Although it has been recognized for almost two centuries, myocarditis is still a challenging diagnosis due to the wide heterogeneity of its clinical manifestations and evolution. Moreover, the diagnostic gold standard, endomyocardial biopsy (EMB), is infrequently used, making hard to determine the exact incidence of myocarditis.

Clinical presentation includes a wide range of symptoms, ranging from asymptomatic or subclinical disease with mild dyspnea and chest pain to sudden death, due to cardiogenic shock or malignant ventricular arrhythmias. Equally, the evolution of myocarditis largely varies: albeit short-term prognosis is usually good, with complete or partial recovery, dilated cardiomyopathy with chronic heart failure is the major long-term consequence of myocarditis, developing often several years after the acute onset.

This narrative review aims to summarize the current knowledge about myocarditis, with a particular attention to predictors of short- and long-term prognosis, in order to provide a rational and practical approach to the diagnosis, evaluation and treatment of suspected myocarditis.

尽管它已经被认可了近两个世纪，但由于其临床表现和演变的广泛异质性，心肌炎仍然是一个具有挑战性的诊断。此外，诊断金标准，心内膜心肌活检 (EMB) 很少使用，因此很难确定心肌炎的确切发病率。

临床表现包括多种症状，从伴有轻度呼吸困难和胸痛的无症状或亚临床疾病到因心源性休克或恶性室性心律失常引起的猝死。同样，心肌炎的演变也大不相同：尽管短期预后通常良好，可完全或部分恢复，但扩张型心肌病伴慢性心力衰竭是心肌炎的主要长期后果，通常在急性发作后数年发展。

这篇叙述性综述旨在总结当前有关心肌炎的知识，特别关注短期和长期预后的预测因素，以便为疑似心肌炎的诊断、评估和治疗提供合理和实用的方法。