Clinical management of acute myocarditis in daily practice: an expert practical view

Acute Myocarditis (AM) encompasses a broad spectrum of clinical presentations and causes. Despite the recent advances in cardiovascular imaging, pathology, virology, and genetics, specific therapies are still lacking. This collaborative review aims to analyse the current evidence to answer practical questions that physicians may face during the early management of patients presenting with an acute form of the disease, complicated or not. This review analyses current evidence to address practical questions posed by acute cardiovascular physicians during the early management of acute, or potentially, myocarditis. Based on the current literature, this review provides a step-by-step approach to treat AM patients from their admission in the cardiac intensive care unit (CICU) to discharge, by answering 10 clinical questions: Might this patient be suffering from an AM? Should I hospitalize this patient and, if so, where? Which cardiac imaging exam should I perform and what can I learn from it? Is this patient requiring an EMB? What should the non-invasive aetiological work-up be? Is her/his episode of AM of viral, toxic, or other origin? Does this patient need specific treatments or mechanical circulatory support? Is there an indication for guideline-directed medical heart failure treatment? When can the patient be discharged and resume physical activity? Notably, this review highlights the need to build a multidisciplinary response team to address the many diagnostic and therapeutic challenges of AM patients. It also points out the lack of evidence to guide the treatment of these patients.

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Publication Details

Journal
European Heart Journal Acute Cardiovascular Care
Published
2025-04-08
DOI
https://doi.org/10.1093/ehjacc/zuaf057
Citations
1
Primary Topic
Viral Infections and Immunology Research
Type
article
Field-Weighted Citation Impact
1.39
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article

Clinical management of acute myocarditis in daily practice: an expert practical view

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1 citations
European Heart Journal Acute Cardiovascular Care
Viral Infections and Immunology Research
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article

Clinical management of acute myocarditis in daily practice: an expert practical view

Gal Tsaban, Ward Heggermont, Marco Morosin, Christophe Vandenbriele, Max Lenz, François Roubille, Enrico Ammirati, Alessandro Sionís, Hannah Schaubroeck, Stéphane Heymans, Clément Delmas, Mathieu Kernéis, Jamol Uzokov, Rosalinda Madonna, Katarine Vardanyan
article en
1 citations

Abstract

Acute Myocarditis (AM) encompasses a broad spectrum of clinical presentations and causes. Despite the recent advances in cardiovascular imaging, pathology, virology, and genetics, specific therapies are still lacking. This collaborative review aims to analyse the current evidence to answer practical questions that physicians may face during the early management of patients presenting with an acute form of the disease, complicated or not. This review analyses current evidence to address practical questions posed by acute cardiovascular physicians during the early management of acute, or potentially, myocarditis. Based on the current literature, this review provides a step-by-step approach to treat AM patients from their admission in the cardiac intensive care unit (CICU) to discharge, by answering 10 clinical questions: Might this patient be suffering from an AM? Should I hospitalize this patient and, if so, where? Which cardiac imaging exam should I perform and what can I learn from it? Is this patient requiring an EMB? What should the non-invasive aetiological work-up be? Is her/his episode of AM of viral, toxic, or other origin? Does this patient need specific treatments or mechanical circulatory support? Is there an indication for guideline-directed medical heart failure treatment? When can the patient be discharged and resume physical activity? Notably, this review highlights the need to build a multidisciplinary response team to address the many diagnostic and therapeutic challenges of AM patients. It also points out the lack of evidence to guide the treatment of these patients.

European Heart Journal Acute Cardiovascular CareVol. 14(7)
University of Pisa (IT), Universitat Autònoma de Barcelona (ES), Ben-Gurion University of the Negev (IL), Centre National de la Recherche Scientifique (FR), Université Toulouse III - Paul Sabatier (FR), Inserm (FR), Université de Montpellier (FR), Guy's and St Thomas' NHS Foundation Trust (GB), Royal Brompton & Harefield NHS Foundation Trust (GB), Maastricht University Medical Centre (NL), Soroka Medical Center (IL), Ghent University Hospital (BE), Hospital de Sant Pau (ES), Harefield Hospital (GB), University Medical Center (US), Maastricht University (NL), Sorbonne Université (FR), Physiologie et Médecine Expérimentale du Coeur et des Muscles (FR), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Centro de Investigación en Red en Enfermedades Cardiovasculares (ES), Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA (AT), Royal Brompton Hospital (GB), Assistance Publique – Hôpitaux de Paris (FR), European Heart Network (BE), Onze Lieve Vrouwziekenhuis Hospital (BE), Centro de Investigación Biomédica en Red (ES), Gerash University of Medical Sciences (IR), Pitié-Salpêtrière Hospital (FR), Hôpital Rangueil (FR), Mayo Clinic in Arizona (US), Unité de recherche sur les maladies cardiovasculaires et métaboliques (FR), Institut des Maladies Métaboliques et Cardiovasculaires (FR), Ludwig Boltzmann Institute for Cancer Research (AT), Tashkent Pediatric Medical Institute (UZ), Imperial College London (GB), University of Milano-Bicocca (IT), Medical University of Vienna (AT), KU Leuven (BE)
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Openalex Percentile: Top 21%
Viral Infections and Immunology Research
1.39
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