Med. praxi. 2025;22(5):366-370 | DOI: 10.36290/med.2025.044

Myocarditis in the differential diagnosis of dyspnea

MUDr. Petra Appeltauerová, MUDr. Julius Godava, MUDr. Hana Poloczková, Ph.D., MUDr. Karel Lábr, Ph.D., prof. MUDr. Jan Krejčí, Ph.D., FHFA

^I. interní kardioangiologická klinika Fakultní nemocnice u sv. Anny v Brně, Lékařská fakulta Masarykovy univerzity v Brně

Myocarditis is an inflammatory disease of the heart muscle that can have infectious (most commonly viral) or non-infectious origins, including autoimmune or toxic causes. The disease is characterized by a wide spectrum of clinical manifestations, ranging from a subclinical course to fulminant forms ending in acute heart failure or sudden cardiac death. Diagnosis requires a comprehensive approach, including history, laboratory tests, imaging, and in some cases, endomyocardial biopsy. Treatment depends on the severity of the course and may include targeted immunosuppression or antiviral therapy in addition to symptomatic therapy and treatment of heart failure. This text provides an overview of current knowledge on the etiology, diagnosis, and treatment of myocarditis. It highlights the risk factors in the patient's history, the symptoms with which patients often present to the general practitioner, and the investigative methods that are available in the general practitioner's office. A complementary clinical case report of a young patient with breathing difficulties highlights why it is necessary to think about this disease and refer the patient to a specialist department for investigation.

Keywords: shortness of breath, chest pain, myocarditis, inflammatory cardiomyopathy, dilated cardiomyopathy, heart failure, differential diagnosis, cMR (cardiac magnetic resonance), endomyocardial biopsy, viral infection.

Received: May 16, 2025; Accepted: May 19, 2025; Published: December 1, 2025  Show citation