Pediatric Viral Myocarditis - A Review

Pediatric myocarditis is a common pediatric illness most commonly secondary to a preceding viral infection. It is a leading cause of acquired heart failure, cardiomyopathy, and cardiac transplantation in pediatrics. Due to the variability in presentation, the diagnosis is often unrecognized until later in the disease course. It should be considered in the differential diagnosis of all children presenting with respiratory distress, since this is the most common presentation. Imagining modalities, such as cardiac magnetic resonance imaging have become a useful diagnostic tool in recent years; however, endomyocardial biopsy remains the gold standard diagnostic test. Treatment of viral myocarditis is mainly supportive, with debatable role of anti-inflammatory, immunosuppressing immunomodulators and anti-viral therapy. Although, the outcome is generally favorable, delay in supportive care may be associated with a worse prognosis. We focus on the clinical presentation, review diagnostic and treatment options of viral myocarditis.