Myocarditis in children 2024, new themes and continued questions
Jason F Goldberg1, Joseph A Spinner2, Jonathan H Soslow3
1Inova L.J. Murphy Children's Hospital, Falls Church, Virginia.
Insights
Pediatric myocarditis has increased post-COVID-19. This review covers diagnosis, risk, and treatment, focusing on cardiac MRI and molecular biomarkers for better outcomes in children.
Area of Science:
- Cardiology
- Pediatrics
- Infectious Diseases
Background:
- Pediatric myocarditis incidence has risen since the COVID-19 pandemic.
- Unanswered questions persist regarding diagnosis, risk stratification, and optimal therapy for pediatric myocarditis.
Purpose of the Study:
- To review recent publications on pediatric myocarditis.
- To highlight ongoing unanswered questions in the field.
- To discuss advancements in diagnosis and treatment.
Main Methods:
- Review of recent scientific literature.
- Analysis of emerging data on COVID-19 associated myocarditis.
- Evaluation of cardiac magnetic resonance (CMR) and molecular biomarker applications.
Main Results:
- COVID-19 era has provided clearer insights into myocarditis incidence and prognosis related to infection and vaccination.
- Cardiac MRI is increasingly utilized in pediatric myocarditis, with ongoing efforts to define its role.
- Precision medicine approaches, including molecular evaluations, show promise for diagnosis and risk stratification.
Conclusions:
- Recent findings on COVID-19 associated myocarditis, CMR, and molecular biomarkers can aid clinicians.
- Further research is needed to address remaining questions in pediatric myocarditis management.
- Advancements offer potential for improved patient care and outcomes.
Purpose Of Review:
While pediatric myocarditis incidence has increased since the coronavirus disease 2019 (COVID-19) pandemic, there remain questions regarding diagnosis, risk stratification, and optimal therapy. This review highlights recent publications and continued unanswered questions related to myocarditis in children.
Recent Findings:
Emergence from the COVID-19 era has allowed more accurate description of the incidence and prognosis of myocarditis adjacent to COVID-19 infection and vaccine administration as well that of multi-system inflammatory disease in children (MIS-C). As cardiac magnetic resonance technology has shown increased availability and evidence in pediatric myocarditis, it is important to understand conclusions from adult imaging studies and define the use of this imaging biomarker in children. Precision medicine has begun to allow real-time molecular evaluations to help diagnose and risk-stratify cardiovascular diseases, with emerging evidence of these modalities in myocarditis.
Summary:
Recent information regarding COVID-19 associated myocarditis, cardiac magnetic resonance, and molecular biomarkers may help clinicians caring for children with myocarditis and identify needs for future investigations.
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