Myocarditis (peds)

This page is for pediatric patients. For adult patients, see: myocarditis

Background

  • Rare but potentially fatal
  • Most common cause of heart failure in previously healthy children
  • Inflammation of myocardium
  • Typically viral but often no pathogen identified

Clinical Features

Differential Diagnosis

Pediatric Shortness of Breath

Pulmonary/airway

Cardiac

Other diseases with abnormal respiration

Evaluation

Management

  • Management tailored to severity of disease
  • Maintain euvolemia, diuretics as needed
  • If cardiac function significantly depressed, consider dopamine or dobutamine
  • Consider afterload reduction with nitroprusside if normotensive
  • Treat arrhythmias
    • Avoid digoxin due to risk of precipitating more significant dysrhythmias in irritable myocardium

Disposition

  • Admit, often to ICU

See Also

External Links

References

  1. Freedman SB1, Haladyn JK, Floh A, Kirsh JA, Taylor G, Thull-Freedman J. Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation. Pediatrics. 2007 Dec;120(6):1278-85.
  2. Dancea AB. Myocarditis in infants and children: A review for the paediatrician. Paediatr Child Health. 2001;6(8):543–545. doi:10.1093/pch/6.8.543
  3. Durani Y1, Egan M, Baffa J, Selbst SM, Nager AL. Pediatric myocarditis: presenting clinical characteristics. Am J Emerg Med. 2009 Oct;27(8):942-7.
  4. Durani Y1, Egan M, Baffa J, Selbst SM, Nager AL. Pediatric myocarditis: presenting clinical characteristics. Am J Emerg Med. 2009 Oct;27(8):942-7.
  5. Freedman SB1, Haladyn JK, Floh A, Kirsh JA, Taylor G, Thull-Freedman J. Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation. Pediatrics. 2007 Dec;120(6):1278-85.
  6. Shu-Ling C1, Bautista D, Kit CC, Su-Yin AA. Diagnostic evaluation of pediatric myocarditis in the emergency department: a 10-year case series in the Asian population. Pediatr Emerg Care. 2013 Mar;29(3):346-51.
  7. Freedman SB1, Haladyn JK, Floh A, Kirsh JA, Taylor G, Thull-Freedman J. Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation. Pediatrics. 2007 Dec;120(6):1278-85.
  8. Durani Y1, Egan M, Baffa J, Selbst SM, Nager AL. Pediatric myocarditis: presenting clinical characteristics. Am J Emerg Med. 2009 Oct;27(8):942-7.
  9. Eisenberg MA1, Green-Hopkins I, Alexander ME, Chiang VW. Cardiac troponin T as a screening test for myocarditis in children