Myocarditis classification: Difference between revisions

Jump to navigation Jump to search
← Older edit
VisualWikitext
Kristin Feeney (talk | contribs)
administrator, Bureaucrats, nocaptcha, Administrators, Widget editors
4,312 edits
No edit summary
Undo revision 1697383 by Homa Najafi (talk)
Tag: Undo
 
(77 intermediate revisions by 8 users not shown)
Line 1: Line 1:
__NOTOC__
{{Myocarditis}}
{{Myocarditis}}
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Varun Kumar]], M.B.B.S.
{{CMG}} {{AE}} [[Varun Kumar]], M.B.B.S. {{Maliha}} {{Homa}}


==Overview==
==Overview==
[[Myocarditis]] can be classified clinicopathologically into: '''fulminant myocarditis, acute myocarditis, chronic active myocarditis and chronic persistent myocarditis'''.
Myocarditis can be [[Classification|classified]] based on the [[Causes|causative]], [[histological]], and clinicopathological [[criteria]]. [[Causes|Causative]] [[criteria]] include three main groups, as well as [[infectious]], [[Immune-mediated disease|immune-mediated,]] and [[toxic]] myocarditis. Based on the type of [[Infiltration (medical)|infiltrating]] [[Cells (biology)|cells]] myocarditis divided in [[lymphocytic]], [[eosinophilic]], [[polymorphic]], [[giant cell]] myocarditis, and [[cardiac sarcoidosis]]. [[Acute]], [[fulminant]], [[chronic]] active, and [[Chronic (medicine)|chronic]] persistent are subtypes of clinicopathopogical [[classification]].  


==Clinicopathological classification<ref name="pmid1960305">{{cite journal| author=Lieberman EB, Hutchins GM, Herskowitz A, Rose NR, Baughman KL| title=Clinicopathologic description of myocarditis. | journal=J Am Coll Cardiol | year= 1991 | volume= 18 | issue= 7 | pages= 1617-26 | pmid=1960305 | doi= | pmc= | url= }} </ref>==


*'''Fulminant myocarditis''' - Fulminant myocarditis occurs following a viral prodrome.  Fulminant myocarditis presents as acute severe cardiovascular compromise with ventricular dysfunction. The prognosis is good if the patient survives the acute illness<ref name="pmid10706898">{{cite journal| author=McCarthy RE, Boehmer JP, Hruban RH, Hutchins GM, Kasper EK, Hare JM et al.| title=Long-term outcome of fulminant myocarditis as compared with acute (nonfulminant) myocarditis. | journal=N Engl J Med | year= 2000 | volume= 342 | issue= 10 | pages= 690-5 | pmid=10706898 | doi=10.1056/NEJM200003093421003 | pmc= | url= }} </ref>.  On [[endomyocardial biopsy]], there are multiple focci of inflammation.
==Classification==


