Myocarditis in the Modern Era: Navigating Diagnosis, Innovative Treatments, the COVID-19 Challenge and the Role of Artificial Intelligence.

Abstract

Myocarditis is an inflammatory disease of the myocardium with diverse aetiologies, ranging from infections and autoimmune processes to drug-induced reactions. Clinical manifestations vary widely from mild chest discomfort to life-threatening complications such as acute heart failure, cardiogenic shock and sudden cardiac death. Although the diagnosis of myocarditis historically relied heavily on invasive biopsy, recent advances in noninvasive imaging modalities, notably cardiac magnetic resonance (CMR) imaging, have transformed clinical practice. The Lake Louise Criteria (LLC), supplemented by parametric imaging techniques, have significantly enhanced diagnostic accuracy. Furthermore, the emergence of COVID-19 has renewed interest in myocarditis due to its association with viral-induced myocardial injury. This review synthesises the current understanding of myocarditis, including epidemiological insights, its diverse aetiologies, diagnostic innovations including the importance of viral load quantification and contemporary management strategies.