Current role of endomyocardial biopsy in the management of dilated cardiomyopathy and myocarditis

Dilated cardiomyopathy is a common cause of congestive heart failure. Despi te a thorough cardiovascular evaluation, a specific cause is frequently not found, and the disorder then is considered idiopathic. Endomyocardial biop sy (EMB) may yield diagnostic and prognostic information in patients with i diopathic dilated cardiomyopathy; however, the yield of useful information with this procedure among patients with heart failure is low, and the risks of occasional cardiac perforation and death further limit its use. Recent publications in the field of myocarditis and cardiomyopathy have renewed in terest in the use of EMB in select patients to diagnose specific and potent ially treatable myocarditides; however, the role of EMB in the workup of pa tients with dilated cardiomyopathy is not well defined. In this article, we discuss the risks and utility of EMB in the management of patients with di lated cardiomyopathy and specific myocarditides.