*'''Acute myocarditis''' - Acute myocarditis presents with a less distinct onset of the illness.  When the patient does present, there is already a decline in left ventricular dysfunction. Acute myocarditis may progress to [[dilated cardiomyopathy]].
*Myocarditis can be [[Classification|classified]] based on the [[Causes|causative]], [[histological]], and clinicopathological [[criteria]].
*Myocarditis may be [[Classification|classified]] according to [[Causes|causative]] [[criteria]] into three groups:<ref>{{cite journal|title=Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of Cardiomyopathies|journal=Circulation|volume=93|issue=5|year=1996|pages=841–842|issn=0009-7322|doi=10.1161/01.CIR.93.5.841}}</ref><ref name="LeoneVeinot2012">{{cite journal|last1=Leone|first1=Ornella|last2=Veinot|first2=John P.|last3=Angelini|first3=Annalisa|last4=Baandrup|first4=Ulrik T.|last5=Basso|first5=Cristina|last6=Berry|first6=Gerald|last7=Bruneval|first7=Patrick|last8=Burke|first8=Margaret|last9=Butany|first9=Jagdish|last10=Calabrese|first10=Fiorella|last11=d'Amati|first11=Giulia|last12=Edwards|first12=William D.|last13=Fallon|first13=John T.|last14=Fishbein|first14=Michael C.|last15=Gallagher|first15=Patrick J.|last16=Halushka|first16=Marc K.|last17=McManus|first17=Bruce|last18=Pucci|first18=Angela|last19=Rodriguez|first19=E. René|last20=Saffitz|first20=Jeffrey E.|last21=Sheppard|first21=Mary N.|last22=Steenbergen|first22=Charles|last23=Stone|first23=James R.|last24=Tan|first24=Carmela|last25=Thiene|first25=Gaetano|last26=van der Wal|first26=Allard C.|last27=Winters|first27=Gayle L.|title=2011 Consensus statement on endomyocardial biopsy from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology|journal=Cardiovascular Pathology|volume=21|issue=4|year=2012|pages=245–274|issn=10548807|doi=10.1016/j.carpath.2011.10.001}}</ref><ref name="KindermannBarth2012">{{cite journal|last1=Kindermann|first1=Ingrid|last2=Barth|first2=Christine|last3=Mahfoud|first3=Felix|last4=Ukena|first4=Christian|last5=Lenski|first5=Matthias|last6=Yilmaz|first6=Ali|last7=Klingel|first7=Karin|last8=Kandolf|first8=Reinhard|last9=Sechtem|first9=Udo|last10=Cooper|first10=Leslie T.|last11=Böhm|first11=Michael|title=Update on Myocarditis|journal=Journal of the American College of Cardiology|volume=59|issue=9|year=2012|pages=779–792|issn=07351097|doi=10.1016/j.jacc.2011.09.074}}</ref><ref name="SagarLiu2012">{{cite journal|last1=Sagar|first1=Sandeep|last2=Liu|first2=Peter P|last3=Cooper|first3=Leslie T|title=Myocarditis|journal=The Lancet|volume=379|issue=9817|year=2012|pages=738–747|issn=01406736|doi=10.1016/S0140-6736(11)60648-X}}</ref><ref name="DennertCrijns2008">{{cite journal|last1=Dennert|first1=R.|last2=Crijns|first2=H. J.|last3=Heymans|first3=S.|title=Acute viral myocarditis|journal=European Heart Journal|volume=29|issue=17|year=2008|pages=2073–2082|issn=0195-668X|doi=10.1093/eurheartj/ehn296}}</ref><ref name="MaronTowbin2006">{{cite journal|last1=Maron|first1=Barry J.|last2=Towbin|first2=Jeffrey A.|last3=Thiene|first3=Gaetano|last4=Antzelevitch|first4=Charles|last5=Corrado|first5=Domenico|last6=Arnett|first6=Donna|last7=Moss|first7=Arthur J.|last8=Seidman|first8=Christine E.|last9=Young|first9=James B.|title=Contemporary Definitions and Classification of the Cardiomyopathies|journal=Circulation|volume=113|issue=14|year=2006|pages=1807–1816|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.106.174287}}</ref><ref name="BockKlingel2010">{{cite journal|last1=Bock|first1=Claus-Thomas|last2=Klingel|first2=Karin|last3=Kandolf|first3=Reinhard|title=Human Parvovirus B19–Associated Myocarditis|journal=New England Journal of Medicine|volume=362|issue=13|year=2010|pages=1248–1249|issn=0028-4793|doi=10.1056/NEJMc0911362}}</ref><ref>{{Cite journal
  | author = [[P. Liu]], [[T. Martino]], [[M. A. Opavsky]] & [[J. Penninger]]
| title = Viral myocarditis: balance between viral infection and immune response
| journal = [[The Canadian journal of cardiology]]
| volume = 12
| issue = 10
| pages = 935–943
| year = 1996
| month = October
| pmid = 9191484
}}</ref><ref name="CambridgeMacArthur1979">{{cite journal|last1=Cambridge|first1=G|last2=MacArthur|first2=C G|last3=Waterson|first3=A P|last4=Goodwin|first4=J F|last5=Oakley|first5=C M|title=Antibodies to Coxsackie B viruses in congestive cardiomyopathy.|journal=Heart|volume=41|issue=6|year=1979|pages=692–696|issn=1355-6037|doi=10.1136/hrt.41.6.692}}</ref>
**[[Infectious]] myocarditis
**[[Immune-mediated disease|Immune-mediated]] myocarditis
**[[Toxic]] myocarditis


