Abstract <p>Myocarditis is a serious inflammatory heart disease, the diagnosisof which is often challenging. Although in some cases, the diseaseresolves spontaneously, it can lead to the development of acute heartfailure and even death, or the formation of chronic myocardial remodelingresulting in dilated cardiomyopathy. The clinical signs of myocarditis arediverse and largely overlap with the symptoms of other cardiovasculardiseases, complicating diagnosis and making the search for specificclinical markers of the disease a relevant task. The gold standard fordiagnosing myocarditis is endomyocardial biopsy, which is an invasiveprocedure. This review aims to systematize current understandingof the role of cardiac mast cells in the mechanisms of inflammatoryinjury and myocardial remodeling in myocarditis of various etiologies.A special focus is on analyzing their mediator effects and the potentialfor pharmacological modulation of mast cell activity as an avenuefor pathogenetically targeted therapy of inflammatory heart diseases.</p>