A patient with myocarditis may present in a number of ways. The authors are from multiple institutions in Europe participating in a European Society of Cardiology Working Group.
Clinical presentations of myocarditis:
(1) pseudo-AMI (acute coronary syndrome-like) with chest pain, ST-segment and T-wave changes, elevated serum troponin concentration and normal coronary angiography
(2) new onset or worsening of heart failure
(3) chronic or progressive heart failure in the absence of coronary artery disease or known causes
(4) fulminant, life-threatening condition (aborted sudden death, life-threatening arrhythmia, cardiogenic shock or severely impaired left ventricular function)
The diagnosis may be easier if:
(1) the person is young
(2) the patient was previously healthy
(3) the onset follows a viral infection, drug or other exposure
(4) the patient has been diagnosed with an autoimmune disorder associated with myocarditis
The diagnosis may be challenging if the patient:
(1) is older
(2) has pre-existing heart disease
(3) does not have a known exposure
