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Myocarditis in children: diagnosis and management
1Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98105.
JHLT Open
|August 21, 2025
Summary
Pediatric myocarditis diagnosis relies on clinical findings, not just biopsies or MRI. Common symptoms like fever and GI issues can mask cardiac problems, requiring careful evaluation.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Pathology
Background:
- Myocarditis diagnosis traditionally relied on endomyocardial biopsy, now rare in pediatrics.
- Cardiac MRI is limited in children due to sedation and technical challenges.
- Current pediatric myocarditis diagnosis is primarily clinical, based on noninvasive findings.
Purpose of the Study:
- To review current diagnostic and treatment strategies for pediatric myocarditis.
- To highlight the challenges and common presentations of myocarditis in children.
- To discuss the role of various diagnostic modalities and emerging treatments.
Main Methods:
- Review of clinical presentations, diagnostic tools (echocardiography, biomarkers, ECG), and infectious workup.
- Discussion of current treatment paradigms, including supportive care and immunomodulatory therapies.
- Analysis of limitations of traditional diagnostic methods in pediatric populations.
Main Results:
- Clinical symptoms (fever, GI issues) often mimic non-cardiac conditions.
- Echocardiography is crucial, though findings vary; biomarkers (troponin, BNP) offer prognostic value.
- Parvovirus B19 and HHV6 are identified as common viral causes in pediatric myocarditis.
Conclusions:
- Pediatric myocarditis diagnosis is predominantly clinical, integrating symptoms, biomarkers, and imaging.
- Supportive care, heart failure management, and mechanical support are mainstays of treatment.
- The use of steroids and IVIG is common but debated; future therapies may involve immunomodulation.
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