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

J.T. Lie, MD
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Mayo Clinic and Mayo Medical School, Rochester, Minnesota

Ann Intern Med. 1988;109(7):525-528. doi:10.7326/0003-4819-109-7-525
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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


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