[The course of myocarditis in childhood]

Seventeen patients, aged from 2 days to 16 1/2 years, all suffering from acute myocarditis, were observed between 1975 and 1987. At the onset of the acute infection all patients had a severe disfunction of the left ventricle. Two patients died after hospital admission. Death occurred after one day and after five days, respectively. Postmortem examination showed inflammatory reaction within the myocardium with cellular infiltrates in both cases, and a variable degree of myocardial necrosis in one. The remaining 15 patients had follow-up check-ups between 2 months and 8.25 years later. Electrocardiographic abnormalities disappeared within 3 month in all patients, and the reduced fractional shortening of the left ventricle became normal in 80% of the patients after 5.5 months. At the last follow-ups one patient showed dilated cardiomyopathy. The other patients showed complete recovery regarding their functional capacity and regarding other clinical findings even though 50% still had some minor abnormalities in the echocardiogram and on the chest x-ray. Based on the findings of this follow-up investigation, the prognosis of acute myocarditis in childhood seems as being favourable, although some residual myocardial damage may occur. In most cases this residual myocardial damage is clinically and functionally insignificant. However, in some rare cases, significant chronic myocardial damage will be found.