • Chapter
  • First Online:

Abstract

Myocarditis/inflammatory cardiomyopathy is defined as inflammatory involvement of heart muscle with leukocytic cell infiltration and nonischemic degeneration/necrosis of myocytes.

The actual incidence of myocarditis is unknown, although the disease process is often related to infections. The commonest driver is primary viral infection, although occasionally reactivation of viral infections may be relevant. Furthermore, bacterial, fungal and protozoal infections may be implicated. Other drivers for myocarditis include autoimmune processes, drugs and toxins. Many cases, however, are ultimately designated idiopathic. The patterns for these myocarditis processes are described and the various pathophysiology is discussed.

In reality, many cases of clinical myocarditis cannot be morphologically verified by endomyocardial biopsy. Clinicians, immunologists, pathologists and those using molecular tests must combine their analyses to explore and redefine myocarditis. At present, whilst considerable progress in the understanding of this disease has been made in the last 50 years, it remains a serious challenge!

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Aretz HAT, Billingham ME, Edwards WD, et al. Myocarditis: a histopathologic definition and classification. Am J Cardiovasc Pathol. 1987;1:3–14.

    PubMed  CAS  Google Scholar 

  2. Richardson P, Mckenna W, Bristow M, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation. 1996;93(5):841–2.

    Article  PubMed  CAS  Google Scholar 

  3. Maisch B, Bültman B, Factor S, et al. World Heart Federation consensus conferences’ definition of inflammatory cardiomyopathy (myocarditis): report from two expert committees on histology and viral cardiomyopathy. Heartbeat. 1999;4:3–4.

    Google Scholar 

  4. Gravanis MG, Sternby NH. Incidence of myocarditis. Arch Pathol Lab Med. 1991;15:390–2.

    Google Scholar 

  5. Woodruff JF. Viral myocarditis: a review. J Infect. 1998;37:424–79.

    Google Scholar 

  6. Eckart RE, Scoville SL, Campell Cl, et al. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med. 2004;141:829–34.

    PubMed  Google Scholar 

  7. Karjalainen J, Heikkilä J. Incidence of three presentations of the acute myocarditis in young men in military service: a 20-year experience. Eur Heart J. 1999;20:1020–5.

    Article  Google Scholar 

  8. Bloomfield P, Bradbury A, Grubb NR, Newby DE. Cardiovascular disease. In: Davidson’s principles and practice of medicine. 20th ed. Edinburgh: Churchill Livingstone; 2005. p. 519–646.

    Google Scholar 

  9. Winters GL, McManus BM. Myocarditis. In: Silver MD, Gotlieb AI, Schoen FJ, editors. Cardiovascular pathology. 3rd ed. New York: Churchill Livingstone; 2001. p. 256–84.

    Google Scholar 

  10. Bowles NE, Bowles KR, Towbin JA. Viral genomic detection and outcome in myocarditis. Heart Fail Clin. 2005;3:407–17.

    Article  Google Scholar 

  11. Lotze U, Egerer R, Glück B, Zell R, Sigusch H, Erhardt C, Heim A, Kandolf R, Bock T, Wutzler P, Figulla HR. Low level myocardial parvovirus B19 persistence is a frequent finding in patients with heart disease but unrelated to ongoing myocardial injury. J Med Virol. 2010;82(8):1449–57.

    Article  PubMed  CAS  Google Scholar 

  12. Rassi Jr A, Rassi A, Marin-Neto JA. Chagas disease. Lancet. 2010;37(9723):1388–402.

    Article  Google Scholar 

  13. Carod-Artal FJ. Trypanosomiasis, cardiomyopathy and the risk of ischemic stroke. Expert Rev Cardiovasc Ther. 2010;815(5):717–28.

    Article  Google Scholar 

  14. Manoji Muditha Pathirage LP, Kularante SAM, Wijesinghe S, Ratnatunga NVI, Gaarammana IB. Fulminant colitis and toxic myocarditis: a unifying cause? Lancet. 2009;374:2026.

    Article  Google Scholar 

  15. Tejada JG, Saavedra J, Molina L, Forteza A, Gomez C. Hydatid disease of the interventricular septum causing pericardial effusion. Ann Thorac Surg. 2000;71:2034–5.

    Article  Google Scholar 

  16. Hess OM, McKenna W, Schultheiss H-P. Myocardial disease. In: Camm AJ, Lüscher TF, Serruys PW, editors. Cardiovascular medicine. 2nd ed. Oxford: Oxford University Press; 2009. p. 665–716.

    Google Scholar 

  17. Boon NA, Colledge NR, Walker BB, Hunter JAA. Diseases of the heart valves. In: Davidson’s principles and practice of medicine. 20th ed. London: Churchill Livingstone; 2006. p. 616–8; Stewart S, Winters GL, Fishbein MC, et al. Revision of 1990 working formulation for the standardization of nomenclature in the diagnosis of heart rejection. J Heart Lung Transplant. 2005;24:1710–20.

