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Endomyocardial Biopsy in Patients with Unexplained Congestive Heart Failure

Leon C. Chow, MD; Howard C. Dittrich, MD; and Ralph Shabetai, MD
[+] Article and Author Information

Grant Support: Partial support by grant PHSHL 07444 from the National Institutes of Health.

Requests for Reprints: Ralph Shabetai, MD, Cardiology 111-A, San Diego Veterans Administration Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161.

Current Author Addresses: Dr. Chow: Suite 712, 3838 California Street, San Francisco, CA 94118.

Dr. Dittrich: Cardiology H-811A, University of California San Diego Medical Center, 225 Dickinson, San Diego, CA 92103.

Dr. Shabetai: Cardiology 111-A, San Diego Veterans Administration Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161.


© 1988 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1988;109(7):535-539. doi:10.7326/0003-4819-109-7-535
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Study Objective: To determine the incidence of myocarditis proved by biopsy findings in patients presenting with unexplained congestive heart failure.

Design: Retrospective review.

Setting: General medical services of a Veterans Administration and university hospital.

Patients: Ninety consecutive patients presenting with unexplained congestive heart failure who had endomyocardial biopsy as a part of their diagnostic evaluation.

Measurements and Main Results: Classification of biopsy findings according to a recently proposed scheme for histologic diagnosis of myocarditis (Dallas criteria) showed myocarditis in only 4 of 90 (4.4%) patients (95% CI, 0.2 to 8.6), although two thirds of the patients had symptoms of congestive heart failure for less than 3 months.

Conclusions: The incidence of myocarditis proved by endomyocardial biopsy findings is low in patients presenting with unexplained congestive heart failure and raises questions concerning the need for this procedure in this patient group.

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