Cardiac troponin-I as a screening tool for myocarditis in children hospitalized for viral infection
Related Experiment Video
Updated: Jun 19, 2026
A Sensitive and Specific Quantitation Method for Determination of Serum Cardiac Myosin Binding Protein-C by Electrochemiluminescence Immunoassay
Published on: August 8, 2013
M Renko1, M Leskinen, T Kontiokari
1Department of Paediatrics, University of Oulu, Oulu, Finland. marjo.renko@oulu.fi
Insights
Routine troponin-I screening for children hospitalized with infections is not useful for detecting myocarditis. The study found a low incidence of myocarditis, even in infants with elevated troponin-I levels.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Biomarker Research
Background:
- Myocarditis incidence in children is uncertain due to underdiagnosis of mild cases.
- A prospective screening study was conducted to assess the utility of troponin-I (TnI) in diagnosing myocarditis in hospitalized children.
Purpose of the Study:
- To determine if routine troponin-I (TnI) screening can identify undiagnosed myocarditis in children hospitalized with acute infections.
- To evaluate the incidence of myocarditis in this pediatric population.
Main Methods:
- Prospective screening of 1009 children hospitalized for acute infections between October 2005 and July 2008.
- Blood samples for troponin-I (TnI) were collected, and elevated levels (>0.06 microg/L) triggered electrocardiogram (ECG) and cardiac ultrasound.
- Serial TnI measurements were performed until normalization.
Main Results:
- Six out of 1009 children had elevated TnI levels; none showed signs of myocarditis on ECG or cardiac ultrasound.
- Five of these children were neonates (<30 days old) with respiratory infections, including RSV.
- Four neonates had persistently high TnI levels (>0.37 microg/L) for two months, which eventually normalized.
Conclusions:
- The incidence of myocarditis during viral infections in children is low.
- Routine troponin-I (TnI) screening is not beneficial for detecting asymptomatic myocarditis in hospitalized children.
Aim:
The incidence of myocarditis in children is uncertain because patients with minor symptoms can remain undiagnosed. We hypothesized that screening all children who are hospitalized for an acute infection with troponin-I (TnI) would reveal myocarditis cases and performed a prospective screening study.
Methods:
Between October 2005 and July 2008, a blood sample for TnI measurement was taken every time a sample for C-reactive protein measurement was drawn. If TnI value was above the screening limit (0.06 microg/L), electrocardiogram (ECG) and cardiac ultrasound were performed. TnI measurements were repeated until at normal level.
Results:
Altogether, 1009 children were screened during the 33 months. TnI was above the screening limit (0.06 microg/L) in six children. None of them had any signs of myocarditis in ECG or cardiac ultrasound. Five of those six children were younger than 30 days. All had a respiratory infection as a cause for hospitalization, three of which was caused by RSV. In four children, all younger than 30 days, TnI levels remained high (>0.37 microg/L) for two months, but decreased after that to normal levels.
Conclusion:
The incidence of myocarditis during viral infections is low and a routine TnI screening for asymptomatic myocarditis is not useful.
Related Concept Videos
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:14Myocarditis III: Medical Management
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:22Myocarditis IV: Nursing Management
01:30Acute Coronary Syndrome III: Diagnostic Studies