Myokarditis

Zusammenfassung

Die Myokarditis ist eine entzündliche Herzmuskelerkrankung, die durch Infektionserreger, am häufigsten Viren, Medikamente und toxische Substanzen, sowie im Rahmen von Autoimmunerkrankungen auftreten kann. Die Diagnose einer Myokarditis basiert auf klinischen und nicht invasiven Methoden (EKG, Echokardiografie, kardiale Magnetresonanztomografie), wobei der Goldstandard weiterhin die Endomyokardbiopsie darstellt. Spezifische Behandlungsstrategien sollten deshalb nur auf dem Boden einer standardisierten Biopsiediagnostik einschließlich histologischer, immunhistochemischer und immunhistologischer Analysen und nicht aufgrund rein klinischer Untersuchungsergebnisse durchgeführt werden. Die frühzeitige Diagnosestellung einer Myokarditis ist entscheidend, da ein positiver Behandlungserfolg nur dann eintreten kann, wenn im Myokard noch ein regeneratives Potenzial vorliegt. Fortgeschrittene irreversible Myokardschädigungen führen zur Entwicklung und Progression einer Herzinsuffizienz.

Abstract

Myocarditis is an inflammatory disease of the myocardium, which can be caused by infections, most commonly of viral origin, drugs and toxins as well as in the context of autoimmune disorders. Diagnosis is based on clinical presentation and non-invasive tests (ECG, echocardiography, cardiovascular magnetic resonance imaging), however endomyocardial biopsy still remains the gold standard. A specific etiology-directed therapy should be initiated only after standardized biopsy diagnosis including histological, immunohistochemical and immunohistological analysis and not only based on clinical aspects. Early recognition of myocarditis is imperative, as positive therapy effects can only be expected, if there is myocardium with regenerative capacity. Advanced stages of myocarditis with irreversible myocardial damage will progress to heart failure.

Schlüsselwörter

Myokarditis - Endomyokardbiopsie - EKG - Magnetresonanztomografie - Therapie

Key words

myocarditis - endomyocardial biopsy - electrocardiogram - cardiovascular magnetic resonance - therapy

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