Department of Cardiology and Pneumology, University Medicine Berlin, Campus Benjamin-Franklin, Medical Clinic II, Hindenburgdamm 30, Berlin 1210, Germany.
Heart Fail Clin. 2010 Oct;6(4):483-96, viii-ix. doi: 10.1016/j.hfc.2010.05.009.
Myocarditis is an inflammatory disease of the cardiac muscle caused by myocardial infiltration of immunocompetent cells following any kind of cardiac injury. Acute myocarditis in childhood is often a result of a viral infection that produces myocardial necrosis and triggers an immune response to eliminate the infectious agent. Chronic myocardial injury may develop by postinfectious immune or autoimmune processes or be associated with systemic autoimmune diseases, which, in the long run, are responsible for persistent or progressive ventricular dysfunction, arrhythmias, and cardiac complaints. The disease often presents as an acute form of dilated cardiomyopathy, but because of its broad spectrum of presentation the clinical diagnosis is frequently misleading. If the underlying infectious or immune-mediated causes of the disease are carefully defined by clinical and biopsy-based tools, specific immunosuppressive and antiviral treatment options in addition to basic symptomatic therapy may avoid unnecessary interventions and improve prognosis in many patients with acute and chronic disease.
心肌炎是一种心肌炎症性疾病，由心肌免疫活性细胞浸润引起，发生于任何类型的心脏损伤之后。儿童急性心肌炎常由病毒感染所致，其导致心肌坏死并触发免疫反应以清除感染因子。慢性心肌损伤可能由感染后免疫或自身免疫过程引起，也可能与全身性自身免疫性疾病相关，而后者从长期来看可导致持续性或进行性心室功能障碍、心律失常和心脏不适。该病常表现为扩张型心肌病的急性形式，但由于其表现谱广泛，临床诊断常具误导性。如果通过临床和基于活检的工具仔细明确了疾病的潜在感染或免疫介导原因，则除基本对症治疗外，还可选择特定的免疫抑制和抗病毒治疗方案，这可能避免许多急性和慢性疾病患者的不必要干预，并改善预后。
