| Domain | Recommended identifier/ontology term | Meaning/use | Evidence/qualification |
|---|---|---|---|
| Disease | **MONDO:0004496** *(validate in live MONDO release)* | Myocarditis disease concept for cross-ontology mapping and KB normalization | Commonly used MONDO identifier for myocarditis; validate against current ontology release before production use. Myocarditis is a heterogeneous inflammatory myocardial syndrome rather than a single Mendelian disorder (pqac-00000002, pqac-00000005) |
| Disease | **MeSH: D009205** | NLM MeSH descriptor for indexing literature on myocarditis | Stable literature-indexing term; useful for PubMed/MeSH harmonization (pqac-00000002, pqac-00000005) |
| Disease classification | **ICD-10-CM: I40** | Acute myocarditis diagnosis code family | Appropriate for acute presentations; aligns with clinical spectrum emphasizing recent-onset inflammatory myocardial injury (pqac-00000002, pqac-00000004) |
| Disease classification | **ICD-10-CM: I51.4** | Myocarditis, unspecified | Use when documentation confirms myocarditis without subclassification; less specific than acute myocarditis coding (pqac-00000002) |
| Disease resources | **No single OMIM/Orphanet ID recommended** | Avoid forcing myocarditis into a monogenic rare-disease identifier slot | Do **not** invent OMIM/Orphanet IDs; myocarditis spans infectious, autoimmune, toxic/drug-related, and genetically susceptible forms (pqac-00000002, pqac-00000005) |
| Phenotype (symptom) | **HPO: Chest pain** *(validate HP accession in live HPO)* | Common presenting symptom, especially infarct-like/pseudoinfarction phenotype | Frequently reported in acute myocarditis presentations; exact HPO accession should be verified live (pqac-00000004, pqac-00000005) |
| Phenotype (symptom) | **HPO: Dyspnea** *(validate HP accession in live HPO)* | Symptom of heart failure/hemodynamic compromise | Seen across acute and chronic inflammatory cardiomyopathy phenotypes (pqac-00000002, pqac-00000004) |
| Phenotype (symptom) | **HPO: Fatigue** *(validate HP accession in live HPO)* | Nonspecific constitutional/cardiac symptom | Common but nonspecific; useful as supportive phenotype only (pqac-00000002) |
| Phenotype (symptom) | **HPO: Palpitations** *(validate HP accession in live HPO)* | Symptom suggesting atrial/ventricular arrhythmia | Myocarditis may present with arrhythmias even without classic heart-failure syndrome (pqac-00000004, pqac-00000005) |
| Phenotype (symptom) | **HPO: Syncope** *(validate HP accession in live HPO)* | Transient loss of consciousness related to malignant arrhythmia/hemodynamic instability | Important high-risk presentation trigger for urgent workup (pqac-00000004) |
| Phenotype (symptom/sign) | **HPO: Fever** *(validate HP accession in live HPO)* | Febrile inflammatory/infectious presentation | Supports inflammatory trigger but is not required for diagnosis (pqac-00000002) |
| Phenotype (laboratory) | **HPO: Elevated cardiac troponin level** *(validate HP accession in live HPO)* | Biomarker evidence of cardiomyocyte injury | Acute myocarditis commonly shows elevated high-sensitivity troponin; useful in diagnosis and follow-up (pqac-00000002, pqac-00000012) |
| Phenotype (imaging/functional) | **HPO: Ventricular dysfunction** *(validate HP accession in live HPO)* | Reduced systolic performance/LV or biventricular dysfunction | Central phenotype in inflammatory cardiomyopathy and prognostic assessment (pqac-00000002, pqac-00000004) |
| Phenotype (rhythm) | **HPO: Cardiac arrhythmia** *(validate HP accession in live HPO)* | Broad rhythm-disturbance phenotype | Includes atrial and ventricular arrhythmias; a recognized myocarditis presentation (pqac-00000004, pqac-00000005) |
| Phenotype (critical illness) | **HPO: Cardiogenic shock** *(validate HP accession in live HPO)* | Fulminant hemodynamic collapse phenotype | Indicates severe/fulminant myocarditis and is a major biopsy/treatment-escalation trigger (pqac-00000002, pqac-00000004) |
| Anatomy | **UBERON: heart** *(validate UBERON accession in live release)* | Primary organ affected | Heart-level anatomical anchor for disease localization (pqac-00000002, pqac-00000005) |
| Anatomy | **UBERON: myocardium** *(validate UBERON accession in live release)* | Primary tissue targeted by inflammation | Core tissue compartment for pathology, MRI, and biopsy annotation (pqac-00000002, pqac-00000005) |
| Cell type | **CL: cardiomyocyte** *(validate CL accession in live release)* | Primary injured parenchymal cell | Cardiomyocyte injury/necrosis drives troponin release and systolic dysfunction (pqac-00000002, pqac-00000015) |
| Cell type | **CL: T cell** *(validate CL accession in live release)* | Major adaptive immune effector cell | T-cell infiltrates are central in lymphocytic myocarditis and giant-cell myocarditis biology (pqac-00000005, pqac-00000014) |
