Asian Journal of Medical Principles and Clinical Practice

Background: Inflammatory cardiomyopathy, characterized by infiltration of inflammatory cells in the myocardium and an increased risk of heart failure, has a variety of etiologies. Inflammatory cardiomyopathy is strongly associated with viral infections, but it can also be caused by bacterial, protozoal, or fungal infections, as well as a variety of drug-related toxic and immunological diseases. Despite extensive research, complex inflammatory cardiomyopathy due to left ventricular dysfunction, heart failure, or arrhythmias has a poor prognosis. Currently, the reason is not clear why some patients recover without residual myocardial injury while others develop cardiomyopathy. The respective roles of pathogens, host genomics, and environmental factors in disease progression and treatment, in which viruses are active and can only be observed, are still being discussed. As a result, treatment strategies are not well established. In this review, we summarize and evaluate the available evidence for the pathogenesis, diagnosis, and treatment of myocarditis and inflammatory cardiomyopathy, with a specific focus on viral and viral myocarditis. In addition, we identify information spaces, analyze available test models, and suggest future field directions. Current information and open questions on the cardiovascular effects associated with severe respiratory coronavirus 2 (SARS-CoV-2) infection are also discussed. This review is the result of a scientific collaboration between members of the Heart Failure Association of ESC, the Heart Failure Society of America, and the Japanese Heart Failure Society.

Conclusion: Myocarditis is always a challenging condition to diagnose and control. Its contribution to lifelong illness and death is significant.