Myocarditis heart failure: A review of clinical status and meta-analyses of diagnostic performance of cardiac magnetic resonance and therapeutic value of immunosuppressive therapy

Myocarditis heart failure or inflammatory cardiomyopathy is a polymorphic disease complicated by heterogeneous clinical presentation and evolution. Patients with myocarditis presenting with severe left ventricular (LV) dysfunction and life-threatening arrhythmias represent a demanding challenge to clinicians. Although molecular evaluation of the myocardium using endomyocardial biopsy and modern techniques of cardiovascular imaging provide valuable insights into its etiology and pathophysiology, diagnosis remains a clinical challenge because of varied modes of clinical presentation, diversity of approaches to diagnosis, a spectrum of clinical courses and unsettled perspective on therapeutics in different patient settings and viral pathologies. This review seeks to frame recent clinical advances in diagnosing and managing myocarditis HF within the latest understanding of clinical presentation, etiology and pathophysiology obtained from experimental animal models and clinical trials. The objective is to improve understanding of the clinical status of myocarditis heart failure.