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We aimed to focus on the possible diagnostic workup for this condition in settings where endomyocardial biopsy as a gold standard is not always feasible, detect the etiologic cardiotropic viruses in our locality, and follow the clinical course in patients admitted with clinically suspected myocarditis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective observational study. We recruited patients with clinically suspected myocarditis presenting at a university hospital from October 1st, 2020 until March 31st, 2021. All Patients had a diagnostic coronary angiography and were included only if they had a non-obstructive coronary artery disease. All patients also had cardiac magnetic resonance imaging (CMR) with contrast. Sera were obtained from all suspected patients for detection of antibodies against viruses using enzyme-linked immunosorbent assay, and viral genomes using polymerase chain reaction (PCR), and reverse transcription\u2013PCR. Endomyocardial biopsy was done for patients with a typical CMR picture of myocarditis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 2163 patients presenting to the hospital within the 6\u00a0months, only 51 met the inclusion criteria. Males represented 73%, with a mean age of 39\u2009\u00b1\u200916\u00a0years. CMR showed an ischemic pattern in 4 patients and thus they were excluded. We classified patients into two categories based on CMR results: group A (CMR-positive myocarditis), 12 patients (25.5%), and group B (CMR-negative myocarditis), 35 (74.5%) patients. On serological analysis, 66% of patients (n\u2009=\u200931\/47) showed antibodies against the common cardiotropic viruses. Parvovirus B19 IgM in 22 patients (47%) and coxsackievirus IgM in 16 (34%) were the most observed etiologies. Regarding the outcome, 42.5% of patients recovered left ventricular ejection fraction and three patients died at 6\u00a0months\u2019 clinical follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with Clinically suspected myocarditis represented 2.2% of total hospital admissions in 6\u00a0months. CMR is only a good positive test for the diagnosis of acute myocarditis. Parvovirus B19 and coxsackievirus were the most common pathogens in our locality.<\/jats:p><jats:p><jats:italic>Trial registration<\/jats:italic>: Clinical trial registration no., NCT04312490; first registration: 18\/03\/2020. First recruited case 01\/10\/2020. URL:<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/register.clinicaltrials.gov\/prs\/app\/action\/SelectProtocol?sid=S0009O3D&amp;selectaction=Edit&amp;uid=U0002DVP&amp;ts=2&amp;cx=9zdfin\">https:\/\/register.clinicaltrials.gov\/prs\/app\/action\/SelectProtocol?sid=S0009O3D&amp;selectaction=Edit&amp;uid=U0002DVP&amp;ts=2&amp;cx=9zdfin<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12872-022-02833-0","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T06:02:43Z","timestamp":1662444163000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical course, viral etiology, and the diagnostic workup for patients with suspected myocarditis: a single-center prospective study"],"prefix":"10.1186","volume":"22","clinical-trial-number":[{"clinical-trial-number":"nct04312490","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Shimaa S.","family":"Khidr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ahmed","family":"El-Mokhtar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shery Refaat","family":"Asaad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helal F.","family":"Hetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona Hussein","family":"Abdel-Rahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr Ahmed Aly","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman K. 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