[Update on myocarditis].

Myocarditis is an illness characterized by myocardial infiltration with inflammatory cells and non-ischemic myocytic necrosis. The clinical presentation of myocarditis varies widely and diagnosis is sometimes difficult to establish. The current incidence of myocarditis is also difficult to determine as endomyocardial biopsy, the diagnostic gold standard, is unfrequently used, or even not justified. The leading causes are infections, immune-mediated injury and toxins. Prognosis is most often good but, in some patients, the disease can be fulminant with progression to cardiogenic shock, or occurrence of sudden cardiac death. Prognosis in myocarditis patients varies according to the underlying aetiology. Treatment is generally symptomatic, but in some cases, a specific therapy is appropriated as a function of the corresponding aetiology. This paper aims to review current knowledge concerning myocarditis, with particular emphasis on «urgent» situations.