Myocarditis: A Clinical and Pathologic Study of Forty-five Cases

¹ The Cardiovascular Section, Department of Internal Medicine and Department of Pathology, Marquette University School of Medicine and the Veterans Administration Hospital, Wood, Wisconsin.

1. A series of 45 cases of myocarditis is presented as a clinical and pathological study.

2. A classification of myocarditis based on the clinical course, which is substantiated by pathological findings, is presented.

3. Multiplicity of etiology is discussed. In most instances, myocarditis occurs as a cardiac complication of another illness.

4. Congestive heart failure is the most common symptom complex.

5. Non-specific T-wave changes, frequently reversible, form the usual electrocardiographic findings.

6. Globose cardiac enlargement with reduced muscular excursion, also reversible in some instances, is the typical fluoroscopic cardiac contour.

7. The differential diagnosis, particularly in reference to pericarditis, rheumatic heart disease and coronary heart disease is discussed.

8. Conditions described by others as idiopathic cardiac hypertrophy, subintimal fibrosis, and nutritional heart disease may be considered to be variants of myocarditis.

9. Treatment at present consists of the management of the underlying etiological disease, bed rest, and supportive cardiac measures.

10. Clinical awareness of this entity will lead to a greater incidence of recognition and perhaps towards more effective therapeutic management.