ULTRASTRUCTURAL ASPECT OF MYOCARDITIS - ITS RELEVANCE FOR THE DIAGNOSIS

The Dallas consensus was used to reveal active or borderline inflammat ory loci by light microscopy (LM). When lymphocyte-cardiocyte interact ion was observed by electron microscopy (EM), the deleterious or dorma nt pattern of inflammatory process was recognized. The first was deter mined by lymphocytes that adhered to cardiocytes, next to necrotic car diocytes or admired with debris. The second was marked by scattered ly mphocytes between preserved cardiocytes and the absence of lymphocytes adhered to cardiocytes and necrotic cardiocytes. The deleterious patt ern of the inflammatory process (EM) commonly supplemented the active appearance of inflammatory loci (LM). In contrast, the borderline outl ook of the LM completed either the deleterious or dormant pattern of t he EM. This discrepancy was related to the restricted resolution of LM , which might hide the actual stage of the disease. The diagnosis of m yocarditis was founded on mutual LM and EM observations. The active or borderline appearance of LM of the deleterious pattern (EM) was consi dered indicative for the active stage of myocarditis. The borderline o utlook of the LM of the dormant pattern of the EM was admitted to indi cate either the healing phase of the disease with lymphocytes still la gging behind, or a latent phase of the ongoing myocarditis, according to the patient's hemodynamic status.