Myocarditis and Endomyocardial Biopsy in Unexplained Heart Failure: A Diagnosis in Search of a Disease

Excerpt

Sakakibara and Konno in 1962 (1) and 1963 (2) first described a safe technique for transvascular, closed chest, right and left ventricular endomyocardial biopsy. Ten years later Caves and associates (3-5) adopted the technique as a useful diagnostic tool for the management of cardiac allograft rejection. In less than a decade, the role of endomyocardial biopsy has been expanded to include the diagnosis of doxorubicin cardiotoxicity, primary and secondary myocardial diseases, and myocarditis (6).

Despite endorsements by some investigators (6-8), the diagnostic yield of endomyocardial biopsy for myocarditis in patients with unexplained heart failure appears to be as predictable as