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Pediatric myocarditis: presenting clinical characteristics

Yamini Durani1, Matthew Egan, Jeanne Baffa

  • 1Division of Emergency Medicine, Department of Pediatrics, Alfred I. duPont Hospital for Children, Thomas Jefferson University, Wilmington, DE 19899, USA. ydurani@nemours.org

The American Journal of Emergency Medicine
|October 28, 2009
PubMed

Insights

Pediatric acute myocarditis and dilated cardiomyopathy (DCM) often present with breathing difficulties, mimicking viral illnesses. Key indicators like hepatomegaly and cardiomegaly with abnormal ECGs can aid diagnosis.

Area of Science:

  • Pediatric Cardiology
  • Pediatric Critical Care Medicine

Background:

  • Acute myocarditis and dilated cardiomyopathy (DCM) are serious cardiac conditions in children.
  • Early and accurate diagnosis is crucial for effective management and improved outcomes.
  • Distinguishing these conditions from common pediatric illnesses can be challenging.

Purpose of the Study:

  • To characterize the clinical presentations of pediatric patients diagnosed with acute myocarditis and DCM.
  • To identify key clinical features that may aid in the early differentiation of these conditions.

Main Methods:

  • Retrospective cross-sectional study of pediatric patients over a 10-year period at two tertiary care hospitals.
  • Patient identification using International Classification of Diseases, Ninth Revision (ICD-9) codes.
  • Review of 693 patient charts, with 62 patients enrolled.

Main Results:

  • The study included 62 pediatric patients, with 39% diagnosed with myocarditis and 61% with DCM.
  • Common presenting symptoms included shortness of breath, vomiting, poor feeding, upper respiratory infection (URI), and fever.
  • Key examination findings included tachypnea, hepatomegaly, respiratory distress, fever, and abnormal lung examination.
  • Cardiomegaly was present in 63% on chest x-ray, and all patients had abnormal electrocardiogram (ECG) results.

Conclusions:

  • Pediatric acute myocarditis and DCM frequently present with respiratory distress, mimicking other common illnesses.
  • Hepatomegaly, cardiomegaly, and abnormal ECG findings are important indicators that can help differentiate myocarditis and DCM from other pediatric conditions.
  • These clinical signs warrant further investigation for cardiac involvement in children presenting with concerning symptoms.
Abstract

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