Endomyocardial Biopsy

Excerpt

The role and utility of endomyocardial biopsy (EMB) in the work-up of cardiovascular diseases remains controversial, and the practice varies widely in different centers. EMB is a diagnostic modality used to evaluate various cardiac diseases in which non-invasive testing is usually not able to formulate a clinical diagnosis. Performing a biopsy is not without complications, and less invasive diagnostic procedures such as cardiac magnetic resonance imaging (MRI) or positron emission tomography (PET) scans outcompete EMB for certain indications. However, there do exist certain conditions and scenarios in which doing an EMB is helpful in establishing the diagnosis when no other diagnostic test yields a substantial diagnosis. As with every diagnostic modality, the EMB procedure has unique characteristics in terms of sensitivity, specificity, and predictive values for different diseases. EMB is a multistep process consisting of deciding about indication, biopsy taking, sample handling, and interpretation. Apart from its clinical use, EMB also serves research purposes.