*'''Chronic active myocarditis''' Chronic active myocarditis has a less distinct onset of the illness.  There are clinical and histologic relapses and the development of ventricular dysfunction. Histologically, chronic inflammatory changes with mild to moderate fibrosis may be present.
*Myocarditis may be [[Classification|classified]] according to [[histological]] [[criteria]] into five groups:<ref>{{Cite journal
| author = [[H. T. Aretz]], [[M. E. Billingham]], [[W. D. Edwards]], [[S. M. Factor]], [[J. T. Fallon]], [[J. J. Jr Fenoglio]], [[E. G. Olsen]] & [[F. J. Schoen]]
  | title = Myocarditis. A histopathologic definition and classification
| journal = [[The American journal of cardiovascular pathology]]
| volume = 1
| issue = 1
| pages = 3–14
| year = 1987
| month = January
| pmid = 3455232
}}</ref><ref name="GoreSaphir1947">{{cite journal|last1=Gore|first1=Ira|last2=Saphir|first2=Otto|title=Myocarditis|journal=American Heart Journal|volume=34|issue=6|year=1947|pages=827–830|issn=00028703|doi=10.1016/0002-8703(47)90147-6}}</ref><ref name="LeoneVeinot2012">{{cite journal|last1=Leone|first1=Ornella|last2=Veinot|first2=John P.|last3=Angelini|first3=Annalisa|last4=Baandrup|first4=Ulrik T.|last5=Basso|first5=Cristina|last6=Berry|first6=Gerald|last7=Bruneval|first7=Patrick|last8=Burke|first8=Margaret|last9=Butany|first9=Jagdish|last10=Calabrese|first10=Fiorella|last11=d'Amati|first11=Giulia|last12=Edwards|first12=William D.|last13=Fallon|first13=John T.|last14=Fishbein|first14=Michael C.|last15=Gallagher|first15=Patrick J.|last16=Halushka|first16=Marc K.|last17=McManus|first17=Bruce|last18=Pucci|first18=Angela|last19=Rodriguez|first19=E. René|last20=Saffitz|first20=Jeffrey E.|last21=Sheppard|first21=Mary N.|last22=Steenbergen|first22=Charles|last23=Stone|first23=James R.|last24=Tan|first24=Carmela|last25=Thiene|first25=Gaetano|last26=van der Wal|first26=Allard C.|last27=Winters|first27=Gayle L.|title=2011 Consensus statement on endomyocardial biopsy from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology|journal=Cardiovascular Pathology|volume=21|issue=4|year=2012|pages=245–274|issn=10548807|doi=10.1016/j.carpath.2011.10.001}}</ref>
**[[Lymphatic]] myocarditis
**[[Eosinophilic]] myocarditis
**[[Polymorphic]] myocarditis
**[[Giant cell]] myocarditis
**[[Cardiac sarcoidosis]]


*'''Chronic persistent myocarditis''' - Chronic persistent myocarditis has a less distinct onset ff the illness. Histologically it is characterized by persistent infiltration and myocyte necrosis.  Despite the presence of symptoms, ventricular dysfunction is absent.
*Myocarditis may be [[Classification|classified]] according to clinicopathological four [[criteria]] into three groups:<ref name="FelkerBoehmer2000">{{cite journal|last1=Felker|first1=G.Michael|last2=Boehmer|first2=John P|last3=Hruban|first3=Ralph H|last4=Hutchins|first4=Grover M|last5=Kasper|first5=Edward K|last6=Baughman|first6=Kenneth L|last7=Hare|first7=Joshua M|title=Echocardiographic findings in fulminant and acute myocarditis|journal=Journal of the American College of Cardiology|volume=36|issue=1|year=2000|pages=227–232|issn=07351097|doi=10.1016/S0735-1097(00)00690-2}}</ref><ref name="PinamontiAlberti1988">{{cite journal|last1=Pinamonti|first1=Bruno|last2=Alberti|first2=Ezip|last3=Cigalotto|first3=Alessandro|last4=Dreas|first4=Lorella|last5=Salvi|first5=Alessandro|last6=Silvestri|first6=Furio|last7=Camerini|first7=Fulvio|title=Echocardiographic findings in myocarditis|journal=The American Journal of Cardiology|volume=62|issue=4|year=1988|pages=285–291|issn=00029149|doi=10.1016/0002-9149(88)90226-3}}</ref><ref name="LiebermanHutchins1991">{{cite journal|last1=Lieberman|first1=Eric B.|last2=Hutchins|first2=Grover M.|last3=Herskowitz|first3=Ahvie|last4=Rose|first4=Noel R.|last5=Baughman|first5=Kenneth L.|title=Clinicopathoiogic description of myocarditis|journal=Journal of the American College of Cardiology|volume=18|issue=7|year=1991|pages=1617–1626|issn=07351097|doi=10.1016/0735-1097(91)90493-S}}</ref>
**[[Fulminant]] myocarditis
**[[Acute (medicine)|Acute]] myocarditis
**[[Chronic (medical)|Chronic]] active myocarditis
**[[Chronic]] persistent myocarditis
 
