Paediatric Acute Myocarditis in University Hospital within Years 2010-2015

Inta Bergmane, Elīna Ligere, Baiba Matsone-Matsate, Ingūna Lubaua, Inga Lāce, Valts Ozolins, Lauris Smits, Normunds Sikora

Research output: Contribution to journalMeeting Abstractpeer-review


Acute myocarditis (AM) in children is a rare disease and most often
has viral ethiology but can also arise from bacterial, parasitic,
autoimmune, fungal, toxic, drug-related causes. Myocarditis is
connected with high mortality in small children and the diagnosis
can be missed.
The objectives of the study were to analyse all cases of AM treated
or discovered during autopsy in our hospital during years 2010-
Methods All the cases with AM were selected from hospitals
database and/or autopsy register. We analyzed case histories to
explore the course of disease, causative agents, echocardiographic
findings and the outcome.
Results: There were 11 cases of AM diagnosed during hospitalization: 4 girls and 7 boys (63%), age 8.9 ±4 years. 63,6% complained about chest pain, but 27% were too young to complain,
72,7% had heart rhythm disorders, all 11 patients had elevated
troponin I (3,6 ± 2,7ng/L), 45,5% of patients were in need of
inotropic support, 3- ventilation. Causative agents found in 5 cases
(1- Coxacie B, 1- rheumatic fever, 1-EBV, 1-Dyphteria,
1-Rotavirus). There were 3 cases of death (27,3%): 7 months old
girl with large VSD, pneumonia (cause unrecognized, moderate
myocardial intersticial lymphoid cell infiltration on autopsy),10
year old girl with severe heart rhythm disorders (atrial fibrillation,
undulation), cause of myocarditis unclear, autopsy revealed large
regions of myolysis, severe lymphocytic and moderate leucocytar
interstitial infiltrations, 4 months old girl with atypical haemolyticuremic syndrome and myocarditis with poor cardiac function (EF
30%) (only Rotavirus positive found).
There were 10 cases where myocarditis as a part of diagnosis was
revealed only during autopsy, 6 boys (60%), 4 girls, mean age
1,17± 2,5years (5 days to 8 years), causative agent recognized
in 90%(8 patients with severe septicaemia (2-Acinetobacter
Baumani, 1-Micrococcus lutheus, 1- Pseudomona aeruginosa,
1-Serratia marcescens, 1- Salmonella enteritidis, 1- Clebsiella
oxytoca, 1- Staphylococcus epidermidis (two cases in combination
with RSV),1 -Influenza AH1N1. 4 of the patients were newborn
(3 premature).
Conclusions: AM remains serious disease with high mortality rates
and diagnosis is still often recognized only post mortem. Miocardial damage should be evaluated in patients with severe disease
with a rapid, progressive, downhill course.


  • myocarditis
  • pediatrics

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 3.4. Other publications in conference proceedings (including local)


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