Myocarditis is a type of disease that results in acute, subacute or chronic inflammatory changes in myocardial tissue due to various physicochemical, biological and immunological factors, which can involve the local myocardium or cause diffuse damage to the myocardium. The clinical manifestations vary widely, from asymptomatic to heart failure or severe arrhythmias, and even sudden death, depending on the extent of injury and the impact on cardiac function. As can be seen, myocarditis is a group of diseases with different etiologies, different degrees of urgency, different manifestations, and different prognoses, and should be treated differently. Because of the poor specificity of each of these indicators for the diagnosis of myocarditis, the clinical chaos of a generalized and missed diagnosis of myocarditis is often seen. On the one hand, theoretically, any cold or pneumonia may involve the myocardium, resulting in a much higher incidence of myocarditis than is actually diagnosed (underdiagnosis); on the other hand, clinical studies have found that the diagnosis of myocarditis according to the above non-specific indicators is often overdiagnosed, resulting in a “hat” of myocarditis. The “hats” of myocarditis fly all over the place and the “sticks” are beaten everywhere. The phenomenon of overdiagnosis of myocarditis is commonly seen in the following situations: 1. Misdiagnosis of cardiac neuropathy as myocarditis Most often seen in young and middle-aged women or menopausal women. Often complain of palpitations, weakness, dizziness, poor sleep, muscle throbbing, dyspnea, etc. Other somatic complaints such as insomnia may also be present. The physical examination is mostly normal, or there are signs unrelated to the heart, and often the patient is found to be emotionally unstable, agitated, hypersensitive, or with a dramatic clinical presentation. 2. Mistaking ECG ST-segment (T-wave) changes for myocarditis ECG ST-segment (T-wave) changes are very common in clinical practice, and there are nearly 100 different causes of ECG ST-T changes, which cannot be used to diagnose or exclude myocarditis. Common causes of ST-wave changes include: coronary artery disease, cardiomyopathy, valvular disease, pericardial disease, hypertension, cardiac hypertrophy or enlargement, heart block, cardiac insufficiency, tachycardia, acute or chronic pulmonary hypertension, and pulmonary heart disease. Non-cardiac causes include blood ion disorders (potassium, calcium, etc.), intracranial hypertension, cerebral hemorrhage (subarachnoid hemorrhage), cerebral thrombosis, gallbladder or pancreatic disease, etc. Patients with cardiac neuropathy may also have ST-segment shifts, or T-wave changes, associated with sympathetic excitation, which can disappear after taking aspirin. In addition, certain infectious diseases, due to the direct effect of bacterial or viral toxins, can also cause transient ST-segment (T-wave) changes, and even lead to increased cardiac enzymes (troponin). 3, attribute CK-MB increase to myocarditis CK-MB increase can be seen in addition to myocardial injury (necrosis), but also due to other physiological and pathological conditions such as skeletal muscle, brain and kidney organ damage: such as heavy exercise, skeletal muscle trauma, inflammation, viral infection, urinary toxicity, and brain tissue damage (necrosis) diseases such as encephalitis and cerebral infarction. The normal reference value of myocardial enzyme spectrum is mostly the adult standard, while the majority of children’s myocardial enzyme spectrum is 2-3 times the normal reference value, that is, the normal reference value of pediatric myocardial enzyme is higher than that of adults, so do not think that children with an increased value of myocardial enzyme spectrum are suffering from myocarditis, because there are more factors affecting the CK-MB enzyme spectrum, the clinical use of the determination of cardiac troponin is often The CK-MB enzymes are often used to assist in the diagnosis of myocardial injury (necrosis). 4. Misdiagnosis of benign premature cardiac beats as myocarditis Premature cardiac beats are very common in normal people, and clinically, except for premature beats, often various tests cannot detect cardiac abnormalities, and the clinical prognosis is also good. However, premature heart beats can also be seen in a variety of heart diseases. Therefore, once premature heart beats are detected, it is still advisable to visit a hospital and have the appropriate tests done to exclude organic heart diseases. In addition, premature heart beats are also commonly seen in patients with mitral valve prolapse, which is often associated with sympathetic excitation and clinical manifestations of neurosis; left ventricular pseudo-key cords will also often cause premature beats. Both of these conditions can be diagnosed by echocardiography.