THE CONTEXT
Myocarditis has four described clinical presentations and is self-limiting in most patients, although serious acute and delayed complications can occur.
Four clinical presentations
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Fulminant myocarditis: follows a viral prodrome or influenza-like illness and causes severe heart failure or cardiogenic shock.
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Acute myocarditis: presents over a longer period with heart failure and can lead to dilated cardiomyopathy.
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Chronic active myocarditis: is rare and associated with chronic myocardial inflammation.
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Chronic persistent myocarditis: features focal myocardial infiltrates and can cause chest pain and arrhythmia without necessarily causing ventricular dysfunction.
Prognosis and complications
| Feature | Details |
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Usual course | myocarditis is self-limiting in most patients, with a good immediate prognosis. |
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Fatal complications | death may result from ventricular arrhythmia or rapidly progressive heart failure. |
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Young athletes | myocarditis has been reported as a cause of sudden and unexpected death. |
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Long-term disease | some forms progress to chronic low-grade myocarditis or dilated cardiomyopathy. |
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Chagas disease | patients frequently recover from the acute infection but develop chronic dilated cardiomyopathy 10 or 20 years later. |
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