[Differential diagnosis of myocarditis, cardiomyopathy and chronic ischemic heart disease].

A total of 108 patients with myocarditis and cardiomyopathies and 25 with chronic coronary disease (CCD) were investigated. The most informative diagnostic criteria were identified for the differentiation between noncoronarogenic myocardial disease (NMD) and CCD. Bicycle ergometry was positive in all CCD patients, whereas in those with NMD it was negative or had to be discontinued because of fatigue. NMD was associated with increased activity of transaminases, LDH and its isonenzymes (first and second fractions) and normal lipid spectrum. In CCD patients, enzyme activity was normal, and hyperlipidemia was detected in 88%. Coxsackie virus B2 was found in 24 of 58 NMD patients and only 3 of 25 patients with CCD. Echocardiography was effective in the diagnosis of cardiomyopathies. The diagnostic value of the patient's medical history is emphasized.