Epidemiological Impact of Myocarditis

Abstract

Myocarditis is an inflammatory disease of the heart muscle with a wide range of potential etiological factors and consequently varying clinical patterns across the world. In this review, we address the epidemiology of myocarditis. Myocarditis was considered a rare disease until intensified research efforts in recent decades revealed its true epidemiological importance. While it remains a challenge to determine the true prevalence of myocarditis, studies are underway to obtain better approximations of the proportions of this disease. Nowadays, the prevalence of myocarditis has been reported from 10.2 to 105.6 per 100,000 worldwide, and its annual occurrence is estimated at about 1.8 million cases. This wide range of reported cases reflects the uncertainty surrounding the true prevalence and a potential underdiagnosis of this disease. Since myocarditis continues to be a significant public health issue, particularly in young adults in whom myocarditis is among the most common causes of sudden cardiac death, improved diagnostic and therapeutic procedures are necessary. This manuscript aims to summarize the current knowledge on the epidemiology of myocarditis, new diagnostic approaches and the current epidemiological impact of the COVID-19 pandemic.

Keywords: diagnosis; epidemiology; etiology; incidence and prevalence; myocarditis; myocarditis associated with COVID-19; regional differences.

Figure 1

Age-standardized prevalence of myocarditis in 2017.

Figure 2

Histology and immunohistochemistry of a patient with giant cell myocarditis. Images show a lesion of giant cell myocarditis (magnification 4×–40×). Masson’s trichrome staining (panels 1–4), arrows point out a giant cell and cells in the process of forming a giant cell.