Dallas Criteria for Histopathologic Diagnosis of Myocarditis

Are you examining an endomyocardial biopsy from a patient with heart disease?

Is the material submitted adequate for evaluation?

Number of previous biopsies

Is there evidence of degenerative change or necrosis involving myocytes?

Are viral inclusions present?

Are parasites or other micro-organisms present?

• an endocardial distribution?

• a replacement pattern?

• an interstitial pattern?

• ischemic change associated with coronary artery disease?

• changes of a previous biopsy site?

• tissue artifact?

• myocarditis associated with vasopressor agents?

• myocarditis secondary to other drugs?

• leukemic or lymphomatous infiltrate?

• nonspecific inflammation in idiopathic, dilated cardiomyopathy?

Inflammatory infiltrate

Intensity of inflammatory infiltrate

Distribution of inflammation

Amount of fibrosis

Distribution of fibrosis

Changes compared to last biopsy