==Causative criteria==
 
*Myocarditis can be [[Classification|classified]] based on the [[Causes|causative]] [[criteria]] into [[Immune-mediated disease|immune-mediated]] myocarditis, [[infectious]] myocarditis and [[toxic]] myocarditis. bkjvskaljbkjbkjbakj
 
 
 
 
 
<br />{{familytree/start}}
{{familytree | | | | | | | | | | | | | | B01 | | | | | |B01=Immune-mediated myocarditis}}
{{familytree | | | | | |,|-|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|.| }}
{{familytree | | | | | |!| | | | | | | | |!| | | | | | | | |!| }}
{{familytree | | | | | C01 | | | | | | | C02 | | | | | | | C03 |C01=Allergens|C02=Alloantigens|C03=Autoantigens}}
{{familytree | | | | | |!| | | | | | | | |!| | | | | | | | |!| | | | | |}}
{{familytree | | |,|-|-|^|-|-|.| | | | | |!| | | | | |,|-|-|^|-|-|.| | |}}
{{familytree | | D01 | | | | D02 | | | | D03 | | | | D04 | | | | D05 | |D01=•Tetanus toxoid
 
•Vaccines
 
•Serum sickness|D02='''Drugs:'''
 
•Penicillin
 
•Cefaclor
 
•Colchicine
 
•Furosemide
 
•Isoniazid
 
•Lidocaine
 
•Tetracycline
 
•Sulfonamides
 
•Phenytoin
 
•Phenylbutazone
 
•Methyldopa
 
•Thiazide diuretics
 
•Amitriptyline|D03=Heart transplant rejection|D04=•Infection-negative lymphocytic
 
 
Infection-negative giant cell|D05='''Autoimmune disorders:'''
 
•SLE
 
•Rheumatoid arthritis
 
•Churg-Strauss syndrome
 
•Kawasaki's disease
 
•IBD
 
•Scleroderma 
 
•Polymyositis
 
•Myasthenia gravis
 
•DM type1
 
•Thyrotoxicosis
 
•Sarcoidosis
 
•Wegener's granulomatosis
 
•Rheumatic heart disease|}}
{{familytree/end}}
 
 
 
 
{{familytree/start}}
{{familytree | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | A01=Toxic myocarditis}}
{{familytree | | |,|-|-|-|-|-|v|-|-|-|-|-|+|-|-|-|-|-|v|-|-|-|-|-|.| | | | }}
{{familytree | | B10 | | | | B11 | | | | B12 | | | | B13 | | | | B14 | | |B10=Drugs|B11=Heavy metals|B12=Hormones|B13=Physical agents|B14=Miscellaneous}}
{{familytree | | |!| | | | | |!| | | | | |!| | | | | |!| | | | | |!| | | | }}
{{familytree | | C10 | | | | C11 | | | | C12 | | | | C13 | | | | C14 | | |C10=•Amphetamines
 
•Anthracyclines
 
•Cocaine
 
•Cyclophosphamide
 
•Ethanol
 
•Fluorouracil
 
•Lithium
 
•Catecholamines
 
•Hematine
 
•Interleukin-2
 
•Trastuzumab
 
•Clozapine|C11=•Copper
 
•Iron
 
•Lead|C12=•Phaeochromocytoma
 
 
•Beriberi|C13=•Radiation
 
 
•Electric shock|C14=•Scorpion sting
 
•Snake, and spider bites
 
•Bee and wasp stings
 
•Carbon monoxide
 
•Inhalant
 
•Phosphorus
 
•Arsenic
 
•Sodium azide}}
{{familytree/end}}
 
<br />{{familytree/start}}
{{familytree | | | | | | | | | | | | | | | | | B01 | | | | | | | | | | | | | | |B01=Infectious myocarditis}}
{{familytree | | |,|-|-|-|-|v|-|-|-|-|v|-|-|-|-|+|-|-|-|-|v|-|-|-|-|v|-|-|-|-|.| }}
{{familytree | | C01 | | | C02 | | | C03 | | | C04 | | | C05 | | | C06 | | | C07 | | |C01=Bacterial|C02=Spirochaetal|C03=Fungal|C04=Protozoal|C05=Parasitic|C06=Rickettsial|C07=Viral}}
{{familytree | | |!| | | | |!| | | | |!| | | | |!| | | | |!| | | | |!| | | | |!| | | }}
{{familytree | | D01 | | | D02 | | | D03 | | | D04 | | | D05 | | | D06 | | | D07 | ||D01=•Staphylococcus
 
