B. burgdorferi sensu stricto is responsible for all cases in the United States, whereas B. afzelii and B. garinii are responsible for many cases in Europe, although B. burgdorferi sensu stricto occurs there as well.

The physician next must consider specific heart muscle disease of noninflammatory nature. It has been diagnosed either on endomyocardial biopsy or retrospectively after explantation of the native heart. Myocarditis may occur as a complication of other cardiomyopathies including cardiac amyloidosis, hypertrophic cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy.

[ Criteria that are based on immunoperoxidase staining have greater sensitivity and may have prognostic value. The lack of consensus regarding the value of invasive studies such as endomyocardial biopsy and the overall good prognosis for patients with mild, acute dilated cardiomyopathy who have suspected myocarditis have led to recent recommendations that endomyocardial biopsy should be considered on the basis of the likelihood of finding specific treatable disorders. These limitations have led to alternative pathological classifications with criteria that rely on cell-specific immunoperoxidase stains for surface antigens, such as anti-CD3, anti-CD4, anti-CD20, anti-CD68, and anti–human leukocyte antigen. Carditis occurs in approximately 5 percent of untreated adults in the United States, particularly among men. Contents. However, myocarditis does not always develop early in the course of drug use.

In fact, early administration of hydrocortisone may be associated with better chance of survival . Lyme disease is a multisystem disease caused by infection with Borrelia burgdorferi.

Carditis is less frequent in Europe, affecting approximately 0.3 to 4.0 percent of untreated adults. Carditis is less frequent in Europe, affecting approximately 0.3 to 4.0 percent of untreated adults. Eosinophilic myocarditis has also been seen in 2.4 to 23 percent of patients treated with dobutamine infusion. Prognosis seems relatively good compared to ‘Acute Myocarditis’, presenting with heart failure as the main symptom [The manifestations of myocarditis described above often suggest the clinical diagnosis. Among patients with lupus, myocarditis has been found in approximately 9 percent in clinical studies and 6 percent in echocardiography studies in which global hypokinesis is the suggestive finding. In this Review, we discuss the clinical and histological distinguishing features of fulminant myocarditis and contrast this disease entity with nonfulminant myocarditis. Fatal dengue myocarditis is a very rare complication of dengue fever. Histologically, HSM is usually characterized by an interstitial infiltrate with prominent eosinophils, but little myocyte necrosis. In the acute phase it is characterized by intense and diffuse myocarditis with mononuclear infiltrates. A clinicopathologic classification utilizing both histologic and clinical features may provide prognostic information about patients with heart failure due to myocarditis :

Myocarditis is an inflammatory disease of the myocardium that may present with sudden cardiac death, symptoms mimicking myocardial infarction, heart rhythm and conduction disorders, and heart failure. The incidence of myocarditis is largely unknown because of difficulties establishing the diagnosis and the lack of a gold standard other than myocardial biopsy, which has a low sensitivity, mostly due to sampling error. Acute myocarditis should be suspected whenever a patient, especially a young male, presents with otherwise unexplained cardiac abnormalities of new onset, such as heart failure, myocardial infarction, cardiac arrhythmias, or conduction disturbances. It has been suggested that celiac disease, which is often clinically unsuspected, accounts for as many as 5 percent of patients with autoimmune myocarditis or idiopathic DCM. In the meantime, to ensure continued support, we are displaying the site without styles The authors declare no competing financial interests. The most characteristic cardiac anatomic lesion in the chronic phase is the ventricular apical aneurysm which, in one series, was noted in 52 % of 1078 autopsied Chagasic patients [Systemic lupus erythematosus, Wegener's granulomatosis, giant cell arteritis, Kawasaki disease and Takayasu arteritis may cause myocarditis. A history of recent upper respiratory infection or enteritis may also be elicited in the majority of cases of viral myocarditis.

Severe illness with systemic manifestations of viral disease and heart failure, often referred to as ‘fulminant myocarditis’, may resolve without symptoms but may also lead to heart failure in a limited number of patients.

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