Of molecules and myocardium. PCR diagnosis of viral myocarditis in cardiac biopsies.

T he development of endomyocardial biopsy as a standard procedure has enabled cardiologists to obtain a direct histological diagnosis in a subset of cardiac disease states. In particular, right ventricular biopsy has become invaluable in the assessment of rejection after heart transplantation, in the tissue diagnosis of cardiac amyloidosis, and in the documentation of adriamycin cardiomyopathy. In each of these disease states, the diagnosis rests on the finding of pathognomonic histological features in small biopsies of ventricular tissue. Because many cardiac diseases do not produce specific changes, the usefulness of right ventricular biopsies has been rather restricted.1