•Streptococcus
 
•Pneumococcus
 
•Meningococcus
 
•Gonococcus
 
•Salmonella
 
•Corynebacterium diphtheriae
 
•Haemophilus influenzae
 
•Mycobacterium tuberculosis
 
•Mycoplasma pneumonia
 
•Brucella|D02=•Borrelia
 
•Leptospira|D03=•Aspergillus
 
•Actinomyces
 
•Blastomyces
 
•Candida
 
•Coccidioides
 
•Cryptococcus
 
•Histoplasma
 
•Mucormycosis
 
•Nocardia
 
•Sporothrix|D04=•Trypanosoma cruzi
 
•Toxoplasma gondii
 
•Entamoeba
 
•Leishmania|D05=•Trichinella spiralis
 
•Echinococcus granulosus
 
•Taenia solium|D06=•Coxiella burnetii
 
•R.rickettsii
 
•R.tsutsugamushi|D07=•Coxsackievirus
 
•Echoviruses
 
•Polioviruses
 
•Influenza A & B viruses
 
•RSV
 
•Mumps virus
 
•Measles virus
 
•Rubella virus
 
•Hepatitis C virus
 
•Dengue virus
 
•Yellow fever virus
 
•HIV-1
 
•Adenoviruses
 
•Paravirus B19
 
•Cytomegalovirus
 
•HSV-6
 
•EBV
 
•VZV
 
•HSV}}
{{familytree/end}}
 
==Histological criteria==
 
*Myocarditis can be [[Classification|classified]] based on the type of [[Infiltration (medical)|infiltrating]] [[Cells (biology)|cells]] in [[lymphocytic]], [[eosinophilic]], [[polymorphic]], [[giant cell]] myocarditis, and [[cardiac sarcoidosis]].
 
 
{{familytree/start}}
{{familytree | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | A01=Classification based on histological criteria}}
{{familytree | | |,|-|-|-|-|-|v|-|-|-|-|-|+|-|-|-|-|-|v|-|-|-|-|-|.| | | | }}
{{familytree | | B10 | | | | B11 | | | | B12 | | | | B13 | | | | B14 | | |B10=Lymphocytic|B11=Eosinophilic|B12=Polymorphic|B13=Giant cell|B14=Cardiac sarcoidosis}}
{{familytree/end}}<br />
 
==Clinicopathological criteria==
 
*'''Fulminant myocarditis:''' [[Fulminant]] myocarditis occurs following a [[viral]] [[prodrome]].  [[Fulminant]] myocarditis presents as [[acute]] severe [[cardiovascular]] compromise with [[ventricular dysfunction]]. On [[endomyocardial biopsy]], there are multiple foci of [[inflammation]].<ref name="pmid1960305">{{cite journal| author=Lieberman EB, Hutchins GM, Herskowitz A, Rose NR, Baughman KL| title=Clinicopathologic description of myocarditis. | journal=J Am Coll Cardiol | year= 1991 | volume= 18 | issue= 7 | pages= 1617-26 | pmid=1960305 | doi= | pmc= | url= }} </ref><ref name="pmid10706898">{{cite journal| author=McCarthy RE, Boehmer JP, Hruban RH, Hutchins GM, Kasper EK, Hare JM et al.| title=Long-term outcome of fulminant myocarditis as compared with acute (nonfulminant) myocarditis. | journal=N Engl J Med | year= 2000 | volume= 342 | issue= 10 | pages= 690-5 | pmid=10706898 | doi=10.1056/NEJM200003093421003 | pmc= | url= }} </ref>
 
*'''Acute myocarditis:''' [[Acute]] myocarditis presents with a less distinct onset of the [[illness]].  When the [[patient]] does present, there is already a decline in [[left ventricular dysfunction]]. [[Acute (medicine)|Acute]] myocarditis may progress to [[dilated cardiomyopathy]].
 