    Google Scholar 

  18. Sheppard MNS. Myocarditis, in practical cardiovascular pathology. 2nd ed. London: Hodder Arnold; 2011. p. 193–219.

    Google Scholar 

  19. Cooper LT, Berry GJ, Shabetai R. Idiopathic giant cell myocarditis – natural history and treatment. N Engl J Med. 1997;336:1860–6.

    Article  PubMed  Google Scholar 

  20. Silverman KJ, Hutchins GM, Bulkley BM. Cardiac sarcoid. A clinicopathological evaluation of 84 unselected cases with systemic sarcoidosis. Circulation. 1978;58:1204–11.

    Article  PubMed  CAS  Google Scholar 

  21. Das BB, Recto M, Johnsrude C, Klein L, Orman K, Shoemaker L, Mitchell M, Austin EH. Cardiac transplantation for pediatric giant cell myocarditis. J Heart Lung Transplant. 2006;25:474–8.

    Article  PubMed  Google Scholar 

  22. Konno S, Sakakibara S. Endomyocardial biopsy. Dis Chest. 1963;44:345–50.

    Article  PubMed  CAS  Google Scholar 

  23. Baandrup U, Florio RA, Olsen EGJ. Do endomyocardial biopsies represent the morphology of the rest of the myocardium? Eur Heart J. 1982;1:171–8.

    Google Scholar 

  24. Bock C-T, Klingel K, Kandolf R. Human parvovirus B19-associated myocarditis. N Engl J Med. 2010;362(13):1248–9.

    Article  PubMed  CAS  Google Scholar 

  25. MacLellan WR, Lusis AJ. Dilated cardiomyopathy: learning to live with yourself. Nat Med. 2003;9:1455–6.

    Article  PubMed  CAS  Google Scholar 

  26. Magnani JW, Danik HJS, Dec GW, DiSalvo TG. Survival in biopsy-proven myocarditis: a long-term retrospective analysis of the histopathologic, clinical, and hemodynamic predictors. Am Heart J. 2006;151:463–70.

    Article  PubMed  Google Scholar 

  27. Kuhl U, Pauschinger M, Seeberg B, Lassner D, Noutsias M, Poller W, Schultheiss HP. Viral persistence in the myocardium is associated with progressive cardiac dysfunction. Circulation. 2005;112:1965–70.

    Article  PubMed  Google Scholar 

  28. Caforio ALP, Calabrese F, Angelini A, Tona F, Vinci A, Bottaro S, Ramondo A, Carturan E, Iliceto S, Thiene G, Daliento L. A prospective study of biopsy-proven myocarditis: prognostic relevance of clinical and aetiopathogenetic features at diagnosis. Eur Heart J. 2007;28:1326–33.

    Article  PubMed  Google Scholar 

  29. Kuethe F, Sigusch HH, Hilbig K, Tresselt C, Gluck B, Egerer R, Figulla HR. Detection of viral genome in the myocardium: lack of prognostic and functional relevance in patients with acute dilated cardiomyopathy. Am Heart J. 2007;153:850–8.

    Article  PubMed  CAS  Google Scholar 

  30. Libby P, et al. Braunwald’s heart disease. 8th ed. Philadelphia: Saunders, Elsevier; 2008.

    Google Scholar 

  31. Liu PP, Schultheiss H-P. Myocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, Braunwald E, editors. Heart disease. 8th ed. Philadelphia: Saunders/Elsevier; 2008. p. 1775–92.

    Google Scholar 

  32. Camm JA, Lüscher TF, Serruys PW, editors. The ESC textbook of cardiovascular medicine. 2nd ed. Oxford: Oxford University Press; 2009.

    Google Scholar 

  33. Baughman KL. Diagnosis of myocarditis – death of Dallas criteria. Circulation. 2006;113:593–5.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

I am grateful for a long-lasting cooperation with Dr. Sabine Pankuweit, Universitätsklinikum Giessen & Marburg, Germany, who has been very educational and always kind. Sabine has once again been of great help when preparing this chapter.

Author information

Authors and Affiliations

  1. Department of Pathology Center for Clinical Research, Vendsyssel Hospital, Aalborg University, Bispensgade 37, 9800, Hjørring, Denmark

    Ulrik Baandrup M.D., Ph.D.

Authors
  1. Ulrik Baandrup M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ulrik Baandrup M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. , Department of Pathology, Northern General Hospital, Herries Road, Sheffield, S5 7AU, United Kingdom

    S. Kim Suvarna

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Baandrup, U. (2013). Myocarditis/Inflammatory Cardiomyopathy. In: Suvarna, S. (eds) Cardiac Pathology. Springer, London. https://doi.org/10.1007/978-1-4471-2407-8_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2407-8_8

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2406-1

  • Online ISBN: 978-1-4471-2407-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation