Early Detection of Acute Myocarditis in the Pediatric Population Using Clinically Accessible Data

Area of Science:

• Pediatric Cardiology
• Diagnostic Biomarkers
• Infectious Diseases

Background:

• Early diagnosis of acute myocarditis (AMC) is critical due to high mortality.
• Nonspecific symptoms like fever and abdominal pain challenge AMC differentiation from acute gastroenteritis (AGE).

Purpose of the Study:

• To identify clinical and laboratory markers for early diagnosis of AMC in pediatric patients.
• To differentiate AMC from AGE based on presenting symptoms and diagnostic findings.

Main Methods:

• Retrospective review of clinical data from 7 AMC and 19 AGE pediatric patients.
• Comparison of presenting symptoms, physical examination findings, radiography, and serum lactate dehydrogenase (LDH) levels.

Main Results:

• AMC patients had lower diarrhea rates but higher tachypnea, tachycardia, gallop rhythms, and cardiomegaly.
• Significantly elevated serum LDH levels were observed in AMC patients (p=0.006).
• LDH showed 71% sensitivity and 100% specificity for AMC prediction (AUC=0.857) at a cutoff of 459 U/L.

Conclusions:

• Elevated LDH levels may indicate AMC in pediatric patients.
• Combining LDH with physical exam and chest radiography aids early AMC diagnosis.