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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 4, July/August 2019
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AFRICA
there are no well-established echocardiographic criteria to predict
outcomes in patients with any form of myocarditis, it is a good
opportunity to develop new criteria to guide management and
for prognostic purposes in future. Despite this premise, systolic
and diastolic dysfunction, the presence of regional wall-motion
abnormalities, and changes in echocardiographic image texture
have previously been reported, which may be modified with
larger studies in the future. Echocardiography may further assist
with classification of myocarditis patients into clinically relevant
subgroups, with prognostic implications.
Conclusion
The presentation of acute myocarditis may masquerade as other
cardiac conditions, making the diagnosis even more challenging.
A wide range of diagnostic tests may be warranted when
initially evaluating patients with suspected acute myocarditis,
where conventional echocardiography could assist in excluding
other cardiac diseases. Conventional echocardiography could
be useful to evaluate cardiac chamber size and function, exclude
complications, and help guide further management in terms
of optimising heart failure and thromboprophylaxis therapies
accordingly.
New and advanced echocardiographic modalities, including
STE, should be considered for future daily clinical practice
for early detection of subclinical ventricular dysfunction, to
help develop criteria to predict outcomes, and for prognostic
purposes. Most clinicians are concerned with LV dysfunction,
however echocardiographic exclusion of RV dysfunction is
crucial because RV dysfunction in acute myocarditis is common
and predicts poorer outcomes and an increased need for cardiac
transplantation, compared with LV dysfunction.
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