What is myocarditis?
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A brief historical review of the concepts that have existed in myocarditis in the nineteenth and twentieth centuries is presented. The establishment of this entity is linked with the milestones of discovery in medicine, especially the development of the stethoscope, the microscope, and the science of bacteriology. Yet, despite these advances, chronic myocarditis was still a common diagnosis up to about the third decade of the twentieth century and included conditions such as hypertension. Evidence of myocarditis was often not present or had not been sought. It became clear that the term “myocarditis” was indiscriminately used and, following admonition from such authorities as Sir Thomas Lewis and Dr. Paul White, resulted in under-diagnosis of myocarditis. Clinically, the signs and symptoms of myocarditis are nonspecific and morphologic recognition is also fraught with many pitfalls, among which the distinction from ischemic heart disease and myocardial infarction has to be made. With the introduction of the bioptome, clearer concepts have developed and the latest definition is cited. Sequential biopsies have also permitted a classification into active, healing, and healed myocarditis to be made. Examination of fresh endomyocardial tissue, obtained by bioptome, has also shed light on the pathogenetic mechanisms of two of the three forms of cardiomyopathy, namely, dilated (congestive) cardiomyopathy and endomyocardial disease associated with an eosinophilia. Clear concepts are essential in diagnosing this condition. These are now emerging through morphologic examination of fresh endomyocardial tissue.
KeywordsHypertension Myocardial Infarction Heart Disease Cardiomyopathy Twentieth Century
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- 1.Sobernheim JF (1837) Praktische Diagnostik der inneren Krankheiten mit vorzueglicher Ruecksicht auf pathologische Anatomie. Hirschwald, Berlin, p 117Google Scholar
- 2.Mattingley TW (1973) Some historical notes on the development of the present state of knowledge of diseases of the myocardium. In: Noble O, Fowles RE (eds) Myocardial diseases (Clinical-cardiology monographs). Grune and Stratton, New York London, pp 1–23Google Scholar
- 3.Fiedler A (1900) Ueber akute interstitielle Myokarditis [Abstract]. Zentralbl Inn Med 21: 212Google Scholar
- 4.Josserand E, Gallavardin L (1901) De l'asystolie progressive des jeunes subjets par myocardite subaique primitive. Arch Gen Med 6: 513–546; 684–704Google Scholar
- 5.Aschoff L (1905) Zur Myokarditisfrage. Verh Dtsch Ges Pathol 8: 46–53Google Scholar
- 6.Herrick JB (1912) Clinical features of sudden obstruction of the coronary arteries. JAMA 59: 2015–2020Google Scholar
- 7.Olsen EGJ (1983) Myocarditis—A case of mistaken identity? Br Heart J 50: 303–311Google Scholar
- 8.Fahr GE (1923) Hypertension heart. The most common form of so-called chronic myocarditis. JAMA 80: 981–984Google Scholar
- 9.Wood P (1968) Non-rheumatic myocarditis and miscellaneous cardiopathies. In: Paul Wood's diseases of the heart and circulation. Eyre & Spottiswoode, London, 3rd edn, pp 707–750Google Scholar
- 10.Smith WG (1970) Coxsackie B myopericarditis in adults. Am Heart J 80: 34–46Google Scholar
- 11.Sakakibara S, Konno S (1962) Endomyocardial biopsy. Jpn Heart J 3: 537–543Google Scholar
- 12.Richardson PJ (1974) King's endomyocardial bioptome. Lancet I: 660–661Google Scholar
- 13.Olsen EGJ (1978) Endomyocardial biopsy (Editorial). Br Heart J 40: 95–98Google Scholar
- 14.Olsen EGJ (1981) Panel discussion. In: Goodwin JF, Hjalmarson A, Olsen EGJ (eds) Congestive cardiomyopathy, Kiruna Sweden 1980. Hassle, Molndal, p 122Google Scholar
- 15.Billingham ME, Olsen EGJ, Fenoglio JJ Jr, Edwards WD, Fallon JT, Aretz HT, Schoen FJ, Factor S (1984) Myocarditis pathology panel, Dallas, Texas, March 24Google Scholar
- 16.Olsen EGJ (1982) Cardiomyopathies: Pathology and infectious immune mechanisms. Terapevticheskii Arkhiv No. 11: 75–78Google Scholar
- 17.Olsen EGJ, Spry CJF (1979) Endomyocardial fibrosis and eosinophilic heart disease. In: Goodwin JF, Yu PN (eds) Progress in cardiology, Vol. 8. Lea & Febiger, Philadelphia, pp 281–303Google Scholar
- 18.Krehl L (1981) Beitrag zur Kenntniss der idiopathischen Herzmuskelerkrankungen. Dtsch Arch Klin Med 48: 414–431Google Scholar
- 19.WHO/ISFC (1980) Report of the task force on the definition and classification of cardiomyopathies. Br Heart J 44: 672–673Google Scholar