Viral myocarditis—diagnosis, treatment options, and current controversies

Key Points Myocarditis is a frequent cause of dilated cardiomyopathy with heterogeneous clinical presentations and a wide range of clinical outcomes After infection by a cardiotropic virus, a maladaptive post-viral response ensues, which can cause myocardial cell dysfunction and compromised contractility Advances in our diagnostic capabilities using cardiac MRI as well as molecular detection of viruses by endomyocardial biopsy have improved our understanding and ability to characterize the disease Although comprehensive clinical recommendations specific to the treatment of myocarditis do not exist, modulation of the immune system is a promising therapeutic strategy as suggested by several randomized trials