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proLékaře.cz / Journals / Internal Medicine / 2019 - 10

Inflammatory myocardial disease

Czech version

Authors: Jan Krejčí;  Hana Poloczková
Authors‘ workplace: I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně
Published in: Vnitř Lék 2019; 65(10): 636-642
Category:

Overview

Inflammatory diseases of the heart muscle include myocarditis and inflammatory cardiomyopathy, which is myocarditis associated with a heart muscle dysfunction. The causes of myocardial inflammatory disorders may be infectious, most commonly viral, as well as non-infectious. Diagnosing is difficult, the clinical suspicion of this diagnosis can be established based on clinical picture and non-invasive diagnostic methods, the most important of which is cardiac magnetic resonance imaging. The definitive diagnosis is based on histological and immunohistochemical evidence of inflammation directly from heart muscle samples. These can be obtained by endomyocardial biopsy which is also the gold standard of diagnosis. In addition to the demonstration of inflammatory changes, the exami­nation of biopsy specimens allows for specification of their character and the obtained tissue can also be exami­ned for presence of infectious agents in the myocardium. Based on the findings it is then possible to estimate the prognosis, set the timing of further therapeutic steps (especially device-based therapy) and, in some cases, admi­nister specific treatments.

Keywords:

endomyocardial biopsy – immunosuppressive treatment – myocarditis

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