The diagnosis of myocarditis is usually a diagnosis of exclusion because there are many causes of heart failure. Definite diagnosis of viral myocarditis can only be made with biopsy of the heart muscle, which is a high-risk test. However, there are usually some ECG and blood test abnormalities showing signs of heart muscle damage, while ultrasound of the heart (echocardiography) may show a dilated and weakened heart. Antibodies to the virus may be high in patients with viral myocarditis and can be detected in the blood after a few weeks.
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