Myocarditis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S. Maliha Shakil, M.D. [2] Homa Najafi, M.D.[3]

Overview[edit | edit source]

Myocarditis can be classified based on the causative, histological, and clinicopathological criteria. Causative criteria include three main groups, as well as infectious, immune-mediated, and toxic myocarditis. Based on the type of infiltrating cells myocarditis divided in lymphocytic, eosinophilic, polymorphic, giant cell myocarditis, and cardiac sarcoidosis. Acute, fulminant, chronic active, and chronic persistent are subtypes of clinicopathopogical classification.

Classification[edit | edit source]

• Myocarditis can be classified based on the causative, histological, and clinicopathological criteria.
• Myocarditis may be classified according to causative criteria into three groups:^{[1][2][3][4][5][6][7][8][9]}
  • Infectious myocarditis
  • Immune-mediated myocarditis
  • Toxic myocarditis

• Myocarditis may be classified according to histological criteria into five groups:^[10][11][2]
  • Lymphatic myocarditis
  • Eosinophilic myocarditis
  • Polymorphic myocarditis
  • Giant cell myocarditis
  • Cardiac sarcoidosis

• Myocarditis may be classified according to clinicopathological four criteria into three groups:^[12][13][14]
  • Fulminant myocarditis
  • Acute myocarditis
  • Chronic active myocarditis
  • Chronic persistent myocarditis

Causative criteria[edit | edit source]

• Myocarditis can be classified based on the causative criteria into immune-mediated myocarditis, infectious myocarditis and toxic myocarditis. bkjvskaljbkjbkjbakj

Histological criteria[edit | edit source]

• Myocarditis can be classified based on the type of infiltrating cells in lymphocytic, eosinophilic, polymorphic, giant cell myocarditis, and cardiac sarcoidosis.

Clinicopathological criteria[edit | edit source]

• Fulminant myocarditis: Fulminant myocarditis occurs following a viral prodrome. Fulminant myocarditis presents as acute severe cardiovascular compromise with ventricular dysfunction. On endomyocardial biopsy, there are multiple foci of inflammation.^[15][16]

• Acute myocarditis: Acute myocarditis presents with a less distinct onset of the illness. When the patient does present, there is already a decline in left ventricular dysfunction. Acute myocarditis may progress to dilated cardiomyopathy.

• Chronic active myocarditis: Chronic active myocarditis has a less distinct onset of the illness. There are clinical and histologic relapses and the development of ventricular dysfunction. Histologically, chronic inflammatory changes with mild to moderate fibrosis may be develop after 2 to 4 years.

• Chronic persistent myocarditis: Chronic persistent myocarditis has a less distinct onset of the illness. Histologically it is characterized by persistent infiltration and myocyte necrosis. Despite the presence of symptoms, ventricular dysfunction is absent.^[14]

References[edit | edit source]

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