RT Journal Article
SR Electronic
T1 Acute myocarditis: aetiology, diagnosis and management
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP e505
OP e510
DO 10.7861/clinmed.2021-0121
VO 21
IS 5
A1 Temi Lampejo
A1 Simon M Durkin
A1 Naman Bhatt
A1 Oliver Guttmann
YR 2021
UL http://www.rcpjournals.org/content/21/5/e505.abstract
AB Acute myocarditis is a serious, likely underdiagnosed condition affecting people of all ages and for which the number of UK hospital admissions is rising. A primary diagnosis of myocarditis accounted for 0.04% (36.5 per 100,000) of all hospital admissions in England between 1998 and 2017, although this is likely to be an underestimate of the true burden of myocarditis. The aetiology is broad, including infective and inflammatory conditions as well as exposure to toxic agents. Clinical features are varied and overlap with other acute cardiac conditions making diagnosis a challenge. Cardiovascular magnetic resonance imaging currently serves as the gold standard non-invasive diagnostic modality. If an underlying aetiological process is identified, then therapy may be directed at the cause; however, for most, treatment is supportive and aimed at managing any complications such as heart failure or arrhythmias. There is emerging evidence for immunosuppressive therapy in certain cases. Prognosis is generally good with recovery in most; however, up to 30% with biopsy-proven myocarditis progress to develop a dilated cardiomyopathy and its potential associated complications. All-cause mortality in the UK for patients presenting to hospital with acute myocarditis is approximately 4%.