| Cell type | **CL: macrophage** *(validate CL accession in live release)* | Major innate immune/injury-response cell | Macrophages contribute to inflammation, cytokine signaling, and remodeling (pqac-00000001, pqac-00000014) |
| Cell type | **CL: fibroblast** *(validate CL accession in live release)* | Matrix-producing stromal cell in repair/fibrosis | Fibroblast activation links inflammation to fibrosis and adverse remodeling (pqac-00000014, pqac-00000015) |
| Cell type | **CL: endothelial cell** *(validate CL accession in live release)* | Vascular interface cell relevant to trafficking and edema | Important in leukocyte recruitment and myocardial inflammatory niche interactions (pqac-00000005) |
| Biological process | **GO: inflammatory response** *(validate GO accession in live release)* | General disease-process umbrella term | Captures core inflammatory biology across etiologies (pqac-00000002, pqac-00000005) |
| Biological process | **GO: innate immune response** *(validate GO accession in live release)* | Early trigger/amplification program | Supported by inflammasome, macrophage, complement, and cytokine activation evidence (pqac-00000013, pqac-00000015) |
| Biological process | **GO: adaptive immune response** *(validate GO accession in live release)* | Antigen-driven T/B-cell response | Relevant especially in autoimmune, giant-cell, and postinfectious phenotypes (pqac-00000005, pqac-00000014) |
| Biological process | **GO: cell death** *(validate GO accession in live release)* | Cardiomyocyte injury/necrosis/apoptosis | Explains biomarker release and contractile dysfunction; downstream of immune injury or direct infection (pqac-00000014, pqac-00000015) |
| Biological process | **GO: extracellular matrix organization / fibrosis** *(validate GO accession in live release)* | Remodeling/scarring program | Useful for chronic inflammatory cardiomyopathy and arrhythmic risk annotation (pqac-00000014, pqac-00000015) |
| Diagnostic concept | **CMR using updated Lake Louise criteria** *(guideline concept, not ontology ID)* | Noninvasive tissue characterization for edema/injury | Strong diagnostic role, but EMB remains gold standard for definitive etiologic/histologic diagnosis (pqac-00000002, pqac-00000005) |
| Diagnostic concept | **Endomyocardial biopsy (EMB)** *(procedure concept)* | Gold-standard histology/immunohistochemistry/molecular testing | Most specific tool for subtype confirmation and therapy guidance in high-risk or unclear cases (pqac-00000004, pqac-00000005) |
| Intervention | **NCIT-style: Corticosteroid therapy** *(map to local NCIT term/live code)* | First-line immunosuppression in selected immune-mediated myocarditis subtypes | Not routine for all cases; subtype- and biopsy-context dependent (e.g., giant-cell, eosinophilic, ICI-associated) (pqac-00000008) |
| Intervention | **NCIT-style: Immunosuppressive therapy** *(map to live NCIT)* | Broad category including azathioprine, mycophenolate, calcineurin inhibitors | Evidence strongest in virus-negative inflammatory cardiomyopathy and specific severe immune phenotypes (pqac-00000008, pqac-00000011) |
| Intervention | **NCIT-style: Intravenous immunoglobulin** *(map to live NCIT)* | Immunomodulatory adjunct in selected cases | Used variably; evidence mixed and context-specific (pqac-00000008) |
| Intervention | **NCIT-style: Interleukin-1 inhibition / anakinra therapy** *(map to live NCIT)* | Targeted anti-inflammatory strategy under active investigation | Mechanistically linked to inflammasome/IL-1 signaling; current evidence strongest in selected severe/refractory phenotypes rather than broad low-risk use (pqac-00000015) |
| Intervention | **NCIT-style: Guideline-directed heart failure therapy** *(map to live NCIT)* | Standard supportive therapy for ventricular dysfunction | Core management across many presentations regardless of etiology (pqac-00000008) |
| Intervention | **NCIT-style: Mechanical circulatory support** *(map to live NCIT)* | Rescue support for fulminant/cardiogenic-shock presentations | Important in fulminant myocarditis and bridge-to-recovery/decision pathways (pqac-00000008) |
| Intervention | **NCIT-style: Exercise restriction / sports disqualification** *(map to local concept if NCIT unavailable)* | Secondary prevention to reduce arrhythmic risk during recovery | Common expert-management principle after acute myocarditis; timing of return depends on recovery and risk reassessment (pqac-00000008) |


*Table: This table provides compact disease, phenotype, anatomy, cell-type, process, and intervention terms suitable for a myocarditis knowledge base. It emphasizes where identifiers should be validated live and avoids inventing single-disease Mendelian IDs for this etiologically heterogeneous condition.*