Myocarditis: Etiology, Pathogenesis, and Their Implications in Clinical Practice

SIMPLE SUMMARY: Myocarditis is an inflammatory disease of the myocardium which can lead to serious short-term and long-term sequalae such as sudden cardiac death or dilated cardiomyopathy. It is caused by infectious and non-infectious factors; however, our understanding of processes that govern its pathogenesis is limited. The aim of this review is to summarize available evidence regarding the etiology and pathogenesis of myocarditis, as well as to outline the impact that they have on disease course and patient management. ABSTRACT: Myocarditis is an inflammatory disease of the myocardium caused by infectious or non-infectious agents. It can lead to serious short-term and long-term sequalae, such as sudden cardiac death or dilated cardiomyopathy. Due to its heterogenous clinical presentation and disease course, challenging diagnosis and limited evidence for prognostic stratification, myocarditis poses a great challenge to clinicians. As it stands, the pathogenesis and etiology of myocarditis is only partially understood. Moreover, the impact of certain clinical features on risk assessment, patient outcomes and treatment options is not entirely clear. Such data, however, are essential in order to personalize patient care and implement novel therapeutic strategies. In this review, we discuss the possible etiologies of myocarditis, outline the key processes governing its pathogenesis and summarize best available evidence regarding patient outcomes and state-of-the-art therapeutic approaches.