Myopericarditis in children: elevated troponin I level does not predict outcome

Area of Science:

• Pediatric Cardiology
• Cardiovascular Inflammation
• Clinical Outcomes Research

Background:

• Myopericarditis, characterized by pericarditis with myocardial enzyme elevation, poses diagnostic challenges, especially differentiating it from acute coronary syndromes.
• Limited data exists on pediatric myopericarditis, necessitating further research into its presentation and outcomes in this age group.

Purpose of the Study:

• To delineate the demography, clinical presentation, and outcomes of pediatric myopericarditis.
• To evaluate the prognostic value of elevated troponin I in children diagnosed with myopericarditis.

Main Methods:

• Retrospective review of 880 pediatric patients (under 18) admitted for chest pain, myocarditis, or pericarditis between 2000-2010.
• Myopericarditis defined by pericarditis symptoms and elevated cardiac enzymes (Troponin I, CK-MB).
• Analysis of demographic data, clinical findings, diagnostic evaluations (ECG, echocardiography, coronary angiography), treatment, and follow-up outcomes.

Main Results:

• Twelve pediatric patients (1.4%) with myopericarditis were identified, all male adolescents (median age 16).
• Common symptoms included chest pain (100%), with elevated Troponin I (median 21.4 ng/ml) and CK-MB (median 50.2 ng/ml).
• All patients showed normal left ventricular function on echocardiography, and coronary angiography was normal in those tested; all remained asymptomatic during follow-up.

Conclusions:

• Pediatric myopericarditis exclusively affects male adolescents and presents with elevated cardiac enzymes but benign clinical evolution.
• Myocardial inflammation appears self-limited with no short-term sequelae, and elevated troponin I does not predict an adverse prognosis in this population.
• Further research is warranted to establish the long-term prognosis of myopericarditis in children.