Myocardial enzyme pentameter is an important basis for the diagnosis of myocarditis, but the definitive diagnosis of myocarditis needs to be based on a history of typical antecedent infections, corresponding clinical manifestations and signs, myocardial enzymology, and other evidence of myocardial injury. A variety of viruses can cause myocarditis. Coxsackie group B viruses are the most common cause of the disease, and other common viruses include microvirus B-19, poliovirus, orphan virus, and human herpesvirus type 6. The clinical manifestations of myocarditis depend on the extent and location of the lesions, ranging from complete absence of symptoms in mild cases to cardiogenic shock and sudden death in severe cases. The vast majority of clinically diagnosed viral myocarditis is characterized by arrhythmias as the main complaint or first symptom. The five cardiac enzymes include creatine kinase and creatine kinase isoenzymes, which can be elevated to varying degrees when there is myocardial injury or myocardial infarction, and can help in the diagnosis of heart disease. Serum troponin test can be used to determine the presence of myocardial injury. Elevated troponin suggests possible myocardial injury and is an important marker for acute myocarditis. Endocardial myocardial biopsy can be used to confirm the diagnosis of the disease, but because it is invasive, it is mainly used to examine patients with acute and severe disease, unknown causes, and poor response to treatment.