Clinical diagnosis of myocarditis and dilated cardiomyopathy.

The diagnosis of acute infectious myocarditis can be made on clinical grounds with reasonable certainty. Dynamically evolving electrocardiographic, echocardiographic, and serum cardiac enzyme level changes in a patient with symptoms of both an infection and a heart disease are the basis for the diagnosis. In contrast, the diagnosis of lymphocytic or giant cell myocarditis can be made only on the basis of an endomyocardial biopsy finding. The diagnosis and differential diagnosis of dilated cardiomyopathy are discussed in brief.