Clinicopathoiogic description of myocarditis

Eric B. Lieberman, Grover M. Hutchins, Ahvie Herskowitz, Noel R. Rose, Kenneth L. Baughman

Research output: Contribution to journalArticlepeer-review

266 Scopus citations


Histologic evidence of myocarditis was demonstrated in 35 of 348 patients submitted to endomyocardial biopsy over 5 years. Analysis of the histologic findings and clinical course of these patients resulted in a new clinicopathologic classification of myocarditis in which four distinct subgroups are identified. Patients with fulminant myocarditis become acutely ill after a distinct viral prodrome, have severe cardiovascular compromise, multiple foci of active myocarditis by histologic study and ventricular dysfunction that either resolves spontaneously or results in death. Patients with acute, chronic active and chronic persistent myocarditis have a less distinct onset of illness. Patients with acute myocarditis present with established ventricular dysfunction and may respond to immunosuppressive therapy or their condition may progress to dilated cardiomyopathy. Those with chronic active myocarditis initially respond to immunosuppressive therapy, but they have clinical and histologic relapses and develop ventricular dysfunction associated with chronic inflammatory changes including giant cells on histologic study. Chronic persistent myocarditis is characterized by a persistent histologic infiltrate, often with foci of myocyte necrosis but without ventricular dysfunction despite other cardiovascular symptoms such as chest pain or palpitation.

Original languageEnglish (US)
Pages (from-to)1617-1626
Number of pages10
JournalJournal of the American College of Cardiology
Issue number7
StatePublished - Dec 1991
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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