Literature and authors' own data on the diagnostic value of endomyocardial biopsy in cases with clinical diagnosis of dilatation cardiomyopathy are analysed. It is shown that due to this biopsy the diagnosis of more than 20 heart diseases becomes possible. Myocarditis, the diagnosis of which is particularly difficult, is most frequently masked under dilatation cardiomyopathy. Ultrastructural studies are of great importance allowing to diagnose a number of heart diseases including alcoholic cardiomyopathy and viral myocardial lesions. The authors advocate wider use of endomyocardial biopsy which is sufficiently safe and informative.

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