*'''Chronic active myocarditis:''' [[Chronic (medical)|Chronic]] active myocarditis has a less distinct onset of the [[illness]].  There are [[clinical]] and [[Histological|histologic]] [[Relapse|relapses]] and the [[development]] of [[ventricular dysfunction]].  [[Histologically]], [[Chronic (medicine)|chronic]] [[inflammatory]] changes with mild to moderate [[fibrosis]] may be [[Development (biology)|develop]] after 2 to 4 years.
 
*'''Chronic persistent myocarditis:''' [[Chronic (medical)|Chronic]] persistent myocarditis has a less distinct onset of the illness. [[Histologically]] it is [[Characterization (mathematics)|characterized]] by persistent [[Infiltration (medical)|infiltration]] and [[myocyte]] [[necrosis]].  Despite the presence of [[symptoms]], [[ventricular dysfunction]] is absent.<ref name="LiebermanHutchins1991">{{cite journal|last1=Lieberman|first1=Eric B.|last2=Hutchins|first2=Grover M.|last3=Herskowitz|first3=Ahvie|last4=Rose|first4=Noel R.|last5=Baughman|first5=Kenneth L.|title=Clinicopathoiogic description of myocarditis|journal=Journal of the American College of Cardiology|volume=18|issue=7|year=1991|pages=1617–1626|issn=07351097|doi=10.1016/0735-1097(91)90493-S}}</ref>
 
 
{{familytree/start}}
{{familytree | | | | | | | | | | | A01 | | | | | | | | | | | | | | | A01=Classification based on clinicopathological criteria}}
{{familytree | | |,|-|-|-|-|-|v|-|-|^|-|-|v|-|-|-|-|-|.| | | | }}
{{familytree | | B10 | | | | B11 | | | | B12 | | | | B13 | | |B10=Fulminant myocarditis|B11=Acute myocarditis|B12=Chronic active myocarditis|B13=Chronic persistent myocarditis}}
{{familytree/end}}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WS}}
{{WH}}


[[Category:Medicine]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]
[[Category:Emergency medicine]]
[[Category:Overview complete]]
[[Category:Intensive care medicine]]
 
{{WS}}
{{WH}}

Latest revision as of 13:33, 15 April 2021

Myocarditis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Adrenergic Myocarditis
Giant Cell Myocarditis

Causes

Differentiating Myocarditis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Myocarditis classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Google Images

American Roentgen Ray Society Images of Myocarditis classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Myocarditis classification

CDC on Myocarditis classification

Myocarditis classification in the news

Blogs on Myocarditis classification

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Myocarditis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S. Maliha Shakil, M.D. [2] Homa Najafi, M.D.[3]

Overview

Myocarditis can be classified based on the causative, histological, and clinicopathological criteria. Causative criteria include three main groups, as well as infectious, immune-mediated, and toxic myocarditis. Based on the type of infiltrating cells myocarditis divided in lymphocytic, eosinophilic, polymorphic, giant cell myocarditis, and cardiac sarcoidosis. Acute, fulminant, chronic active, and chronic persistent are subtypes of clinicopathopogical classification.


Classification

Causative criteria




 
 
 
 
 
 
 
 
 
 
 
 
 
Immune-mediated myocarditis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Allergens
 
 
 
 
 
 
Alloantigens
 
 
 
 
 
 
Autoantigens
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
•Tetanus toxoid

•Vaccines

•Serum sickness
 
 
 
Drugs:

•Penicillin

•Cefaclor

•Colchicine

•Furosemide

•Isoniazid

•Lidocaine

•Tetracycline

•Sulfonamides

•Phenytoin

•Phenylbutazone

•Methyldopa

•Thiazide diuretics

•Amitriptyline
 
 
 
Heart transplant rejection
 
 
 
•Infection-negative lymphocytic


Infection-negative giant cell
 
 
 
Autoimmune disorders:

•SLE

•Rheumatoid arthritis

•Churg-Strauss syndrome

•Kawasaki's disease

•IBD

•Scleroderma

•Polymyositis

•Myasthenia gravis

•DM type1

•Thyrotoxicosis

•Sarcoidosis

•Wegener's granulomatosis

•Rheumatic heart disease
 



 
 
 
 
 
 
 
 
 
 
 
 
 
Toxic myocarditis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Drugs
 
 
 
Heavy metals
 
 
 
Hormones
 
 
 
