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Treatment and prognosis of myocarditis in adults

Leslie T Cooper, Jr, MD
Section Editor
William J McKenna, MD
Deputy Editor
Susan B Yeon, MD, JD, FACC


Myocarditis refers to inflammation of the heart muscle. The diagnosis may be suspected by clinical and noninvasive features and is confirmed by histopathologic criteria on endomyocardial biopsy. The clinical manifestations of this disorder vary greatly from asymptomatic changes on an electrocardiogram to fulminant heart failure (HF). (See "Clinical manifestations and diagnosis of myocarditis in adults".)

This topic will review the prognosis and treatment of myocarditis in adults. Treatment of myocarditis consists of both specific therapy aimed at the cause of the myocarditis and nonspecific therapy aimed at the clinical manifestations such as HF and arrhythmias. The etiology, incidence, pathogenesis, clinical manifestations, and diagnosis of myocarditis are discussed separately. (See "Etiology and pathogenesis of myocarditis" and "Clinical manifestations and diagnosis of myocarditis in adults".)

A significant minority of patients with pericarditis also have myocarditis. Myocarditis associated with pericarditis, including vaccinia-associated disease (myocarditis and/or pericarditis), is discussed separately. (See "Myopericarditis".)


Variable disease course — The course of myocarditis varies with the presenting clinical syndrome.

Acute myopericarditis, defined as clinical pericarditis with elevated troponin and preserved left ventricular function, is associated with low risk of heart failure or death (eg, no heart failure or deaths among 114 patients at median three-year follow-up [1]). (See "Myopericarditis", section on 'Prognosis'.)


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Literature review current through: Sep 2016. | This topic last updated: Aug 28, 2015.
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