heart and blood vessel disorders
Myocarditis
Diagnosis of Myocarditis
Electrocardiography (ECG) and measuring cardiac markers Cardiac imaging Sometimes, endomyocardial biopsy Tests to identify cause Doctors suspect myocarditis when otherwise healthy people with no risk factors for heart disease have with symptoms of heart failure or abnormal heart rhythms. ECGis done to look for evidence of a heart problem. Doctors measure levels ofcardiac markers(substances that are present when the heart is damaged) in the blood. Echocardiographycan show abnormalities in people with myocarditis. Cardiac magnetic resonance imagingmay show a characteristic pattern of abnormalities in people with myocarditis. Endomyocardial biopsyin which a doctor takes a sample of tissue from the inner wall of the heart to examine under a microscope, can be done to confirm myocarditis. However, because a diagnosis depends on the doctor obtaining a tissue sample from an area that shows the disease, endomyocardial biopsy may not be the best test for diagnosing myocarditis. Therefore if endomyocardial biopsy shows evidence of myocarditis, the disorder is confirmed, but just because a tissue sample does not show signs of myocarditis does not mean this diagnosis can be eliminated. In addition, because endomyocardial biopsy carries risks of severe complications, including a tear in the wall of the heart and death, it is not routinely done unless doctors suspect giant cell myocarditis (because prompt treatment of giant cell myocarditis may be life saving) or if myocarditis causes severe heart failure or heart rhythm abnormalities. After myocarditis is diagnosed, tests to determine the cause are done. In a young, previously healthy adult who has a viral infection and myocarditis, an extensive evaluation is usually not necessary. A complete blood count is helpful to look for certain types of white blood cells (eosinophils), which are present in large numbers in people with hypersensitivity myocarditis usually due to a drug allergy. Cardiac Catheterization and Coronary Angiography may be useful for ruling out a decrease in blood flow to the heart because myocarditis can mimic a In other cases, a biopsy of heart tissue may be needed to establish a diagnosis. Other tests, including tests for autoimmune disorders, human immunodeficiency virus infection, histoplasmosis, and other infections, may be needed. 