Physical agents
 
 
 
Miscellaneous
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
•Amphetamines

•Anthracyclines

•Cocaine

•Cyclophosphamide

•Ethanol

•Fluorouracil

•Lithium

•Catecholamines

•Hematine

•Interleukin-2

•Trastuzumab

•Clozapine
 
 
 
•Copper

•Iron

•Lead
 
 
 
•Phaeochromocytoma


•Beriberi
 
 
 
•Radiation


•Electric shock
 
 
 
•Scorpion sting

•Snake, and spider bites

•Bee and wasp stings

•Carbon monoxide

•Inhalant

•Phosphorus

•Arsenic

•Sodium azide
 
 


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Infectious myocarditis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Bacterial
 
 
Spirochaetal
 
 
Fungal
 
 
Protozoal
 
 
Parasitic
 
 
Rickettsial
 
 
Viral
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
•Staphylococcus

•Streptococcus

•Pneumococcus

•Meningococcus

•Gonococcus

•Salmonella

•Corynebacterium diphtheriae

•Haemophilus influenzae

•Mycobacterium tuberculosis

•Mycoplasma pneumonia

•Brucella
 
 
•Borrelia •Leptospira
 
 
•Aspergillus

•Actinomyces

•Blastomyces

•Candida

•Coccidioides

•Cryptococcus

•Histoplasma

•Mucormycosis

•Nocardia

•Sporothrix
 
 
•Trypanosoma cruzi

•Toxoplasma gondii

•Entamoeba

•Leishmania
 
 
•Trichinella spiralis

•Echinococcus granulosus

•Taenia solium
 
 
•Coxiella burnetii

•R.rickettsii

•R.tsutsugamushi
 
 
•Coxsackievirus

•Echoviruses

•Polioviruses

•Influenza A & B viruses

•RSV

•Mumps virus

•Measles virus

•Rubella virus

•Hepatitis C virus

•Dengue virus

•Yellow fever virus

•HIV-1

•Adenoviruses

•Paravirus B19

•Cytomegalovirus

•HSV-6

•EBV

•VZV

•HSV
 

Histological criteria


 
 
 
 
 
 
 
 
 
 
 
 
 
Classification based on histological criteria
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Lymphocytic
 
 
 
Eosinophilic
 
 
 
Polymorphic
 
 
 
Giant cell
 
 
 
Cardiac sarcoidosis
 
 


Clinicopathological criteria


 
 
 
 
 
 
 
 
 
 
Classification based on clinicopathological criteria
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fulminant myocarditis
 
 
 
Acute myocarditis
 
 
 
Chronic active myocarditis
 
 
 
Chronic persistent myocarditis
 
 

