Connecting the missing link between dilated cardiomyopathy and viral myocarditis: virus, cytoskeleton, and innate immunity.

Myocarditis classically refers to inflammation of the heart muscle. The mechanisms include host immune dysregulation and viral triggers such as coxsackievirus (CVB), adenovirus, parvovirus, and hepatitis C virus. The pathophysiology is initiated by viral proliferation in a susceptible host, inducing host immune response. The latter, when exuberant, leads to myocyte destruction and dilated cardiomyopathy.1,2 Clinically, patients with viral myocarditis will spontaneously recover in one third of cases, persist with the disease in one third, and deteriorate in another third of the cases.