Can Myocarditis and Dilated Cardiomyopathy be Differentiated from Each Other in Pediatric Patients?

Dilated (congestive) cardiomyopathy (DCM) and myocarditis are conditions that cannot be differentiated on clinical grounds. Most patients consult physicians with symptoms related to congestive heart failure and dysrythmias. In an important number of DCM patients, the etiologic factor is myocarditis. Most patients with myocarditis are cured but approximately 12 % of them develop chronic cardiomyopathy; so patients with myocarditis must be followed-up closely in respect to myocardial dysfunction. The noninvasive diagnostic methods used for the differential diagnosis of myocarditis and DCM are similar in both conditions. The definite diagnosis of myocarditis is reached by endomyocardial biopsy, but in DCM which has a heterogenous etiology, myocardial lesions are variable. There are false positive and negative results in endomyocardial biopsy in both conditions. This article discusses differential diagnosis of myocarditis and dilated cardiomyopathy in the light of current literature.