Myocarditis in 2025: ESC Guidelines advance the field and highlight the opportunity for evidence to follow
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Authors
ShyamSundar V.
Slabaugh G.
Petersen S.E.
Aung N.
Mohiddin S.A.
Khanji,M. Y.
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2025
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Abstract
The 2025 European Society of Cardiology (ESC) Guidelines on inflammatory myopericardial syndromes (IMPS) are a landmark moment for myocarditis, delivering the first comprehensive, standalone guideline for this condition from the ESC. For practicing clinicians, the document finally offers structured diagnostic and management algorithms with graded recommendations spanning imaging, endomyocardial biopsy (EMB), arrhythmia prevention, and disease-specific therapies. However, when set against the backdrop of our recent systematic review of acute myocarditis guidelines, it is evident that recommendations are predominantly based on expert consensus opinion rather than data from randomized clinical trials or meta-analyses. The ESC 2025 guidelines address many of the issues highlighted in our systematic review. Also, the guidelines and our systematic review also converge on key knowledge gaps.
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European heart journal - Quality of care & clinical outcomes