References

  1. ↑ "Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of Cardiomyopathies". Circulation. 93 (5): 841–842. 1996. doi:10.1161/01.CIR.93.5.841. ISSN 0009-7322.
  2. ↑ 2.0 2.1 Leone, Ornella; Veinot, John P.; Angelini, Annalisa; Baandrup, Ulrik T.; Basso, Cristina; Berry, Gerald; Bruneval, Patrick; Burke, Margaret; Butany, Jagdish; Calabrese, Fiorella; d'Amati, Giulia; Edwards, William D.; Fallon, John T.; Fishbein, Michael C.; Gallagher, Patrick J.; Halushka, Marc K.; McManus, Bruce; Pucci, Angela; Rodriguez, E. René; Saffitz, Jeffrey E.; Sheppard, Mary N.; Steenbergen, Charles; Stone, James R.; Tan, Carmela; Thiene, Gaetano; van der Wal, Allard C.; Winters, Gayle L. (2012). "2011 Consensus statement on endomyocardial biopsy from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology". Cardiovascular Pathology. 21 (4): 245–274. doi:10.1016/j.carpath.2011.10.001. ISSN 1054-8807.
  3. ↑ Kindermann, Ingrid; Barth, Christine; Mahfoud, Felix; Ukena, Christian; Lenski, Matthias; Yilmaz, Ali; Klingel, Karin; Kandolf, Reinhard; Sechtem, Udo; Cooper, Leslie T.; Böhm, Michael (2012). "Update on Myocarditis". Journal of the American College of Cardiology. 59 (9): 779–792. doi:10.1016/j.jacc.2011.09.074. ISSN 0735-1097.
  4. ↑ Sagar, Sandeep; Liu, Peter P; Cooper, Leslie T (2012). "Myocarditis". The Lancet. 379 (9817): 738–747. doi:10.1016/S0140-6736(11)60648-X. ISSN 0140-6736.
  5. ↑ Dennert, R.; Crijns, H. J.; Heymans, S. (2008). "Acute viral myocarditis". European Heart Journal. 29 (17): 2073–2082. doi:10.1093/eurheartj/ehn296. ISSN 0195-668X.
  6. ↑ Maron, Barry J.; Towbin, Jeffrey A.; Thiene, Gaetano; Antzelevitch, Charles; Corrado, Domenico; Arnett, Donna; Moss, Arthur J.; Seidman, Christine E.; Young, James B. (2006). "Contemporary Definitions and Classification of the Cardiomyopathies". Circulation. 113 (14): 1807–1816. doi:10.1161/CIRCULATIONAHA.106.174287. ISSN 0009-7322.
  7. ↑ Bock, Claus-Thomas; Klingel, Karin; Kandolf, Reinhard (2010). "Human Parvovirus B19–Associated Myocarditis". New England Journal of Medicine. 362 (13): 1248–1249. doi:10.1056/NEJMc0911362. ISSN 0028-4793.
  8. ↑ P. Liu, T. Martino, M. A. Opavsky & J. Penninger (1996). "Viral myocarditis: balance between viral infection and immune response". The Canadian journal of cardiology. 12 (10): 935–943. PMID 9191484. Unknown parameter |month= ignored (help)
  9. ↑ Cambridge, G; MacArthur, C G; Waterson, A P; Goodwin, J F; Oakley, C M (1979). "Antibodies to Coxsackie B viruses in congestive cardiomyopathy". Heart. 41 (6): 692–696. doi:10.1136/hrt.41.6.692. ISSN 1355-6037.
  10. ↑ H. T. Aretz, M. E. Billingham, W. D. Edwards, S. M. Factor, J. T. Fallon, J. J. Jr Fenoglio, E. G. Olsen & F. J. Schoen (1987). "Myocarditis. A histopathologic definition and classification". The American journal of cardiovascular pathology. 1 (1): 3–14. PMID 3455232. Unknown parameter |month= ignored (help)
  11. ↑ Gore, Ira; Saphir, Otto (1947). "Myocarditis". American Heart Journal. 34 (6): 827–830. doi:10.1016/0002-8703(47)90147-6. ISSN 0002-8703.
  12. ↑ Felker, G.Michael; Boehmer, John P; Hruban, Ralph H; Hutchins, Grover M; Kasper, Edward K; Baughman, Kenneth L; Hare, Joshua M (2000). "Echocardiographic findings in fulminant and acute myocarditis". Journal of the American College of Cardiology. 36 (1): 227–232. doi:10.1016/S0735-1097(00)00690-2. ISSN 0735-1097.
  13. ↑ Pinamonti, Bruno; Alberti, Ezip; Cigalotto, Alessandro; Dreas, Lorella; Salvi, Alessandro; Silvestri, Furio; Camerini, Fulvio (1988). "Echocardiographic findings in myocarditis". The American Journal of Cardiology. 62 (4): 285–291. doi:10.1016/0002-9149(88)90226-3. ISSN 0002-9149.
  14. ↑ 14.0 14.1 Lieberman, Eric B.; Hutchins, Grover M.; Herskowitz, Ahvie; Rose, Noel R.; Baughman, Kenneth L. (1991). "Clinicopathoiogic description of myocarditis". Journal of the American College of Cardiology. 18 (7): 1617–1626. doi:10.1016/0735-1097(91)90493-S. ISSN 0735-1097.
  15. ↑ Lieberman EB, Hutchins GM, Herskowitz A, Rose NR, Baughman KL (1991). "Clinicopathologic description of myocarditis". J Am Coll Cardiol. 18 (7): 1617–26. PMID 1960305.
  16. ↑ McCarthy RE, Boehmer JP, Hruban RH, Hutchins GM, Kasper EK, Hare JM; et al. (2000). "Long-term outcome of fulminant myocarditis as compared with acute (nonfulminant) myocarditis". N Engl J Med. 342 (10): 690–5. doi:10.1056/NEJM200003093421003. PMID 10706898.

Template:WS Template:WH

Retrieved from "https://www.wikidoc.org/index.php?title=Myocarditis_classification&oldid=1697384"