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Current Cardiology Reports

Hot Phases Cardiomyopathy: Pathophysiology, Diagnostic Challenges, and Emerging Therapies

  • Open Access
  • 01-12-2025
  • Cardiomyopathy
  • Myocardial Disease (A Abbate and M Merlo, Section Editors)
Published in:
Authors
Giulia Bassetto
Federico Angriman
Carola Pio Loco detto Gava
Alessia Paldino
Maria Perotto
Luca Bordignon
Marta Gigli
Matteo Dal Ferro
Laura Massa
Alessandro Altinier
Antonio De Luca
Gianfranco Sinagra
Marco Merlo
Published in
Current Cardiology Reports | Issue 1/2025

Abstract

Purpose of Review

Hot phases are a challenging clinical presentation in arrhythmogenic cardiomyopathy (ACM), marked by acute chest pain and elevated cardiac troponins in the absence of obstructive coronary disease. These episodes manifest as myocarditis and primarily affect young patients, contributing to a heightened risk of life-threatening arrhythmias and potential disease progression. This review aims to synthesize recent research on the pathophysiology, diagnostic challenges, and therapeutic management of hot phases in ACM.

Recent Findings

Hot phases have been linked to genetic mutations, particularly in desmosomal proteins such as Desmoplakin (DSP). Diagnostic challenges include differentiating hot phases from isolated acute myocarditis, through identification of red flags and a multimodal approach, including CMR, FDG-PET, endomyocardial biopsy and genetic testing. Emerging therapies, such as immunosuppressive and anti-inflammatory treatments, show promise in managing hot-phase episodes.

Summary

Hot phases in ACM present a significant risk for arrhythmias and disease progression, necessitating a comprehensive diagnostic and therapeutic management. A multimodal diagnostic approach is essential for accurate diagnosis, but further research is needed to refine these strategies and improve prognosis for affected patients.
Title
Hot Phases Cardiomyopathy: Pathophysiology, Diagnostic Challenges, and Emerging Therapies
Authors
Giulia Bassetto
Federico Angriman
Carola Pio Loco detto Gava
Alessia Paldino
Maria Perotto
Luca Bordignon
Marta Gigli
Matteo Dal Ferro
Laura Massa
Alessandro Altinier
Antonio De Luca
Gianfranco Sinagra
Marco Merlo
Publication date
01-12-2025
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 1/2025
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-024-02168-6
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This content is intended for healthcare professionals outside of the UK.

Independent Medical Education Grant:
  • Bayer HealthCare Pharmaceuticals Inc.
Learn more Link opens in a new window
Image Credits
Abstract graphic of layered, concentric circular shapes in bright green, pink, blue, and purple on a dark blue background. The rings and segments form a complex radial pattern without text/© Springer Health+ IME