Diagnostic strategies for viral myocarditis

Clinical manifestations, symptoms and laboratory test results of earlystage viral myocarditis (VMC) are lack of specificity; thus, accurate diagnoses are often difficult. The unified international standards for the diagnosis of VMC are not yet available. Overcautious diagnoses of VMC are hard to avoid and therapeutic delay caused by missed diagnoses is common. Using a literature review and summary of clinical research, we propose the following diagnostic strategies. Clinical diagnosis: diagnostic criteria of 1999 should be strictly followed and diagnoses should be made based on a comprehensive analysis of clinical data and exclusion of other myocardial diseases. Suspected diagnosis: screening examinations of magnetic resonance imaging (MRI) and antimyocardial antibody tests should be performed as supplements to the findings from the medical history, clinical manifestations and laboratory examinations so as to avoid missed or wrong diagnoses of atypical VMC. Etiological diagnosis: myocardial biopsy should be performed with caution and analysis of cardiac troponin could be conducted.