The evolving approach to paediatric myocarditis: a review of the current literature

Area of Science:

• Cardiology
• Pediatrics
• Infectious Diseases

Background:

• Pediatric myocarditis poses diagnostic and management challenges.
• Viral illnesses are the most common cause, with enteroviruses and adenoviruses implicated.
• Clinical presentation ranges widely, from asymptomatic cases to sudden death, necessitating a high index of suspicion.

Purpose of the Study:

• To summarize current literature on pediatric myocarditis.
• To review etiology, clinical presentation, diagnosis, and management strategies.
• To highlight emerging diagnostic tools and controversial treatment approaches.

Main Methods:

• Literature review of pediatric myocarditis.
• Analysis of current diagnostic modalities and treatment options.
• Discussion of evidence supporting or refuting immunosuppressive therapies.

Main Results:

• Emerging evidence supports serum N-terminal B-type natriuretic peptide levels and cardiac magnetic resonance imaging for diagnosis.
• Endomyocardial biopsy remains the gold standard but is invasive.
• Management includes supportive care, cardiac failure management, mechanical support, and transplantation.

Conclusions:

• A high index of suspicion is crucial for diagnosing pediatric myocarditis.
• Non-invasive diagnostic adjuncts show promise in reducing the need for biopsies.
• Management is primarily supportive, with immunosuppression remaining controversial due to limited evidence.