Diffuse ST elevation in a young male due to<unk>  and pericarditis Lymphocytic<unk>  (white arrow points to a lymphocyte), commonly showing myocyte necrosis (black arrow), seen as hypereosinophilic cytoplasm with loss of striations. Endomyocardial biopsy specimen with extensive eosinophilic infiltrate involving the endocardium and myocardium (hematoxylin and eosin stain)<unk>  refers to an underlying process that causes inflammation and injury of the heart. It does not refer to inflammation of the heart as a consequence of some other insult. Many secondary causes, such as a heart attack, can lead to inflammation of the myocardium and therefore the diagnosis of<unk>  cannot be made by evidence of inflammation of the myocardium alone. Myocardial inflammation can be suspected on the basis of electrocardiographic (ECG) results, elevated C-reactive protein (CRP) and/or erythrocyte sedimentation rate (ESR), and increased IgM (serology) against viruses known to affect the myocardium. Markers of myocardial damage (troponin or creatine kinase cardiac isoenzymes) are elevated. The ECG findings most commonly seen in<unk>  are diffuse T wave inversions; saddle-shaped ST-segment elevations may be present (these are also seen in pericarditis). The gold standard is the biopsy of the myocardium, in general done in the setting of angiography. A small tissue sample of the endocardium and myocardium is taken and investigated. The cause of the<unk>  can be only identified by a biopsy. Endomyocardial biopsy samples are assessed for histopathology (how the tissue looks like under the microscope): myocardial interstitium may show abundant edema and inflammatory infiltrate, rich in lymphocytes and macrophages. Focal destruction of myocytes explains the myocardial pump failure. In addition samples may be assessed with immunohistochemistry to determine which types of immune cells are involved in the reaction and how they are distributed. Furthermore, PCR and/or RT-PCR may be performed to identify particular viruses. Finally, further diagnostic methods like microRNA assays and gene-expression profile may be performed. Cardiac magnetic resonance imaging (cMRI or CMR) has been shown to be very useful in diagnosing<unk>  by visualizing markers for inflammation of the myocardium. Consensus criteria for the diagnosis of<unk>  by CMR were published in 2009. File:UOTW 7 - Ultrasound of the Week 1.Ultrasound showing cardiogenic shock due to<unk>  File:UOTW 7 - Ultrasound of the Week 2.Ultrasound showing cardiogenic shock due to<unk>  File:UOTW 7 - Ultrasound of the Week 3.Ultrasound showing cardiogenic shock due to<unk>
Myocarditis
Myocardial stunning
Carditis
Endocarditis
Myopericarditis
Constrictive pericarditis
Pericarditis
Myocardial infarction