Diagnostic Testing for Suspected Myocarditis: the “Real World” Practice

Background: In the setting of clinically suspected myocarditis positive viral serology is of limited utility and routine testing is not recommended by current position statement of ESC Working Group on Myocardial Diseases. The usefulness of the testing for other infection agents and general immunologic testing are not clear.

Aim: To reveal “real world” practice in the searching for specific etiology and effect of this testing on therapy.

Methods: In 30 month period between 01/01/2013 and01/07/2015 twenty three patients with diagnosis of suspected myocarditis were hospitalized. Analysis of inflammatory and immunologic laboratory testing was performed.

Results: In 21 patient (90%) some kind of viral and/or specific bacterial testing was applied. 24 various viral serologic tests were performed and presence of 20 bacterial agents was assessed.

In 9 patients (40%) general immunologic panel was tested, specific testing for serum cardiac autoantibodies was not included.

In only 2 patients specific bacterial agent (zoonotic infection) were revealed and specific treatment was applied. It was no impact of viral serologic and all immunologic testing on therapeutic decisions.

Conclusion: In the settings of suspected acute myocarditis the search for inflammatory agents is of limited value, the implementation of routine immunologic testing is of limited value as well