Myocarditis in infants and children: A review for the paediatrician

Area of Science:

• Pediatrics
• Cardiology
• Infectious Diseases

Background:

• Clinical myocarditis is rare in pediatric populations.
• Coxsackievirus B is the most frequent causative agent.
• Myocardial inflammation leads to impaired cardiac function, particularly in neonates due to immature myocardium.

Purpose of the Study:

• To review the clinical presentation, diagnosis, and management of pediatric myocarditis.
• To highlight the challenges in diagnosing and treating this condition in infants and children.

Main Methods:

• Review of clinical findings including physical examination, chest x-ray, electrocardiogram, and echocardiogram.
• Discussion of diagnostic tools such as viral studies and myocardial biopsy.
• Analysis of treatment strategies including supportive care and pharmacotherapy.

Main Results:

• Children commonly present with sinus tachycardia, gallop rhythm, cardiomegaly, and small electrocardiogram voltages.
• Echocardiography reveals reduced ventricular function.
• Viral studies can identify the pathogen, though myocardial biopsy carries risks.

Conclusions:

• Myocarditis in children requires prompt diagnosis and management, with supportive care as the primary treatment.
• Prognosis is generally poorer in newborns compared to older children.
• The efficacy of immunosuppressive therapy in pediatric myocarditis remains under investigation.