What is myocarditis?


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.

This is a preview of subscription content, log in to check access.


  1. 1.

    Sobernheim JF (1837) Praktische Diagnostik der inneren Krankheiten mit vorzueglicher Ruecksicht auf pathologische Anatomie. Hirschwald, Berlin, p 117

    Google Scholar 

  2. 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 1–23

    Google Scholar 

  3. 3.

    Fiedler A (1900) Ueber akute interstitielle Myokarditis [Abstract]. Zentralbl Inn Med 21: 212

    Google Scholar 

  4. 4.

    Josserand E, Gallavardin L (1901) De l'asystolie progressive des jeunes subjets par myocardite subaique primitive. Arch Gen Med 6: 513–546; 684–704

    Google Scholar 

  5. 5.

    Aschoff L (1905) Zur Myokarditisfrage. Verh Dtsch Ges Pathol 8: 46–53

    Google Scholar 

  6. 6.

    Herrick JB (1912) Clinical features of sudden obstruction of the coronary arteries. JAMA 59: 2015–2020

    Google Scholar 

  7. 7.

    Olsen EGJ (1983) Myocarditis—A case of mistaken identity? Br Heart J 50: 303–311

    Google Scholar 

  8. 8.

    Fahr GE (1923) Hypertension heart. The most common form of so-called chronic myocarditis. JAMA 80: 981–984

    Google Scholar 

  9. 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 707–750

    Google Scholar 

  10. 10.

    Smith WG (1970) Coxsackie B myopericarditis in adults. Am Heart J 80: 34–46

    Google Scholar 

  11. 11.

    Sakakibara S, Konno S (1962) Endomyocardial biopsy. Jpn Heart J 3: 537–543

    Google Scholar 

  12. 12.

    Richardson PJ (1974) King's endomyocardial bioptome. Lancet I: 660–661

    Google Scholar 

  13. 13.

    Olsen EGJ (1978) Endomyocardial biopsy (Editorial). Br Heart J 40: 95–98

    Google Scholar 

  14. 14.

    Olsen EGJ (1981) Panel discussion. In: Goodwin JF, Hjalmarson A, Olsen EGJ (eds) Congestive cardiomyopathy, Kiruna Sweden 1980. Hassle, Molndal, p 122

    Google Scholar 

  15. 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 24

  16. 16.

    Olsen EGJ (1982) Cardiomyopathies: Pathology and infectious immune mechanisms. Terapevticheskii Arkhiv No. 11: 75–78

  17. 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 281–303

    Google Scholar 

  18. 18.

    Krehl L (1981) Beitrag zur Kenntniss der idiopathischen Herzmuskelerkrankungen. Dtsch Arch Klin Med 48: 414–431

    Google Scholar 

  19. 19.

    WHO/ISFC (1980) Report of the task force on the definition and classification of cardiomyopathies. Br Heart J 44: 672–673

    Google Scholar 

Download references

Author information



Rights and permissions

Reprints and Permissions

About this article

Cite this article

Olsen, E.G.J. What is myocarditis?. Heart Vessels 1, 1–3 (1985). https://doi.org/10.1007/BF02072348

Download citation


  • Hypertension
  • Myocardial Infarction
  • Heart Disease
  • Cardiomyopathy
  • Twentieth Century