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    Myocarditis. Reply

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    To the Editor: In the review article on myocarditis by Basso (Oct. 20 issue),(1) the author recommends invasive coronary angiography for diagnostic workup in patients with suspected myocarditis in order to rule out underlying coronary artery disease (CAD).(1) Strong evidence suggests that noninvasive coronary computed tomographic angiography (CCTA) has similar diagnostic accuracy and is associated with a lower incidence of adverse events than invasive coronary angiography in patients with chronic coronary syndrome.(2) In fact, recent guidelines on the management of chest pain(3) and prevention of sudden cardiac death(4) recommend CCTA as a class I indication, which should be preferred over . .

    Myocarditis

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    According to the 1995 World Health Organization task force on cardiomyopathies, myocarditis is an inflammatory disease of the myocardium that is diagnosed on the basis of established histologic, immunologic, and immunohistochemical criteria. Since the introduction of the Dallas criteria in 1987, endomyocardial biopsy has been considered the standard method of diagnosis.Over the past two decades, however, the diagnostic workup has changed with the introduction of new tools, mainly highly sensitive troponin and cardiac magnetic resonance imaging (MRI)8,9; in routine clinical practice, a combination of symptoms and signs, laboratory testing, and imaging studies is often sufficient to establish the diagnosis
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