New ESC instructions introduce a consolidated approach to improve myocarditis and pericarditis

The new guidelines for improving the diagnosis and care of patients with myocarditis and pericarditis have been published today in Congress ESC 2025. This is the first time that ESC has published myocarditis guidelines and myocarditis and myocarditis.

The guidelines give algorithms and easy -to -use flow charts to support medical professionals to better identify, diagnose and cure myocarditis and pericarditis to improve clinical results. They also give personalized recommendations for returning to work and exercise.

The new guidance notes the possible coating between myocarditis and pericarditis and introduces the term “inflammatory myopic syndrome” (IMPS) to be used as a diagnosis of umbrella until a more specific diagnosis. The new term will help increase the consciousness of the spectrum of the disease and allow early diagnosis and better management to improve patients’ results.

The new ESC Guidelines have been produced by an international team of experts including co-presents, Professor Jeanette Schulz-Menger, Charité-Universitätsmedizin Berlin, a member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, ECRCRCRC Experimental and Clinical Research Center, Berlin and Dzhk Deutsches Herzzentrum der Charité – Center for Medical Heart and Cardiology and Nephrology, Helios Berlin -Buch, Berlin, Germany and Professor Massimo Imazio, Head of Cardiac Hospital Maria della Misericordia “, Udine, Italy.

Myocarditis and pericarditis can be difficult to identify as they can develop differently in different patients. Consequently, these conditions have often been diagnosed, which can have a very significant impact on patient health. ”

Professor Jeanette Schulz -Menger, Charité – Universitätsmedizin Berlin

“To improve the diagnosis we have introduced a unifying condition, inflammatory myopereal syndrome and we give new instructions on diagnosis and treatment for clinical doctors.” Professor Schulz-Menger added.

Myocarditis and pericarditis are inflammatory diseases of the myocardial or heart muscle and pericardium, the fibrous sac that surrounds the heart and large blood vessels. Their causes vary and can include genetic sensitivity and infectious diseases. Many patients will fully recover from these diseases, while others may need lifelong monitoring and treatment. Myocarditis is considered to play a role in some cases of sudden heart death in some patients.

The important role of the multi -transport imaging, which focuses on advanced methods of depicting cardiac magnetic resonance and the role of clinical cardiologists was also discussed to guide clinical cardiologists.

Having been diagnosed with myocarditis or pericarditis, patients will often be called upon to avoid daily activities. The new guidance is when additional tests, such as depicting heart magnetic resonance, can help evaluate it if it is advisable to return to exercise and work. This can help recover and support mental health.

While there was an increase in medical knowledge about inflammatory myoppereal syndrome, guidelines also highlight significant elements. They determine the need for further large -scale polycentric tests with predetermined outcome measures. The new study is particularly essential to understand the best way to deal with chronic diseases and specific patient groups, such as children, children of childbirth, pregnant women and those who are breastfeeding and the elderly.

“We hope that this valuable new guidance will allow for a displacement for the care of patients that allow the development of combined expertise in the diagnosis and treatment of myocarditis and pericarditis.

“We also hope that these recommendations will help patients return to their normal lives, including initial exercise and return to work, faster, this will improve their quality of life, can accelerate their recovery, as well as reduce weak days in the workplace.” Professor Imazio added. “We also hope that the gaps of evidence we have identified can be treated urgently by the research community and the funders.”

The new ESC instructions also:

• Give a list of red flags for clinical doctors, including clinical points and/or biomarkers, which may be indications of detecting myocarditis and pericarditis that improve time in diagnosis

• Suggest a complete clinical evaluation, including medical history, physical examination, X -rays, biomarker tests, electrocardiographer and echocardiographer, for initial diagnostic evaluation for all patients who are suspected of having myocarditis

• Ask to be considered a genetic cause and genetic tests for patients with repeated inflammatory myopereal syndrome

• Suggest that complex patients with inflammatory myoppereid syndrome manage a multi -scientific group. The group should consist of different clinical doctors, all with experience in cardiovascular disease, such as clinicians, imaging experts, infectious diseases, surgeons, intensive care experts and geneticists

Data on the prevalence of myocarditis and pericarditis throughout the general population is limited. A register of diseases reported a frequency of acute myocarditis from 6.3 to 8.6 per 100,000 inhabitants, mainly in young men for hormonal agents. Men and younger patients are more likely to be diagnosed, although it is not clear whether these patients are more likely to diagnose. The incidence of acute pericarditis is estimated to be about 3 to 32 cases per 100,000 years. For sudden heart death in young adults, autopsies have shown cases of myocarditis in myocarditis in 1.1 to 12% of cases.

The guidelines “2025 ESC for the management of myocarditis and pericarditis” have been approved by the Union for European Pediatrics and Cardiology and the European Union of Cardio-Thomatic Surgery.