"In addition to the temporal definition, there is a pathological one, which characterises the condition histologically as an inflammatory infiltrate of the myocardium with myocardial fibrosis and distinguishes the term between the usual chronic or chronic persistent form and chronic active myocarditis by the presence of cardiomyocyte injury or necrosis in one part of the world 1,2. The first form, chronic myocarditis, is also seen as a transitional stage between acute myocarditis and chronic inflammatory cardiomyopathy 1,2."
"Native T1 and ECV may indicate myocardial oedema, myocardial injury and myocardial fibrosis and may be elevated in the setting of suspected chronic myocarditis 4,9,23-25 but are less specific than LGE 4."
Expected headings
"Associations"
"MRI"
"A setting with evidence of cardiomyocyte injury, necrosis or cell degeneration associated with an infiltration of inflammatory cells at the cardiomyocyte circumference in the myocardium indicates chronic active myocarditis as per the 2023 JCS guidelines 2."
"presence, pattern and distribution of late gadolinium enhancement"
"Prognosis is variable and not good in patients with associated dilative cardiomyopathy 5. It is closely related to left ventricular function, the presence, extent and location of myocardial injury depicted by late gadolinium enhancement, as well as the presence or absence of myocardial oedema 14-17."
"There are no standardised treatment strategies for chronic myocarditis, and management usually is supportive with symptomatic treatment of heart failure if present 18 and anti-inflammatory treatment of concomitant extracardiac inflammatory disease if present 1,5. Immunomodulatory therapy in addition to conventional therapy has some effect according to a systematic review 5."
"History and etymology"