Myocarditis in Clinical Practice

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Presentation transcript:

Myocarditis in Clinical Practice Gianfranco Sinagra, MD, FESC, Marco Anzini, MD, Naveen L. Pereira, MD, Rossana Bussani, MD, Gherardo Finocchiaro, MD, Jozef Bartunek, MD, PhD, Marco Merlo, MD  Mayo Clinic Proceedings  Volume 91, Issue 9, Pages 1256-1266 (September 2016) DOI: 10.1016/j.mayocp.2016.05.013 Copyright © 2016 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 Photomicrographs of active lymphocytic myocarditis (A, hematoxylin-eosin, original magnification ×20; B, immunohistochemical staining for HLA-DR antigen, original magnification ×20). Courtesy of Rosssana Bussani, MD, Institute of Pathological Anatomy and Histology, Ospedali Riuniti and University of Trieste. Mayo Clinic Proceedings 2016 91, 1256-1266DOI: (10.1016/j.mayocp.2016.05.013) Copyright © 2016 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 Proposal for clinical management of patients with suspected myocarditis. ACEI = angiotensin-converting enzyme inhibitor; AV = atrioventricular; β-b = β-blocker; ECG = electrocardiographic; EMB = endomyocardial biopsy; HLA = HLA antigen; HTx = heart transplant; ICD = implantable cardioverter-defibrillator; LGE = late gadolinium enhancement; LV = left ventricular; LVAD = LV assist device; LVEF = LV ejection fraction; MRB = mineralocorticoid receptor blocker; NYHA = New York Heart Association; PCR = polymerase chain reaction; PVB19 = parvovirus B19. Mayo Clinic Proceedings 2016 91, 1256-1266DOI: (10.1016/j.mayocp.2016.05.013) Copyright © 2016 Mayo Foundation for Medical Education and Research Terms and Conditions