The role of echocardiography in acute viral myocarditis.

The diagnosis of acute viral myocarditis can be very challenging during the initial evaluation, warranting multiple diagnostic tests to be performed, including a full echocardiographic evaluation to exclude other aetiologies that might present similarly. Acute myocarditis may masquerade as acute myocardial infarction in older patients or as any form of cardiomyopathy in young patients. As a result, all these patients need a thorough evaluation and to be managed at a high cardiac-care setting from the very outset. A wide range of diagnostic tests may be warranted, including conventional echocardiography, to exclude other underlying cardiac diseases, to evaluate cardiac chamber size, wall thickness, ventricular function and the presence of pericardial collections, and to assist in guiding further management. Although left ventricular dysfunction tends to be described more often, right ventricular dysfunction has been reported as the most likely cause of unfavourable outcomes, compared with left ventricular dysfunction. Therefore it is important to thoroughly evaluate and report all echocardiographic parameters for both ventricles and to determine the prognosis.